Endoscopic Browlift in the Receding Hairline Patient

The upper third of the face, composed of the forehead and the brow, is a critical aesthetic subunit. Brow ptosis is a common presenting complaint for patients seeking elective improvement of their facial appearance. Browlift surgery has a long history of technique evolution, with various reported methods and refinements. Since the introduction of the endoscopic brow lifting in the 1990s, it has become widely accepted as an approach to forehead rejuvenation. Endoscopy provides minimal incisions in well hidden areas, avoiding long, visible scars. A great number of patients who seek forehead rejuvenation already have a receding hairline. The patient with a receding hairline has been viewed as an unfavorable candidate for the endoscopic browlift approach. This report describes the case of a 67-year-old man with a receding hairline that was referred for brow ptosis and upper eyelid dermatochalasis. An upper eyelid blepharoplasty and an endoscopic browlift were performed. Incisions were placed in the temporal region bilaterally, as well as a single central incision placed in the anterior hairline. Two small horizontal incisions were placed in forehead crease lines for placement of the anchoring pins. This technique allowed for ease of dissection and resulted in inconspicuous scars. There was no elevation of the hairline; the brow was examined to be at a normal position at the level of the supraorbital rim at 12 months postoperative. The patient was highly satisfied with the operative outcome.

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