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

Question

Three weeks post surgery my brows are exactly where they were prior the surgery. My PS used sutures to secure new position. I am planning on having them redone, likely by the same surgeon. I do not want to use Endotines or do a coronal brow lift. 1. If the brows didn't hold first time, is there a higher risk they will droop back again? 2. What can be done differently second time to make sure my brows stay in place? 3. Can they be secured with several methods at the same time? Thank you

A.J. Amadi, MD · Answer

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]

Jeffrey J. Roth, MD, FACS · Answer

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.

Toby Mayer, MD · Answer

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.

Sam Goldberger, MD · Answer

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.

Darryl J. Blinski, MD · Answer

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.

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

Answers (6)