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.

Read full article…

The Fat Has It – For the Whole Face

Written by Frank P. Fechner, MD

When we thoroughly study the changes associated with facial aging we begin to understand that it actually is as straight forward as we may believe. One insight into this enigma of aging is gained by comparing the different procedures used, both surgically and non-surgically, to counteract changes that time has brought. Although fat grafting was described before, it was only about 8 years ago that a few aesthetic surgeons used fat injections to provide volume to the face for rejuvenation. Until then, the maxim was “lifting – lifting – lifting” until normalcy was entirely removed from a person’s face.

Although perfection is still not available, I believe that we moved much closer to where we really want to be. My view has been that the answer lies not in face lifting or volume. Rather, it is the combination of tightening what has dropped and volumizing what is sunken that will provide the most logical approach with the most natural looks. As a result from this revelation, I perform about 98% of facelifts in combination with some fat grafting.
Read full article…

How to Prevent a High Forehead with Brow Lift

Written by Frank P. Fechner, MD

The hairline and size of the forehead are very important to discuss before any browlift procedure. Most browlifts are performed in women; browlifts in men requires an entirley different discussion.

Most techniques used for brow lifting (i.e. endoscopic brow lift, coronal browlift) will, by definition, raise the patient’s hairline. Because a somewhat high hairline is common in most women, approximately 80% of our patients we plan the procedure so that the hairline will be constant. When now the  brows are lifted CONSERVATIVELY, we effectively decrease the height of the forehead which is desirable. This procedure is called a trichophytic (hairline) browlift.

If the hairline is already very high, hairline lowering can be achieved by advancing the scalp forward. It is a little more work to accomplish this but can be of great value in the right situation.

The scar line after these procedure heal very well if planned and sutured meticulously.