An individual assessment of the forehead region is very important. In patients with drooping brows, frown lines and a great many wrinkles, an endoscopic forehead lift is performed.
Classically, forehead lifting required a complete coronal incision stretching from one temple to the other. This scar on the scalp caused alopecia and loss of sensitivity and also made the forehead much broader, due to the traction of the frontal flap.
Endoscopic Forehead Lifting
We perform the forehead lift through two small incisions in the scalp and, using endoscopy, we carry out a controlled dissection of the entire forehead.
First, we make a subperiosteal approach as far as the orbital rim. We locate and preserve the supraorbital and supratrochlear vessels and nerves.
Then we start the treatment of the muscle plane. Via endoscopy, we perform the myectomy (partial resection) of the corrugator and procerus muscles.
If the face has very deep wrinkles at rest, we mark them with needles at each end. We locate them endoscopically and then perform myectomies perpendicular to the horizontal line of the wrinkle in the forehead muscle; in this way, the wrinkle disappears.
At the level of the tail of the eyebrow we detach the outer third in order to raise it.
Then, using an external traction-fixation system placed on the scalp, we raise the outer third of the eyebrow and tighten the skin on the forehead.
Endoscopy plays a vital part in our forehead lift technique and helps to achieve excellent aesthetic results. As only two small incisions are made and there is no coronal scar, there is no risk of alopecia in the area.
If the deformity is less marked, we can also treat this region through the upper blepharoplasty incision, as described in the section on surgery of the eye region.
We were pioneers in the use of this technique in Spain, and we are the authors of the first book on the use of endoscopy in plastic surgery (Endoscopia en Cirugía Plástica y Estética.Ed.Masson. JMª Serra Renom).