Endoscopic Brow lift. Which is best, 3 or 5 incisions to reduce crows feet?

I would say that is does not matter how many incisions your surgeon uses, but instead what matters more is your surgeon's skill and ability in performing the procedure.  For any cosmetic procedure, choose a surgeon who has much experience in facial cosmetic surgery, and who has before/after pictures which show results similiar to your aesthetic goals.

The word crow's feet on the face describes a set of wrinkles noted on the outer eyelid region. These are worsened during smiling and as the skin gets thinner in this area. This problem is usually treated with a neuro-modulator like Dysport, Xeomen or Botox. Then a 3D filler like Juvaderm or Restylane can be used.  Temporal lifting can reduce excessive skin and give temporary improvement but as long as the muscles are moving the crow's feet will come back

Thank you for your question.

I prefer a modified endoscopic brow lift with 4 incisions -- 2 horizontal ones on the sides and 2 vertical ones centrally above the forehead.A brow lift typically doesn't fix crow's feet. For that, Botox Cosmetic, Dysport, or Xeomin would likely work well for that.

To be sure, see two or more board
certified and experienced plastic surgeons in your area for a full and complete
evaluation.



I hope this helps.

If they only put the incisions on the top of the head, you will get mostly a forehead and medial browlift.  Most surgeons will do an incision in the temple area as well.  This allows for a lift of the temporal brow and will help with the crow's feet.  This is the more common and standard incision pattern.  

In reality, the number of incisions doesn't really make a difference as to the effect of the lift. The sole purpose of the incisions is to gain access to the tissue under your skin. I use 3 incisions like you described. To me that is more than enough room, particularly as a head an neck surgeon who uses endoscopes frequently for a variety of other surgical treatments. However, reducing the crow's feet with an endoscopic brown lift is not always ideal. You will get some effect but remember, the biggest effect is on your eye brows and forehead skin.  Patients often benefit from a neuromodulator injected into their Crow's feet to help reduce those wrinkles. 

With respect to brow lift incisions either 3, 4, or 5 incision approaches work well.  It just depends on the comfort level of your surgeon.  The incisions are well concealed and heal quickly.Brow lift procedures work well to elevate a heavy brow but do not fully address the crows feet, for that a neuromodulator like botox is best.Visit with a board certified plastic surgeon in your area that gives you a comprehensive evaluation and can describe what you may expect from the procedure.Best of luck to you

This depends most upon the typical practice of your surgeon and the severity of the aging changes that you are trying to treat. I will typically use 5 incisions but have very skilled colleagues that only use 3 and are capable of creating very nicely results as well. I would ask your chosen plastic surgeon about their technique to get a specific answer. Regardless, endobrow incisions tend to heal very nicely and are hidden behind the hairline. Hair loss or alopecia can happen but is very rare. I hope this information is helpful.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Each surgeons should have a rationale for using the incisions for any operation. I like to fit the surgery to the individual task. You can inquire as to why each surgeon is using each incision. There is no specific standard although one incision is too few and six is too many. Generally speaking you need at least two per side: one for the scope and one for the instrument. Some surgeons/surgeries will place a common incision at the midline, thus making three total. Others will place one on either side of the midline, making for four total. The other use of the incision is for a point of fixation, with a suture, screw, or absorbable device. Often one can use the incision on the side for a point of fixation as well as an entry for the scope of instrument, making for three total incisions. Some like to use two points of fixation for each side, making for four total if each of the two on either side are also used for a point of fixation, or a total of five if there are two points of fixation for each side, plus the entry incision at the midline. In the end, you will have to trust your surgeon to do what he/she feels will achieve your goals.Robin T.W. Yuan, M.D.