What Are the Possible Complications of Having Endotine Implants for my brow?

I stopped using endotine years ago for the following reasons:


They can be felt as a firm bump for months after surgery

They add a significant cost to the surgery which is passed on to the patient

They show no benefit to other methods of fixation (i.e. bone tunnel)

Endotines are used by some surgeons who perform endoscopic browlifts. Endotines are like carpet tacks. After the forehead and scalp are lifted, the endotines are placed beneath the skin to hold everything in place. I performed many endoscopic browlifts and though I prefer to use a different method of "fixation" there is nothing wrong with those that use the endotines. The biggest issue with them is that they can be felt beneath the skin for up to 3-4 months. Rarely, they can be seen. The main drawback is cost which is often passed onto the patient and can be around $300. Extrusion and infection should be extremely rare. A well performed endoscopic browlift is equally as effective as open browlifts in most instances. 

There are many different techniques for fixation in the endoscopic brow lift.  I have used the "bone tunneling" technique, the "screw" technique, the "no fixation" technique and the Endotine technique.  They all basically do the same thing, keep the skin elevated long enough to allow it to stick down to the bone.  The older Endotines stuck around for up to 2 years which made them annoying for the patients.  The newer Endotines dissolve in about 2-3 months and are therefore much less problematic.  And, they are very easy to use. Is there anything wrong with the other techniques? No, they're all fine.  What matters is how comfortable your surgeon is using the technique he has chosen.

In addition the number of of transverse cuts in the periosteum (the layer of tissue just above the bone) will determine how well the tissue can be elevated.