Endoscopic brow lift with endotines

Question

If an endoscopic brow lift is performed and endotines are used for the fixation device, won't the eyebrow fall back to its original position once the endotines dissolve? Is there a better fixation device?

Bhupendra C.K. Patel, MD, FRCS · Answer

The absorption of endotines is over a year or so. The theory goes that the forehead and brows have adhered long before then. Certainly, there are several studies showing this to be the case. One could argue that a more permanent fixation (to bone tunnels or buried screws) might give one the comfort of knowing the lift to be more, well, "permanent"! However, much is made of the height as opposed to shape and relative height. Certainly, many of us have moved away from simple millimeter-height measurements and go more for the overall aesthetic of brows. With that in mind, the question of endotines would be a moot one: I think you would get enough fixation for your surgeon to give you a good, aesthetically pleasing height, contour, curve, shape (call it what-you-will!).No substitute for seeing your surgeon's results, irrespective of the method of fixation he uses: there are many ways to skin a cat!Best of luck. Prof. Bhupendra C. K. Patel MD, FRCS

A. Joshua Zimm, MD · Answer

Most surgeons will agree that the key to an effective and longer acting endoscopic brow lift does not depend on the kind of fixation.  There are no studies that prove the superiority of one fixation technique over another. It's more important to achieve a complete release of all the tissues underneath and around the eyebrow .

Thomas Romo, III, MD · Answer

You ask an interesting question. The long term result of a endoscopic brow lift is not usually thought to be  dependent on the fixation device but more importantly on the length of time the device supports the elevated tissue during healing. This is broken down into short term,one week or less and long term,six weeks or greater. Different surgeons have different opinions. In my case, I believe long term fixation of the elevated fore head tissues gives a better long term result. Since an Endotine maintains it's strength for greater than six months, this device works very well.

John J. Martin, Jr., MD · Answer

As you heal,  you will create scar tissue to hold the forehead and brow in the elevated position.  This occurs over the first few weeks after surgery.  The endotines are designed to hold things in place during this process.  Once the important healing has occurred they are no longer helping and will dissolve.

Chad Robbins, MD · Answer

That's a very good question, the endotines hold the skin in place and scar tissue will form over the next few weeks .  As the scar tissue is formed, the endotines will dissolve over time, the scar tissue will then, hold everything in place.

William Portuese, MD · Answer

In our practice, we perform a coronal brow left with skin removal, not an endoscopic brow lift with repositioning. With a coronal approach we can adjust the hairline upwards or downwards depending upon the patient's desire. Permanent sutures on the fascia layers of the forehead  hold the eyebrows into position along with softening of the depressor muscles of the eyebrows known as the corrugator muscles. For many examples, please see the video and the  link below

Mark Mandell-Brown, MD · Answer

You are very astute.     Some feel that the Endotines which gradually resorb over a year will allow the brow to fall back to original position.  Others feel that it is permanent fixation long after the plates resorbThe answer is probably both events-  some it is long lasting and others not at all.   There are other procedures with permanent suture lift or hairline brow lift . Best to talk each option over with your surgeon !!!!

David M. Deisher, MD (retired) · Answer

I personally have used Endotine for an endoscopic brow
lift.  The Endotine is one way of
fixation of the brow when an endoscope is used to help elevate the forehead
soft tissue.  In my opinion, the Endotine
is an effective way of brow fixation, but there are other ways that are just as
popular.  The disadvantage of the
Endotine is that very thin-skinned individuals can feel the Endotine underneath
the skin until it does dissolve over a six month to one year period.  At the time of your consultation I would
discuss with the plastic surgeon whether he uses an endoscope or limited
incision brow lift, and then discuss the various ways of fixation that he uses
for the brow lift.  I would recommend
that you see a board certified plastic surgeon in consultation for your brow
lift.

Endoscopic brow lift with endotines

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