Is a pretrichial brow lift or an endoscopic brow lift a better way to achieve lift to the mid-brow/forehead? (photos)

Question

I'm getting conflicting opinions: saw one doctor and he said that I would need a pretrichial or direct brow lift to achieve the lift/longevity that I desire. He said an endoscopic lift would not be sufficient. Got a second opinion from a different doctor and she said that an endoscopic lift would give me the results that I want without the scarring of a pretrichial or direct lift. Both seems like great physicians, which leaves me quite confused. I would greatly appreciate further input.

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. I suggest that you move forward and consult with a board certified facial plastic surgeon to determine your candidacy, and treatment plan. An endoscopic brow lift offers the benefits of a quicker recovery time, generally a less invasive incision, and closed incisions with removable or absorbable sutures.
Best wishes,

Andrew Miller, MD · Answer

Even in the best hands, a pretrichial lift will leave a scar along the hairline which in some cases can be quite noticeable.  Plastic surgery is all about not taking risks. A well performed endoscopic brow lift will give a great long term result, using incisions completely within the hairline that are rarely noticed afterwards. Be sure to see a facial specialist for endoscopic brow lift and you should be happy with the result and not worry about a scar.

James Bonaparte, MD, MSc, FRCSC · Answer

Hi there, I may not be able to help with choosing your procedure, but I may at least be able to help you understand the process a bit more. This may help you decide in the end, or at least know the benefits and drawbacks. I posted a link below to an editorial I wrote on the topic. It is a three part discussion of brow and eyebrow lifting. If you get a chance, take a look. Dr James P. Bonaparte

Christian G. Drehsen, MD · Answer

In my opinion the choice of  technique should be based on the desired results in repositioning the brow as well as  the height of the forehead. While an endoscopic lift has debatably the most discreet incision, it fails at effectively lifting the outside of the brow and will reposition the hairline backwards which can be an undesirable side effect in a high forehead. Proper repositioning of the brow is is quite important and improving the eye expression and exposing its beauty . In most of my cases I prefer a wavy and beveled pre-trichial incision that allows a fine repositioning of the brow with a most discreet incision and  without  detrimental displacement of the  hairline as can be seen in my Dual Plane Brow lift results.

Robert Brobst, MD · Answer

Thank you for your questions and photographs. The decision to incorporate a pretrichial incision depends more on your current hairline and forehead shape, then the amount of correction. For patients with high hairlines or very curved foreheads, I usually recommend a endoscopic forehead lift with short central pretrichial incision. Otherwise, a endoscopic approach with 4 small incision hidden within/ behind the hairline is my preferred technique. All these incisions heal very well. Direct techniques and traditional pretrichial forehead lifts also have a role, but are not my first choice in most patients unless advanced male pattern baldness is an issue. I hope this helps. Take care.

William Portuese, MD · Answer

There are many issues are going to go into making a decision regarding a brow lift procedure, and these include asymmetry of the brows, the level of the eyebrows, the thickness of the corrugator and frontalis muscles and the status of the hairline. An in person consultation and examination is usually required discussed the options.

Joel E. Kopelman, MD, FACS · Answer

I recommend a pretrichial lift if your hairline is recessed(because it can lower your hairline) I do not routinely recommend this approach because a hairline scar is not as well camouflaged as an incision behind the hairline.If your hairline is normal then endoscopic brow lift incisions are within the hair and therefore not  have observable. In regard to longevity, in most cases if the attachments to the superior orbital rim are adequately released with an endoscopic approach then the browlift should last a long time.

Is a pretrichial brow lift or an endoscopic brow lift a better way to achieve lift to the mid-brow/forehead? (photos)

Answers (7)

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