An open brow lift
can give you longer lasting results because there is removal of tissue, which
is not possible with the endoscopic approach. The endoscopic approach was
popular 15 years ago, but has gone out of fashion because surgeons have
recognized that the removal of tissue is necessary for a long lasting upper
I'm going to take a completely different approach to this question. I believe there is been a paradigm shift in the thinking of plastic surgeons regarding the descent of the brow.If you look at photos of young women they invariably don't have much lid appearing between their lashes and where the start of the brow begins. Why then are we trying in age to create the look of youth by creating something that doesn't exist in youth. My approach over the last several years is to fill the space where the fat is missing in and around the brow especially in the fat pad that exist below the brow. I believe that the brow lifts that are done with the endoscope sometimes end up too high and the patient has a surprised look. If a brow lift is necessary I agree with what's been said below that the open approach in front of the hairline is the best for longevity and control of brow shape. I hope this information is helpful.
There will be many differing opinions by surgeons about which is the best way to approach a brow lift procedure. In our practice, we prefer the coronal approach to better address eyebrow asymmetry on a more permanent basis with differential amount of skin removal. In addition, the coronal approach can adjust the hairline upwards or downwards, depending upon placement of the incision. Furthermore, the coronal approach allows fascia grafts to be placed between the muscle and the dermis to help with the corrugator lines, in addition to softening the corrugator muscles, and frontalis muscles, which both cannot be performed with a endoscopic approach. For many examples of a coronal browlift, please see the link and the video below
A prehairline open browlift has the advantage of both avoidance of raising the hairline and IMO gives a much longer lasting improvement due to the skin that is removed. When properly performed, most patients feel that their incisions are undetectable to others after about 6 weeks. I feel that the benefits are worth the somewhat longer "open" procedure.
Jon A Perlman MD FACS
Certified American Bd. of Plastic Surgery (ABPS)
ABC TV Extreme Makeover plastic surgeon
Beverly Hills, Ca.
Thanks for your question,
Its a contraversial question and many surgeons will have different opinions on this. I think an endoscopic brow lift works great if done properly and saves you the stress of dealing with scars.
It may be helpfull if you take a look at an editorial on the anatomy of the brow and forehead. I put a link below, it is a three part series and this is part 1.
Dr James P. Bonaparte
Hello! The answer to that question probably depends on the skill and preference of your surgeon. Endoscopic brow lifts do raise the hairline and make the forehead taller while lifting the brow but typically use small incisions. The brow is fixated, but only centrally. Typically a small amount of skin is removed from the temples. A trichophytic brow lift must be done carefully to avoid a noticeable scar at the front of the hairline but does not move the hairline back and is better for addressing very heavy brows, patients with high hairlines and patients who are not candidates for an endoscopic. I do not recommend incisions in the forehead or eyebrow for a typical brow lift due to scars. Good luck!