Why my Endoscopic Brow Lift Did NOT Hold? (photo)

Endoscopic browlifts are a good technique to use for patients with mild to moderate eye brow droop and think skin. But even in the best circumstances, I have not found them to be as long lasting as open [trichophytic or coronal] browlifts.

You state that you don't want a "coronal" browlift, but have you considered a trichophytic [hairline] browlift? This incision is made at the top of your forehead, a few millmeters behind your hairline, in a beveled fashion so that hair can grow through the incision site and mask the scar. The added benefit, beside being a much stronger and long-lasting lift, is that it also shortens the height of the forehead. That is great for patients who have a really high hairline.

Although I initially trained and performed endoscopic browlifts exclusively, I have since transitioned to trichophytic browlifts, with an occasional endscopic lift for the perfect candidate [mild droop with very think skin and very thin hair]

 

The endoscopic browlift can be a very good option.  Like anything else, the surgery needs to fit the patient.  You are taking a couple of options out of the hands of your plastic surgeon.  The forehead needs to be in a fixed position to scar and stay in place.  Often sutures will work.  Our office likes the endotine system.  In your case I would also inquire about a lid ptosis procedure.

Poor results from endoscopic forehead lifts are common. 35 years ago we invented the Irregular Trichophytic Forehead Lift which gives a far more reliable result and NO hair is removed. If properly done the hair will grow thru the scar at the hairline so no scar is seen and a better browlift can be done.

The better question is what are you trying to achieve.  If you want your eyes more open, then brow lifting won't help.  Your eyelids are droopy (known as ptosis) and the only way to open the lids more is to perform a ptosis repair.  In terms of the brow repair, a lot depends on the surgeon's technique.

Looking at your posted photo the location of the brows seems to be elevated. So how much more elevation do you desire? Reasons for failure are the suture relaxed or disrupted, poor technique, poor optioning your case of the surgical procedure. I might suggest using BOTOX doing the healing phase to remove ANY muscle action until the surgery heals. 

You have slight eyelid ptosis that should be addressed before the forehead or at the same time.Your picture show excess skin of the upper lid that can be treated at the same time. The use of sutures for the forehead suspension is not effective since the reattachment time for the periosteum is 4 weeks.