With an endoscopic brow lift, are holes drilled into the skull?

Access points for an endoscopic browlift are all very similar; however, the method of fixation may change depending on the surgeon.  Specific retaining ligaments are released to move the brow to its new position, which is either fixated by stitches, or by small sheets that are similar to "carpet tacks."  In order to secure either of these, small partial-thickness holes are drilled into the skull.  I recommend seeking a Board-Certified plastic surgeon to accurately examine you and formulate a surgical plan tailored to your wishes.  Good luck!

Although some endoscopic techniques do require small holes to be drilled in the skull bone there are also other techniques that do not require this maneuver. Make sure you discuss the various options in detail with your surgeon before making a final decision.

Endoscopic brow lift fixation points are similar but the method of fixation varies from surgeon to surgeon. For example, small drill tunnel hole can be placed in the outermost portion of the skull with sutures that are passed through it, removable or dissolvable screws to which  stitches are attached or stitching the fibrous tissue over the bone. All of these methods work well.

Some surgeons use a special surgical drill to make tiny openings in the skull for an endoscopic forehead lift, but it can be done with sutures, as well.

In many cases a hole will be drilled in the outer layer of the skull in order to anchor a suture, endotine device or another fixation device. The skull is composed of two layers and is thick. An experienced surgeon can perform this maneuver safely. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

when doing an endoscopic browlift most surgeons will use some sort of fixation.  This is frequently done with the use of drill holes, especially if using endotine implants for the fixation.  They are small holes with no risk to you.     

Some surgeons drill holes in the skull for endoscopic forehead lift, but it can be done without any skull manipulations but rather sutures.

The development of the endoscopic brow lift has allow plastic surgeons to elevate the brow without making an incision back in the hair that went from ear to ear, also called a Coronal Forehead Lift.  Because excess scalp was removed, there was no need to tact the forehead flap down.  In the Endoscopic Lift, the forehead elevation comes after releasing the skin and sliding it up into the desired position.  Without some form of fixation, the brow would slip back.  There are several different methods to do this, but most all involve anchoring the skin to the skull.  The skull itself is never opened into the brain.  It is all done in the outer layer.  Think of an Oreo cookie as the skull, only one  cookie wafer has a hole drilled into it and either a suture or a special anchor is inserted into the hole. 

There are multiple ways to lift the forehead and eyebrows. Typically, the browlift is performed with either a coronal approach or an endoscopic approach, and each one of them has their own advantages and disadvantages. Fixation of the tissues is required to hold the brows into position so that they do not fall down in the immediate postoperative period. In our practice, we use sutures, rather than drilling holes into the outer table of frontal bone

With an endoscopic brow lift it is necessary to fix the brow in the desired position.  In order to do this it is necessary to place a hole in the outer table of the skull.  This is done with a guarded drill that prevents over penetration so that the chance of entering the cranial cavity is almost non-existent. It is important to choose a skilled and experienced surgeon to reduce risk and get the best result. It is best to have an endoscopic brow lift if the forehead is relatively short.  If the patient has a high forehead then there are better choices than an endoscopic lift to avoid raising the hairline and causing the appearance of hair loss.