Abstract. This is a retrospective review of our experience with the endoscopic brow lift. We reviewed 128 procedures performed by two senior faculty members over the last 5 years. We evaluated the age, gender, operating time, complications, and outcome and conclude that endoscopic brow lift is a safe, efficient procedure with a low complication rate. The operating time is short, and there is a very high patient acceptance. The procedure has taken its place as an integral part of facial rejuvenation in our practice. Endoscopic brow lift has gained popularity since its introduction in 1994 [1] and we have performed 218 brow lifts at St. Joseph Hospital since then. This is a retrospective review of 128 cases performed over the last 5 years by two senior faculty members.
Materials and MethodsCharts of patients who had had endoscopic brow lifts before December 31, 1998 were reviewed and the technique was analyzed. Age, gender, operating time, other procedures performed, and outcomes were evaluated. An objective measurement of the brow elevation was not possible because of the retrospective nature of the review. We chose random patients and performed subjective analysis of the elevation by looking at the brow position, frown lines, transverse forehead rhytids, and by making comparisons with the preoperative pictures.
TechniqueThe technique has undergone various modifications, most of which involved the placement of incisions and the way the elevation was secured. We started with vertical incisions where the incision was closed in a transverse fashion following resection of bilateral dog ears (Fig. 1). Then we placed a screw in the outer table of the skull through a vertical incision and secured the elevation with a Prolene suture wrapped around the screw (Fig. 2). With our current fixation technique the forehead and temporal and parietal scalp are infiltrated with 0.5% lidocaine with epinephrine. Three vertical incisionsone in the midline and one on each side leveled with the apices of the brows-are placed 1-2 cm behind the hair line (Fig. 3A). The infiltrated posterior scalp is elevated in a subgaleal plane (B) and the forehead is elevated to a point 2 cm cephalad to the supraorbital rim in a subperi-
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