Endoscopic forehead lift is a surgical technique in which the forehead, temples and eyebrows are lifted through limited surgical incisions with the help of a special imaging system and special surgical instruments. In endoscopic forehead lift surgery, 4-5 vertical incisions of 2-3 cm in length are made in the scalp, usually in a size that will allow the entry of endoscopic instruments. The forehead and temple area is isolated from the bone surface it is attached down to the eyebrows. The connective tissue layers that hold the eyebrows in place are carefully separated. Afterwards, the forehead/temple/eyebrow unit is raised as a whole and fixed to the micro-tunnels established in the bone.
The ideal patient group for endoscopic forehead lift includes individuals who are in the early stages of forehead aging, with eyebrows recently starting to get low and the forehead height being shorter than 6 cm. One of the most important uses of endoscopic forehead lift is to prevent droopy eyebrows that may emerge after upper eyelid surgery.
A significant proportion of middle-aged patients with excess skin on the upper eyelid also have drooping forehead/temple and eyebrows. The skin accumulating on the upper eyelid causes weight. The upper eyelid sends a help signal to the brain. The brain sends the command “raise the eyebrows” to the frontalis muscle, which is like a roller blind covering the forehead.
As a result, we raise our eyebrows within an involuntary and unconscious reflex mechanism. In this group, if an upper eyelid surgery is performed alone, the upper eyelid becomes lighter after the operation, the signal from the eyelid to the brain disappears, the forehead muscle relaxes and the eyebrows return to their original low state. With the drooping of the eyebrows, the skin fold on the external half of the upper eyelid appears as if it has recurred.
We call this phenomenon “balanced latent brow ptosis”. When the balance is disturbed by upper eyelid surgery, the latent brow ptosis turns into manifest ptosis. Endoscopic forehead lift is an ideal method to prevent potentially-drooping eyebrows through this mechanism. Contrary to popular belief, the goal is not to raise the brows too much but by only 1-3 mm, or sometimes just to maintain its original position.
The key advantage of the endoscopic forehead lift technique is the absence of long scars that run along the scalp as in conventional approaches. The recovery time is shorter and the scars are less noticeable. We rarely observe sensation changes in the scalp, which we almost always observe in Coronal and Hairline techniques. In addition, since the endoscopic forehead lift addresses the forehead/temple and eyebrow unit as a whole, the brows rise together with the temple area and forehead, providing a natural eyebrow contour. In this technique, frowning muscles can be weakened and vertical wrinkles between the eyebrows can be reduced.
The disadvantage of the endoscopic technique is that the effect of the method and the permanence of the effect are more limited than what the conventional techniques have to offer. The endoscopic technique does not provide good results in the patient group where the distance between the eyebrows and the hairline is more than 6 cm and the forehead is round. In some patients, forcing the indications leads to results below par. In patients with unsatisfactory results, it may be necessary to repeat the endoscopic technique with a different fixation method or to repeat the operation with Coronal/Hairline techniques.
For detailed information about endoscopic forehead lift and to find out whether this technique is suitable for you, feel free to contact us.
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