Can an endoscopic brow lift be done with only one 1" incision in middle behind hairline? (photos)

My surgeon suggested I receive upper and lower blepharoplasty combined with an endoscopic forehead lift. Do you agree? He said, I will only have one incision and the procedure will not address any forehead wrinkles. Is it possible to receive a satisfactory eyebrowlift (conservative!) by using only one incision? Everything I read points to using several small incisions, placed just behind the hairline. I am also concerned about elevating my forehead, as it is already rather large.

Doctor Answers 15

Hairline Incisions for Brow Lift

It takes 3-4 small incisions places behind the hairline. Check with your surgeon.


Salt Lake City Plastic Surgeon
5.0 out of 5 stars 15 reviews

Can an endoscopic brow lift be done with only one 1" incision in middle behind hairline?

Your best results will come from an open trichophytic browlift to shorten your forehead and move the high hairline down. Even the surgeons that originated the endo lift have begun giving up on it because of incomplete results and frequent revisions and redos. It is rare indeed to ever have to redo a well done open browlift, even decades later.

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

Endoscopic browlift

I would be worried about elevating your hairline, even a little bit, with any kind of endoscopic browlift.  And I agree with others that a one incision endoscopic browlift would probably not be possible (at least to make a lasting change).  Beware of "minimally invasive" techniques that are not proven to produce results.  From your photos, I'm not really sure you need a browlift at all.  You might be fine with just a blepharoplasty.  Of course, it is hard to tell with photos, however.  Good luck!

Matthew Bridges, MD
Richmond Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Brow lift: what incisions to use?

I agree with others. I have done hundreds of endoscopic brow lifts: you need at least 3 incisions: one to put the scope in, another for your instrument to elevate the tissues, and you must have them on each side because of the curvature of the forehead.  Looking at your photo, I do think you have some lateral hooding, and some sight frown lines.  The frown lines can be improved through the upper eyelid incision, and the lateral hooding is best corrected in my opinion through an incision in each temple area: which will not change your hairline.  I have virtually stopped doing endoscopic brow lifts because of the flexibility of working through the temple, and the ability to do the procedure without special equipment...even as an office procedure.  There are a number of ways to get a nice result, but I agree: a meaningful central browlift will raise the hairline unless the incision is made at the hairline: which will leave a visible scar. In your case, aesthetically I think a temporal browlift would give you the best result in addition to an upper eyelid blepharoplasty.  Of course the lower eyelids are a separate issue.

One incision endo brow lift

Thank you for your question about your brow lift.

  • The endo brow lift requires several small incisions.
  • Your forehead is very high and your brows are not low.
  • I would avoid any operation that further raises your forehead.
  • You might consider a second opinion before having surgery.
Always see a Board Certified Plastic Surgeon.
Hope you find this information helpful Best wishes

Proceed with Caution- It is very important to select the proper procedure for the best results

Proceed with caution.  First things first.  You have to select the proper procedures to address the issues of concern.  If you select the wrong procedure, chances of a good outcome are slim.  Judging by your pictures, I am not sure what would be accomplished by operating on your lower eyelids as they look perfectly fine- no wrinkles or excess fat or dark circles.  You do have mild skin redundancy of your upper eyelids so an upper blepharoplasty should help open up your eyes and make you look more refreshed.  Your eyebrows are a little low, but only slightly, and you are correct in that your forehead is "large" with a high hairline- making an endoscopic brow lift more challenging, which would also raise your hairline even more, giving you an even "larger" forehead.  It would be very challenging to do an endoscopic brow lift through just one incision.  Most doctors including me use multiple (usually 3-5 small (1cm)) incisions behind the hairline to be able to place the camera scope and instruments to do what we need to do, see what we need to see and have enough exposure to adequately free up and raise the forehead, and very importantly, to secure it in place.  I would recommend you seek other consultations prior to proceeding.

Agree

One central incision makes it very hard to suspend the brow laterally. I think you are a good candidate for an endoscopic brow lift but at least 3 and usually 5 small incisions is the norm 

Benjamin C. Marcus, MD
Madison Facial Plastic Surgeon
4.6 out of 5 stars 39 reviews

Endoscopic brow lift techniques

The question I would ask yourself is : "how much higher do I want my eyebrows?" or even "do I want my eyebrows higher than they are now?"  If your answer is that you want the eyebrows higher, then I would move on to what technique can be used for elevating the eyebrows.  Best wishes,


Below is a link to someone with low eyebrows who had an endoscopic lift. 

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 32 reviews

Browlift

I don't think there is any way to do an endoscopic browlift with one incision and actually lift the brow.  You need to do at least 3 and up to 5 incisions.  Looking at your pictures, you may not need a browlift.  Or at most you could do a temporal browlift only to elevate just the outer brow.  You are correct that you have a high forehead.  If you really needed a browlift, you would want to consider doing a pretrichial browlift which would actually lower the hairline.  But I don't think you need it.    

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 25 reviews

Browlift vs eyelid surgery

In our practice, a brow lift is only performed on patients with low eyebrows. When we perform a brow lift on patients with a high hairline,  We place the incision at the hairline and shorten the forehead. When patient's have a  high forehead, we place the incision behind the hairline. The horizontal frontalis lines and vertical corrugator lines and also be addressed at the same time, when needed.
The primary goal of upper eye lid surgery is to remove the excess  hooded skin touching the eyelashes. The primary goal of lower eyelid surgery is to remove the herniated fat bags creating the puffiness look. For many examples of eyelid surgery and brow lifts, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 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.