Is there a Brow Lift That Suspends the Brow by Drilling into the Bone?

Endoscopic browlifts which avoid a large incision and do not involve removing excess skin work by redraping the brow and forehead soft tissue in a higher position against the skull. To maintain this position, they are fixated to the bone through shallow holes drilled into the bone. It is very safe and is not "neurosurgery". That is the the hole that is drilled is not full thickness through the skull.

Sometimes it is necessary to elevate the eyebrows in order to help provide definition to the upper eyelids. There are a number of techniques that can be helpful in elevating the forehead skin and the brows. When larger skin incisions are used, then sutures to the tissue near the incisions suffice to hold the new position. When smaller incisions (endoscopic assisted) are made, then sometimes a small shallow hole is made in the outer bone layer to help stabilize the skin with either a tiny screw or absorbable plate. Small tunnels have also been used. But another option to avoid the small bone holes is a suspension suture placed behind the incisions and buried under the hair-bearing scalp.   When the lateral (outer) brow is the main focus-and it often is- then the incision is made in the  the temple region, and sutures alone provide adequate fixation. Not every patient needs brow elevation with aging but it when necessary, the least invasive option might the place to start discussion with your surgeon.

One method of fixating an endoscopic browlift is to drill holes in the outer later of the skull bone. This is a safe option. The skull is thick and composed of two separate layers. The main issue with this type of browlift is not drilling holes in the outer layer of the skull bone but the extent and durability of the endoscopic lift. Many surgeons, myself included, have gone back to gold standard "open" browlift approaches such as the trichophytic and coronal lifts because the offer more precise brow lift and shape and the results are more predictable and durable.Stephen Weber MD, FACS

Browlift and bone drilling vs. the Irregular Trichophytic Forehead Lift and which gives the best results. As the co-inventor of the ITF lift I have a long history of using both. Yes, the bone can be drilled and the forehead lifted without an endotine. However, the reason we invented the ITF forehead lift 35 years ago is: 1. It gives the most reliable forehead lift  2. No hair is removed  3. The resultant scar if properly done does not show 4. The hairline can be lowered  5. The entire brow is raised creating a rested look, unlike the lateral temporal browlift which can create an evil look since it does not raise the medial brow!

So what is the downside?? Temporary numbness of the scalp behind the incision for 6-12 months. I have never revised a hairline or been asked to do so. 

In addition to the many excellent opinions already given here I would add a lateral , temporal subcutaeous brow lift with skin excision inside the hair line without need for bone fixation.