Face

Endoscopic Brow Lift

This procedure is helpful for patients who are experiencing wrinkling in the forehead, sagging eyebrows, and prominence of vertical wrinkles between the eyebrows. Some patients wish to correct what they believe is an angry or stern appearance of their forehead and eyebrows.

Patients in good general health who desire a more youthful and rested appearance of the forehead, brows and upper eyelids may benefit from this procedure.

Patients with more significant medical problems are advised to undergo medical clearance before surgery.

Many patients undergo regular injections of Botox into frown lines between the eyebrows. While an effective treatment for these overactive corrugator muscles, the effect generally wears off after 3-4 months. Some patients elect to undergo endoscopic brow lift surgery in an effort to more permanently address these hyperactive muscles.

Historically, brow lift surgery involved an incision across the crown of the scalp from ear to ear (coronal brow lift). While allowing for effective brow rejuvenation, some patients experienced troubling numbness or itching of the scalp relating to the division of multiple small sensory nerve branches which course from the brow area to the scalp. While some of this resolved over time, some did not.

With the advent of endoscopic techniques in the 1990’s, endoscopic forehead rejuvenation became a reality. This procedure allows for effective brow rejuvenation utilizing relatively small incisions hidden within the scalp. Permanent sensory changes in the scalp are very uncommon.

Patients with a high hairline should be aware that some elevation of the hairline occurs with this procedure.

Performed on an outpatient basis under general anesthesia at Houston Methodist St. John Hospital, incisions for the endoscopic forehead lift are within the hair; endoscopic visualization allows for accurate dissection, and modification of frowning musculature, while reducing the likelihood of scalp numbness . During the procedure, forehead tissues are lifted and repositioned, and the corrugator muscles that cause frown lines are weakened. Firm fixation helps ensure long-lasting results.

Most patients undergoing this procedure are discharged in the afternoon after surgery.

Patients undergoing concomitant surgery, such as facelift or body contouring surgery have the option for an overnight stay.

While this procedure is sometimes performed under local anesthesia in outpatient facilities, Dr. Casso recommends general anesthesia at Houston Methodist St. John Hospital, which provides the patient with a comfortable surgical experience, and close, expert nursing attention, treatment of postoperative nausea, if present, and immediate medical attention in the event of any unforeseen emergency. The option for surgery in a full-service, state-of-the-art facility such as Houston Methodist St. John provides patients with a measure of safety and security which is unmatched.

Initial discomfort is controlled with oral medication. Patients are seen frequently in the postoperative period. Cool packs are applied to the eyes, and patients sleep with the head of bed elevated to minimize eyelid swelling.

Sutures are removed within 10 days, and most swelling or bruising is gone in 10 to 14 days. Most patients can return to light activities within 1-2 weeks. Vigorous exercise is deferred for about a month.

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