Endoscopic or Coronal for a dramatic result? (photos)

My eyebrows droop severely, but I don't want to get a coronal brow lift because it just seems too risky. I've heard that you can only get a dramatic result, (around 1 cm of lift) with a coronal brow lift. Is that true? Can I get the same amount of lift with an endoscopic brow lift in the area between my brows? Thanks!

Doctor Answers 12

Dramatic results with a browlift

There are few methods and techniques to undergo a browlift. You commented on two approaches including the endoscopic brow lift and the coronal brow lift. Both of these procedures can't successfully raise the brow.  Generally speaking, and aggressive coronal brow lift can create a more dramatic result than an aggressive endoscopic browlift. And overall beauty concepts, I do not like the aesthetics of an aggressive brow lift so I tend to favor the endoscopic browlift method.
I hope this helps

Endoscopic or Coronal for a dramatic result?

Hi Adeen, a hairline incision browlift is likely the best option to help you achieve a "dramatic" result.  While I perform many browlift with the endoscopic approach, it's an operation designed more for stabilization of brow position to prevent further drooping rather than to achieve significantly higher brow elevation.  Incidentally, we try to avoid excess brow elevation which can caused the "surprised' look.

I'd advise staying away from a coronal browlift as it can lead to unfavorable changes to the hairline and forehead proportions.

Tom D. Wang, MD
Portland Facial Plastic Surgeon
4.9 out of 5 stars 27 reviews

It's not the technique that's important, it's the surgeon who is using it!

Hello!

Coronal brow lift and endoscopic brow lifts can be equally effective when used by a skilled surgeon on the right patient. While the coronal technique can achieve the most lift of the brows, the downside is the long scar which can potentially be visible. The best patients for the coronal technique are those who have heavy brows that crowd the eyes, have excess forehead skin with poor elasticity (so older folks), have tall foreheads (i.e. the hairline either needs to be brought down or at least it should be moved), or who need maximal lift (~10 millimeters). 

The endoscopic technique enjoys the advantage of essentially being scarless (unless one is bald) since the small incisions are placed in the hair-bearing scalp. In general I use it in patients who have short foreheads, who have good skin elasticity (so younger folks), who have no excess forehead skin, and who need a modest or subtle amount of lift (a few millimeters). 

A technique that is somewhere in the middle and that I use a lot is the "limited incision lateral lift." This involves short incisions on either side placed right in the hairline. When done properly these incisions heal virtually invisibly and can address patients of all skin types, elasticity and excess with excellent results and beautiful lift. 

Finally, in all of these techniques I can access the corrugator muscles which cause you to frown. By surgically weakening these muscles patients enjoy a permanent Botox effect with reduction of frown lines - a win/win!

Keep in mind that these are just tools for a surgeon to use; magical results don't happen from the instrument itself, but rather from the skilled surgeon who uses it!

All the best in your search!
- Dr. Rad

Ariel N. Rad, MD, PhD
Washington DC Plastic Surgeon
5.0 out of 5 stars 48 reviews

Choose the Surgeon, Not the Approach

From looking at your photos, you are correct in that a brow lift should give you the results you desire.  In fact,you should be able to get the amount of lift you are looking for from either a coronal or an endoscopic brow lift. There are pros and cons to both. My recommendation would be to find a surgeon that you trust, has a good reputation, has  good before and after photos, and whose patients review them highly, and let them choose the approach they think would work best for you. After all, ultimately what you are going to live with and appreciate is not how it was done but how it looks in the end. Good luck.

Michael R. Menachof, MD
Greenwood Village Facial Plastic Surgeon
4.4 out of 5 stars 26 reviews

Open versus endoscopic procedure

In my opinion, an endoscopic brow lift is less powerful and doesn't last as long as an open browlift.  An open browlift may be done with a coronal, hairline or direct incision.  I would favor the hairline incision without being able to see you and would recommend consultation with a board certified plastic surgeon who can examine you, your hairline and hair pattern and make a recommendation face to face.  As with anything in life, there are pros and cons to each method but if your want real results, you will need to have something done surgically.  I think the downsides to a hairline procedure are minimal and it may be the way for you.  

ENDOSCOPIC BROWLIFT TO ELEVATE BROWS

Dear adeen, In my opinion an endoscopic browlift approach is much better then a coronal lift and leaves no tell tale signs of surgery while providing a very nice result that gives the patient a youthful appearance. When I perform an endoscopic browlift with mid-face suspension I undermine down below the malar region through five small incisions hidden in the hairline. The entire facial unit of skin, muscle and soft tissue is lifted both upward and laterally. Most patients state that they "look like they used to" prior to the beginning signs of the aging process. There is  minimal downtime and no tell tale signs of surgery. The video above shows an example as well as multiple examples of before and afters in the link below. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 199 reviews

Brow lift

Dear Adeen
an important factor in a brow lift is the distance between your hairline and your eyebrow (forehead height).  An endo brow can raise your eyebrows while maintaining the same forehead height while an open brow lift with a hairline incision can lift your brows and shorten your forehead. Both are excellent techniques in the proper hands. 

Afshin Parhiscar, MD
Bay Area Plastic Surgeon
4.9 out of 5 stars 49 reviews

Endoscopic or Coronal for a dramatic result?

The coronal lift has little use any more, the preferred open approach is the trichophytic hairline approach. While the endoscopic approach sounds appealing, it has a high revision rate and has been abandoned by many surgeons.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Endoscopic or Coronal Brow Lift

I feel a better, more dramatic and predictable brow lift result can be achieved using the Trichophytic Hairline Incision that we described more than 30 years ago. With this approach we can lift the brows, reduce the forehead, and maintain or alter the hairline position as necessary. Hair will grow through and in front of the incision so a scar is not seen. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Types of central forehead/brow lifts

A coronal lift is rarely a best choice. For the type of brow shape change you want, a hairline approach or an endoscopic one can work nicely depending on the height of your hairline. Either approch results in mimimal hair loss. See a surgeon with experience in both approaches. 

Sheldon S. Kabaker, MD FACS
San Francisco Facial Plastic Surgeon
4.7 out of 5 stars 29 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.