Does Endoscopic Brow Lift Last As Long As Full Coronal Brow Lift?

This is one of the most controversial topics in the area of facial rejuvenation. The opinions are largely divided amongst the surgeons in the field. The coronal lift has historically been considered the most robust or probably long lasting lift, but obviously it comes at the cost of a more extensive surgery. The less invasive alternatives such as temporal or endoscopic lift when picked for the right candidate can often deliver the desired results, but considering the large variety of techniques and fixation methods employed by different surgeons a true objective comparison is nearly impossible. Another important point that can not be understated is that many individual factors including, gender, the shape of the brow and the degree of its drooping, the shape and length of the forehead, the degree of hair loss and its pattern are also all significant parameters to be taken into the equation when it comes to choosing the best modality for each individual patient.

Some studies do show that open techniques tend to last longer than endoscopic techniques, but this is highly dependent on the surgeon's technique. There are also studies that show certain endoscopic techniques are equivalent to open techniques. Not all coronal or endoscopic techniques are the same. With respect to fixation device failure, this could be true, but would be uncommon. I do not have experience with these fixation devices because I use a suture technique to fixate the brows and avoid any drilling or anchoring into the skull. Once the soft tissue has healed, the brow stays in position without the need for a permanent or long-term device under the skin. In my experience, the endoscopic brow lift is an excellent choice for many patients, and the results are excellent even in the long-term.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 and last longer than doctors (like myself) who try to steer patients to small incision lifts.  Personally, if it was me, I would prefer having a brow lift with the smaller incisions.  Personally, I do not believe that one type of browlift lasts longer than another.

This represents an area of controversy in facial cosmetic surgery. There are those who feel that a coronal brow lift will last longer than an endoscopic brow lift. Most proponents of this view attribute this increased duration to the resection of excess skin.
In contrast, many surgeons feel that an endoscopic brow lift can be equally effective if performed properly. They feel that the results are excellent when adequate soft tissue release and appropriate fixation are utilized. They also feel that the longevity of brow elevation under these circumstances can be equivalent to an open brow lift procedure.
Proponents of endoscopic brow lift feel that a more relevant question is related to the final aesthetic result. They argue that the open approach is associated with more scarring, more numbness, more hair loss and elevation of the anterior hairline.
In the final analysis, the surgeon’s sense of aesthetics and artistry are more important than the technique utilized. Both procedures have a place in the management of brow descent. In the majority of patients, the open traditional brow lift offers no advantage over endoscopic brow lift. It’s important to find the technique that is best for each individual patient.

In my opinion, and in my hands, I believe that an endoscopic brow lift has great longevity. There are two basic forms of brow lift: endoscopic and open. I do not believe that a Coronal brow lift has any relevance in brow lift surgery given that there is a better open brow lift option: the Trichophytic Brow Lift.
A Trichophytic approach utilizes and irregularly irregular wavy pattern that mimmicks the natural hairline and a bevelled incision to allow hair growth through the eventual scar. A Trichophytic approach allows for skin removal and allows for stabilization or lowering of the hairline. A Coronal approach allows for skin removal, but by definition elevates the hairline. A Trichophytic approach allows for greater control of the glabellar muscles and brow elevation than an endoscopic approach.
However, a properly performed endoscopic approach with complete brow release has yielded excellent results for my patients and saves operative time in the circumstance of multiple procedure cases. A large percentage of patients prefer to have a smaller incision if possible, making the endoscopic brow lift the preferred approach in patients with a normal hairline. Patients with a high hairline require a Trichophytic approach.

Brow lift surgery is not one specific operation, but rather many potential operations. Each patient is unique and one plastic surgery method may be more appropriate. Each patient must evaluate the various advantages & disadvantages for each procedure.
Unlike traditional brow lift surgery that involves an incision across the entire forehead, the endoscopic brow lift is a minimally invasive method of lifting the brows. This minimally invasive plastic surgery is performed via very small incisions hidden in the scalp to recreate a youthful appearance.
There are several advantages over the conventional brow lift, including:

incisions are smaller
recover is faster and generally easier
less bruising, swelling, and numbness

The results of endoscopic brow lift are long lasting. The duration of results generally is not dependent on the failure of fixation devices, as the forehead re-sticks to the bone only after a few days. Generally, any brow fixation method is realistically important in the first few days after surgery.

How long an endoscopic browlift lasts depends on how the operation is performed. Endoscopic just means the doctor uses tubes to do the procedure, nothing more. If all the brow attachments are released and fixation is solid, the endoscopic browlift should have great longevity. If the frown muscles are "roughed up a little bit", longevity could be minimal. The more aggressive the endoscopic browlift, the more the hairline will rise (i.e. the forehead will rise). Where the brow is lifted is very much an artform, so no two doctors perform the procedure alike. Areas of baldness around the (usually 3) incisions are common.
Coronal lifts involve an ear to ear incision. The deep branch of the supraorbital nerve is always cut, so nerve problems are common. The hairline always rises. Areas of baldness around the incisions are common. For these reasons we never perform coronal lifts on any patient.
Hairline or modified hairline browlifts do not raise the halrline, but the scar can be visible. Depending on how it is performed, the scar can be visible or minimally visible.
Below is a book chapter in the textbook Mathes that goes into some more depth on many of the methods available to lift the brow, and its relationship to the midface as well.

There are different browlifts that can each achieve a good result but it's important for the surgeon the pick the right procedure for an individual patient. Endobrows can work well in a large group of patients, but not in all patients, and those with a lot of loose forehead skin or with a receding hairline, for example, may get a better result with a more traditional approach. Given that you have already had several consults, I would recommend at this point going with the individual you feel the most comfortable based on your consult and their before and after photos to give you the result you want.

You need to look at the whole picture. Each has its risks and benefits and it pros and cons. I generally go thru the whole arena of what the pros and cons are for each. I perform all 3 types of browlifts and cater it to the particular person. But in a general comment a coronal lift is a more powerful lift no matter how you look at it and how good you are at the endoscopic lift.
The longevity for the endo brow is not so much the fixation, that those has some to do with it, but it is really the release fo the retaining ligaments.
Good luck.

IF endobrows were the definitive solution that they were intially thought to be, then we all would be performing them Clearly, their appeal is the limited incisions. However, there is an increasing trend for limited incision (temporal) forehead lifts.