Why Would A Surgeon Use An Endotine Fixation Device For An Endocscopic Brow Lift?

Why would a board certified plastic surgeon use an endotine fixation device for a brow lift instead of relying on their own suturing abilities? Wouldn't the endotine have a greater failure rate?

Doctor Answers 10

Endotine use for forehead lifting

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There are many different ways to perform eyebrow and forehead lifting as well as a number of different ways to resuspend the brow muscles and forehead tissue. The Endotine system is an absorbable device which has several prongs that grasp the forehead tissue and another prong that fits into a small hole in the forehead bone. The theory behind this method is that it allows a widespread support while the brow tissue re-adheres to the forehead bone. One of the disadvantages of this device is that it can be felt through the skin and is a little more expensive than other methods. One popular method is to make a tunnel through the forehead bone which can fit a suture. When doing this procedure, I prefer to use a permanent suture to secure the forehead tissue, in its elevated position, to the bone, thereby offering long-term support.

However, the choice of eyebrow elevation technique should be based on the individual patient, their concerns, and their expectations and should be a conversation with you and your surgeon.

Inland Empire Facial Plastic Surgeon

Why use fixation device in Endoscopic browlift

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Fixation following brow lifting is different in every surgeon's hands.  What is most important is that the brow tissue is completely elevated and released from its natent position.  At the level of the supraorbital rims (just above your eyes) there is a ligament called the arcus marginalis.  This area needs to be completely released from lateral to medial.  It is also routine for the corrugator mucsulature (between your eyes) to be divided.  Once this tissue is completely freed and released your brow can be repositioned superiorly for an appropriate browlift.  Fixation varies between suture techniques, bone tunnels, screw placements and the endotine device.  The endotine is favorable for two reasons:  it dissolves after 9 months which is far greater than the time for you to heal, and it creates a three dimensional zone of fixation that sutures cannot mimic.  Overall, it is a good option in the brow.

Shepherd G. Pryor, MD
Scottsdale Facial Plastic Surgeon
4.6 out of 5 stars 23 reviews

Brow lift

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when doing a brow lift, there is not much soft tissue to work with and you need to get some fixation in bone. I happen to like the endotines, and use them, but there are other alternatives. This is the preference of your surgeon.

Jack Peterson, MD
Topeka Plastic Surgeon
4.6 out of 5 stars 47 reviews

Brow lift and endotines

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  Personally, I actually do rely on sutures, not endotine or screw fixation for my browlifts.  But I think I am in the minority of doctors who do this.  That said, I definitely do not believe that use of endotines means a lower chance of success.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 140 reviews

Why Would A Surgeon Use An Endotine Fixation Device For An Endocscopic Brow Lift?

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Endotine use depends on the surgeon's preference. I have used bone tunnels for the past 15 years with no irritations or failures. Some surgeons may not be comfortable with bone tunnel procedure.

Mohsen Tavoussi, MD, DO
Orange County Facial Plastic Surgeon

Endotine Fixation With Browlift

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The absorbable endotine fixation device works as well as other methods of fixation in browlift surgery. I also use this device in cheeklift surgery. Go to our website bevhills.com for a complete discussion of various browlift techniques.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Endotines in browlifts

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The browlift requires release of the forehead from the bone, some muscle work and then fixation of the tissues higher so they will heal.  The Endotine is a dissolvable device that holds the forehead up while it sticks back down to the bone.  It is a very popular fixation device but not the only way to do it.

Brow lift requires fixation

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After the complete dissection of the endoscopic brow lift the forehead has to be held up to maintain the elevated position.  The fixation is a matter of surgeon's preference and training.  The Endotine is fairly common but there are other methods.  My preferred method is to use tunnels in the bone to attach the sutures to in the forehead  and fascia fixation on the sides.

It is best to go with what ever method your surgeon is familiar with.

Best Wishes

Dr. Peterson 

Marcus L. Peterson, MD
Saint George Plastic Surgeon

Why use an Endotine with a brow lift.

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Why use an Endotine with a brow lift is a good question., The Endotine acts as several sutured and fixes the lift to the bone which gives more "hold" than suturing if done by an experienced surgeon.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Why use fixation device in Endoscopic Brow Lift

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 IMHO, the real question should be "why do an Endoscopic Brow Lift that requires any form of fixation that untimately weakens and fails at all".  I have performed Brow Lifts for over 20 years and will not use the Endoscopic technique because all forms of fixation, IMHO, will fail at some time and most seem to be within 12 months.  For that reason, I only perform Coronal Brow Lifts that trim scalp as the method of holding the eyebrows up.  Much more reliable and effective. 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 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.