Endoscopic Forehead Lift – Here are the Facts

Written by Frank P. Fechner, MD

As we age our eyes become more saggy looking and the brows get heavy. The solution may come in the form of a browlift. Over the years, the endoscopic browlift (sometimes also called “endo-brow”) has been labelled as being of “minimally invasive nature … with a recovery that is fast and comfortable”. Interestingly, there are many experienced facial cosmetic surgeons that dispute this claim.

If compared to an open approach, some of the distinguishing facts include:

1. Incision: Endo-brows are usually performed through 5 incisions placed within the hair. Adding them all together, they are commonly somewhat shorter than the one longer incision used in the open browlift.

2. Extent of surgery: During an endoscopic forehead lift, more significantly more dissection is necessary in order to achieve the necessary mobilization of the forehead tissues.

3. Recovery: Most likely, recovery is similar or longer than after open browlift. In fact a recent published article on endoscopic browlifts describes pain, swelling and bruising to last at least 4 weeks in 75% of patients. This is certainly longer than we routinely see after open browlift surgery.

4. Aesthetic outcome: The debate is ongoing… Many facial plastic surgeons feel that the open surgery continues to represent the “gold standard” in forehead rejuvenation. Certainly, softening of frown lines (the “number 11” between the brows) can be more effectively treated using open surgery; the endoscope may be a hindrance for safe muscle manipulation.

Here is an example of a Endoscopic Brow Lift result – published in September 2012 in the premier facial plastic surgery journal (Arch Facial Plast Surg):

Endo-Brow – Published Result. Procedure Not Performed by Dr. Fechner


In comparison, this is one of our patients after Open Browlift:

Before and After of Open Browlift. Procedure performed by Dr. Fechner

What is the message:

1. We do not seek a procedure, but an aesthetically pleasing outcome.

2. The desired look should determine how and with which procedures we can get there.