Endoscopic Browlift
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In this segment, Dr. John Martin discusses options for browlifting with his siblings, Drs. Edward and Kathryn Martin.
When a patient comes to the office for a cosmetic consultation for upper lid surgery, it is very important to check their brow height. With age the brow will begin to fall, and may aggravate and increase the amount of redundant skin present in the upper lids. If an upper lid blepharoplasty is performed, it may actually pull the brow down further, creating a smaller more closed appearing eye. By raising a low brow, this will give a more open appearance to the eye area, and improve the crow’s feet.
There are several ways to lift a drooping brow. A direct brow lift is done by making an incision just above the brow hairs. An ellipse of skin is excised and the wound sutured, elevating the brow. This works well but will produce a small scar at the brow. For men with a bushy brow, it is easily hidden by the brow hair.
A coronal browlift was the surgery of choice for many years. In this surgery an incision is made behind the hairline across the top of the head, from ear to ear. While this surgery gives a nice lift to the brow, it can create a scar and can leave some people with a bald patch along the top of their head.
More recently physicians have been performing an endoscopic browlift. In this surgery, several small incisions are made behind the hairline. An endoscope is used to help the surgeon dissect inferiorly to the brow, to free up the tissue from the bone. The brow and forehead can then be elevated. An Endotine implant is frequently used to help maintain the brow elevation. A small hole is drilled into the cranium, and the plastic Endotine implant is placed into the hole. The skin of the forehead is then elevated and hooked to the implant, which will dissolve in about 3 months, by which time the forehead and brow will have healed in their elevated position.
When doing the endoscopic browlift, the muscles between the brows can be cut to help diminish the frown lines. Some patients may still need Botox however to keep the lines from reforming.