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.