ENDOSCOPIC FOREHEAD LIFT
The upper third of the face is an important aesthetic unit which is uniquely individual and crucial to overall
facial balance and harmony. Beauty and attractiveness in this facial area is defined by the proportions of the
forehead, as well as by the specific characteristic features and relationships of the hairline, eyebrows and eyes.
The appearance of the upper face is influenced by static and dynamic components, and these unique features
portray identity, emotion and expression. The hairline defines and frames the face and forehead, whereas the
eyebrows overshadow or accentuate the eyes. The eyes are unique with respect to shape, size, angulation, color
and expression. The eyes, being the windows to the soul, communicate, interact and project personal emotions.
The anatomical features of the upper one-third of the face are specific with respect to age, gender and ethnicity.
Women typically are considered attractive by soft angles and features, specifically with a low feathered hairline,
elevated and slightly arched brows, and large, angulated and expressive eyes. Men typically have a prominent
forehead with chiseled features, a higher hairline, deep set eyes, and low horizontally placed eyebrows.
With the aging process, hairlines soften and drift upward, expressive creases take permanence, and the brows
descend and encroach upon the eyes. This loss of shape and size of the eye is influenced by brow descent and
excessive overriding eyelid skin. These anatomical aging changes may inadvertently project a sad or sullen,
angry or fatigued appearance to the eyes. In response, individuals often compensate by elevating the brows to
counteract the effects of downward muscle pull, gravity, and the aging process resulting in secondary
midforehead furrows and creases. Additionally, repetitive squinting or frowning creates an irregular furrowed
brow with vertical lines, interbrow fullness, and a residual stern or harsh appearance.
Options to correcting the aging forehead, brow and upper eyelid include Botox therapy, injectible fillers,
forehead lifting techniques (foreheadplasty) and upper eyelid surgery (blepharoplasty). In aesthetic surgery, the
definitive goal is to create balance while minimizing the evidence of surgical technique. Surgical correction of
the upper third of the face has evolved into a very elegant technique called the endoforehead lift which
aesthetically improves the forehead by tightening the redundant skin, elevating the eyebrows to a more youthful
position, softening the folds and creases, and opening the appearance of the eyes creating a more youthful, alert
and refreshed appearance. Endoscopic forehead surgery utilizes small entry incisions to correct these aging
features. It is an option to the traditional open forehead technique which entails a long scalp incision and the
additional risks of hair loss, scar visibility, post surgical itching and scalp numbness. The endoscopic forehead
lift is indicated in the younger patient, for those with minimal skin redundancy and forehead aging, individuals
with thinning hair patterns, and the bald male patient. It does, however, elevate the hairline since the forehead
and scalp is shifted upward and posteriorly to a more rejuvenated level. Typically, the cosmetic and functional
outcome of the endoscopic brow lift is obtained with less recovery time.
The endoforehead lift is performed in our surgical facility on an outpatient basis. Intravenous sedation is
administered to achieve a deep level of conscious sedation and comfort. The technique is performed in a
“closed manner” by several, small, indiscernible scalp incisions through which delicate surgical instruments are
passed. The forehead creases and frown lines may be addressed by modifying or weakening selective muscle
groups, and the skin and eyebrows are lifted, repositioned, and secured with small sutures, screws or plates.
The scalp incisions are closed and the forehead is gently secured with a circumferential scalp dressing after the
procedure.
Endoscopic Forehead Lift
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The initial healing process from endoscopic forehead surgery takes several days as there is often variable
degrees of bruising and swelling. Typically, the swelling and bruising may occur around the eyes and into the
lower portions of the face. Ice, head elevation and positioning often remedy these responses to surgery
Tightness of the forehead and discomfort is well controlled with analgesics. You will be followed closely after
your surgical procedure to provide comfort and assistance in scalp and forehead care. Please understand that
there is an emotional recovery period to any surgery, as downtime and post surgical facial swelling and
discoloration is expected prior to achieving your final cosmetic result.
As with any surgical procedure, although infrequent, certain risks may occur with endoscopic forehead lifting.
Even when the surgeon utilizes the utmost skill, technique and judgment during this procedure, postoperative
complications can occur. The majority of patients experience some relaxation upon resolution of the swelling
after the endoforehead lift resulting in mild forehead/brow descent as skin stretches and relaxes. Potential risks
may include infection and bleeding, suture extrusion or foreign body reaction, irregularities and unevenness,
incisional scarring with hair loss, forehead and scalp numbness (temporary or permanent), forehead weakness
(temporary or permanent), brow asymmetries, poor response to therapy, forehead and scalp irregularities and
others. Typically, if your brows are asymmetrical they will remain asymmetrical after this technique. The final
aesthetic outcome from endoscopic forehead lifting surgery cannot be guaranteed since response to surgery and
healing is unique and varies individually.
Since endoscopic forehead lifting is for cosmetic purposes, the fee for this surgery will include the surgeon,
anesthesia provider and surgery center costs, all required in advance of the scheduled procedure. These fees are
non-refundable and if additional secondary surgery is requested, this will entail additional patient expense.
The majority of patients are pleased with the outcome of endoscopic forehead techniques. It is important to my
staff and I that you are well informed and comfortable with this technique prior to undertaking the aesthetic
procedure. My staff and I are available for you to address any questions or concerns prior to undertaking this
procedure and we shall offer you any support you will need throughout your recovery period.
Please acknowledge your review and understanding of this information by providing your signature below.
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Patient Signature
______________________
Date
___________________________________
Peter M. Schmid, D.O.
______________________
Date
PMS/kdw-06/10/03
Endoscopic Forehead Lift
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