Coronal Brow Lift Vs Endoscopic Brow Lift?

In most patients today, you can do a more
minimally invasive procedure than a full browlift.  However, if you have a low forehead and full head of hair
and want a lot of eyebrow elevation, a full brow lift may be for you!!  Find a true expert - a board certified plastic
surgeon with expertise in cosmetic eyelid and browlift surgery -know before you
go!!

Coronal brow lifts are a good option for some patients, but not something that I commonly perform. I will commonly use either an endoscopic approach or a trichophytic approach. The coronal approach hides the incision within the hair, but does tend to elevate the hairline. This same result can be achieved with an endoscopic brow lift and avoid the long incisions and extended recovery associated with the coronal approach.
In the patient with an already high hairline who is concerned about raising the hairline even further, I would not use a coronal brow lift or an endoscopic approach and would instead use a trichophytic approach where the incision is made directly at the hair line. The downside of this technique is that the incision will be visible initially until it heals and fades over time.
Each patient is unique, so it is important to tailor the procedure to the needs of each individual.
All the best,

It depends who you ask.  I try to discuss different options with my patients and discuss that different physicians may approach any problem in various ways.  There are plenty of doctors who do coronal brow lifts and swear that their results are superior to doctors (like myself) who try to steer patients to small incision endoscopic lifts.  Personally, if it was me, I would prefer having a brow lift with the smaller incisions.

This is a very difficult question to answer without the benefit of a physical examination or patient photographs. Each patient needs to be considered individually and the best option varies from patient to patient. In our experience the best choice of procedure depends on several factors. These include the patient’s aesthetic goals and the specifics of their forehead anatomy. In some cases, the surgeon’s experience with a particular technique may also contribute to his recommendation.
Brow Lift surgery has historically been performed by making an incision across the top of the head from ear to ear, and pulling the skin in an upward direction. The excess skin is removed and the brow is fixed in its new position. The muscles that cause frown lines are treated as well.
In contrast, endoscopic brow lift is performed through several small incisions placed behind the hairline. The procedure is performed with an endoscope accomplishing the same goals as the open technique. A fixation device is utilized to hold the brow in its new position.
In severe cases of brow descent, the open approach has the advantage of being able to raise the brow more than the endoscopic approach. In addition, the skin may be more easily mobilized with this technique and fixation is not an issue because the excess skin is actually resected.
In contrast, the major advantages of the endoscopic brow lift are less scarring, less numbness, less elevation of the hairline, and less hair loss. The procedure is much less invasive and associated with much shorter recoveries.
It’s important to realize that both techniques require adequate mobilization of the scalp and appropriate fixation to maintain the brow’s new position. The surgeon’s sense of aesthetics and artistry are important with either technique. Both procedures have a place in the management of brow descent. In the majority of patients, the open traditional brow lift offers no advantages over endoscopic brow lift.

The descion you and your surgeon make about which forhead lift is best for you depends on numerous variables.  Without photos, it is difficult to give you an accurate answer.  The forehead lift that will ultimately be best for you depends on your concerns with your hairline position, placement of inscicions, and desired outcome.

There are many methods for performing a browlift or forehead lift including an endoscopic browlift (through tiny incisions with the assistance of telescopes) , bicoronal forehead lift (extensive incision from ear to ear across the top of the head) and a tricophytic or hairline browlift. (hidden along the hairline. Each of these techniques achieves a similar result through the brow and the forehead in terms of smoothing of lines and gentle elevation of the brows.

The key difference is in how they affect your hairline. The Bicoronal (ear to ear) browlift elevates or pulls your hairline back, raising the frontal hairline by up to one inch. The Endoscopic lift has minimal effect of the position of the hairline. The tricophytic or hairline browlift can be used to adjust the hairline, usually lowering it to address a receding hairline or widow's peaks in the temporal hairline.
 

Best of luck!

Dr. Clevens

There are various types of brow lifts, which have arisen over the years.
The most popular is the endoscopic approach, which has been around for over 10 years at this point. Other approaches, like the coronal have been used for decades. Variations of these approaches, such as trichophytic approaches also exist.
There are pros and cons of and indications for each type or approach. The endoscopic approach is the most popular, since it avoids problems with long scars, hair loss at the incision, and generally has a shorter healing time than coronal lifts.
Coronal lifts can give a more powerful lift. Howevere, most patients really don't need that degree of elevation. Trichophytic lifts are used in patients with high and elongated foreheads, since it moves the hairline forward, closer to the eyebrows.
Hope you find the choice that is right for you.
Best of luck

Certainly, a coronal browlift is still the gold standard for browlifting: it is safe and effective.
Efficacy is probably superior to "endo-brows" if you would compare the results from multiple facial cosmetic surgeons. The reason lies in the basic technical difference: the endo-brow shifts the whole scalp, forehead and brows backwards and relies on this new position to hold up over time. In contrast, open browlifts (i.e. coronal and hairline approaches) allow for removal of scalp or skin excess.
Of course, all patients like the "small incision" idea. Few patients though object to virtually invisible incision lines, even if they are longer. An endo-brow is not a "smaller" or minimal invasive procedure and the last thing we want is wondering a year after surgery if the brows really benefited from surgery...

The two forms of brow lift I offer in my practice are endoscopic (smaller incision) and trichophytic (wavy incision along the hairline). I use the endoscopic approach for patients who have normal hairlines. Frankly, most patients will choose a procedure that offers smaller incisions. However, in situations where a patient has a higher hairline, an approach must be chosen that will stabilize or even lower the hairline. The trichophytic approach affords the surgeon the ability to raise the brows with this advantage; the disadvantage is a larger incision is required. However, if the incision is made in a curvilinear fashion and beveled, the scar will be inconspicuous and hair will grow thorough it. A coronal lift, because the incision is behind the hairline, will raise the hairline and requires a larger incision. Therefore, I almost never use a coronal approach.

The traditional method of performing brow lift is the coronal technique with an incision in your hair. This method give the most "pull" on your brows. New techniques, such as endoscopic, are also effective and only require a few small incisions. Also, some techniques use a combination of a partial coronal incision and the endoscope. So, it really depends on the training of your surgery and which procedure is most appropriate for your anatomy. All of the techniques are good when used in the appropriate situation. Good luck.

If there is a facial rejuvenation surgery that is over-recommended and often overdone these days, it is without question the browlift. Look no further than the celebrity photo magazines for pictures of stars who look like they have just sat down on a plate of tacks. The goal of aesthetic plastic surgery should be to make a person look better and more youthful, not merely different, and certainly not as though one is perpetually surprised. My goal is to provide my patients with results which appear natural, and an unnatural-appearing brow is a dead giveaway that a person has had facial plastic surgery.

I rarely see a patient that has such significant brow descent that I recommend elevation of the entire brow. However, I frequently see browlift patients for whom conservative elevation of the lateral brow produces a more rested, bright, and even elegant appearance. This is very easily simulated with gentle upward traction on the skin of the lateral forehead – if you feel that this may apply to you then try it in the mirror and the improvement will be quite obvious.

A youthful, feminine brow rests above the level of the orbital rim, which is the upper margin of the bony socket in which the eye resides. An aesthetically pleasing brow is somewhat arched laterally, and the lateral end or "tail" of the brow is higher than the medial end. It is quite common for the female brow to assume an essentially flat or horizontal orientation as a person ages.

If the skin and soft tissues lose enough elasticity with age and sun exposure, the lateral brow may even descend to a level below the orbital rim, producing a tired or even 'surly' appearance. The medial brow is relatively fixed in position and in most cases does not descend much, if any. In years past, a browlift surgery required an incision across the top of the head, from ear to ear. This was replaced in the 1990's, for most surgeons, by the endoscopic browlift, which allowed the same procedure to be performed through small incisions just behind the hairline.

While I used endoscopic browlift techniques for several years to treat brow descent, more recently I have transitioned to performing a limited incision lateral browlift that does not require the use of an endoscope. The relatively short incision is hidden behind the temporal hairline, and no incisions are required in the scalp directly above the eyes. The advantage is as follows: this approach allows me to not only redrape the lateral brow (conservatively!) in a higher position, but it also allows me to reposition the skin and soft tissues of the lateral periorbital area in an upward direction, producing a more complete rejuvenation of the periorbital area. Additionally, through this same incision I can perform suspension of the midface (cheek) if that is part of the surgical plan.

Rejuvenation of the brow by means of a lateral browlift will also, in most cases, improve the appearance of the upper eyelids. When the lateral brow is repositioned above the orbital rim, the vertical elevation may eliminate the appearance of wrinkled or 'crepey' upper eyelid skin. If the lateral upper lid skin is 'hooded' over the lateral corner of the eye, this improves as well. While upper blepharoplasty (upper lid skin excision) is often performed in concert with a lateral browlift, for many patients the upward positioning of the brow eliminates the need for skin excision.