Open coronal vs endoscopic forehead lifts

A forehead lift is the general term for a procedure that elevates the forehead and eyebrows in a patient whose brows are considered too low.  It can be done traditionally as an "open" procedure using an incision from ear to ear across the scalp.  Alternatively, an "endoscopic" forehead lift attempts to do the same thing but through a few small incisions in the scalp relying on TV cameras to provide the visualization needed to perform the surgery rather than an open approach under direct vision. 

When it was first developed, the endoscopic approach was extremely popular because of the lesser incisions, the magnification views of the structures on the TV and perhaps a quicker recovery.  The keys to success are an adequate release of the structures holding the brow down and adequate fixation of them in their elevated position so they can heal where they are placed.  After years of studying the results however, there are some definite limitations on the procedure and interestingly, the open approach is making somewhat of a comeback.

Go to a surgeon who is comfortable with both procedures and ask what might be best for you and why.

The coronal lift is one long incision across the scalp. The endoscopic approach involves five smaller vertical incisions. With the endoscopic lift is there is less numbness of the scalp postoperatively. While the endoscopic approach will raise the hairline, cannot address the frontalis muscles or dermal atrophy of the corrugator muscles. There is more control of the corrugator muscles with the coronal approach, along with placing fascia grafts underneath the dermal atrophy wrinkles between the eyebrows. The hairline can be brought down in a coronal lift because the skin that is removed can be the non hair-bearing skin.

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