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Understanding Perceived Forehead Changes Post-Endoscopic Brow Lift: The Impact of Frontalis Muscle Contraction.

Lianji Xu^1,2, Haoge Huang², Edward I Lee³

¹. Department of Plastic and Reconstructive Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China.

Plastic and Reconstructive Surgery

|April 21, 2026

Summary

Endoscopic brow lift surgery does not enlarge the forehead. The perceived increase in forehead height is due to the relaxation of the frontalis muscle after surgery, not actual tissue elongation.

Keywords:

AI analysis Brow position Closed-eye state Endoscopic brow lift Forehead height

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Area of Science:

Plastic Surgery
Facial Aesthetics
Surgical Outcomes

Background:

Endoscopic brow lift is common, but concerns exist regarding postoperative forehead height increase.
Frontalis muscle contraction is hypothesized to influence perceived forehead dimensions.
Accurate measurement techniques are needed to assess forehead changes post-surgery.

Purpose of the Study:

To investigate perceived forehead dimension changes after endoscopic brow lift.
To differentiate between actual forehead elongation and changes due to muscle activity.
To utilize AI for precise facial measurements in assessing surgical outcomes.

Main Methods:

Analysis of 35 patients undergoing endoscopic brow lift.
Utilized SPIGA model (AI) for facial landmark detection.
Measured forehead height and brow position in open and closed-eye states (pre- and post-op).

Main Results:

Significant forehead height increase observed in the open-eye state post-surgery (P<0.001).
No significant forehead height change noted in the closed-eye state (P>0.05).
Perceived forehead enlargement attributed to comparison of pre-op contracted state vs. post-op relaxed state.

Conclusions:

Endoscopic brow lift does not inherently increase forehead size.
Perception of forehead elongation is linked to frontalis muscle relaxation post-surgery.
AI integration offers precise methods for evaluating facial changes in future research.