Endoscopic brow and forehead lift: how it works, what the scars are like and how recovery goes

An endoscopic brow lift, also called an endoscopic forehead lift, is an operation that repositions the brows and the tissues of the forehead and temples. Instead of a long incision across the scalp, the surgeon works through several small incisions behind the hairline, using an endoscope: a thin tube with a camera and light that shows the inside of the forehead on a screen.

An endoscopic brow lift is usually considered when the upper third of the face shows signs of ageing, for example:

• brows that sit low or have dropped at the outer end;
• a heavy, hooded look caused by the brow pressing down on the upper eyelid;
• deep horizontal forehead lines;

A traditional open (coronal) brow lift uses one long incision from ear to ear across the top of the head. It gives the surgeon wide access but leaves a longer scar and can cause more numbness of the scalp. The endoscopic approach was developed to achieve a similar lift in a less invasive way.

At the consultation the surgeon assesses brow position, forehead height, eyelid skin and the balance of the whole face. It is important to check whether heaviness of the upper eyelid comes from a low brow, from excess eyelid skin or from both, because this changes the plan.

The operation is performed under general anaesthesia and usually takes one to two hours, longer if combined with another procedure. In broad terms:

1. the surgeon marks the planned lift and makes several short incisions behind the hairline;
2. the endoscope is inserted, and the tissues of the forehead and temples are carefully released;
3. the muscles responsible for frown lines may be softened;

Recovery after an endoscopic brow lift is usually easier than after a full facelift, but it still takes time. Swelling and bruising can spread down to the eyelids and cheeks in the first days. Many people feel ready for office work and social plans after about 10 to 14 days, and the final look settles over a few months.

A brow lift treats the upper third of the face only. If sagging also affects the cheeks, jawline or neck, it is often combined with an SMAS facelift, or performed as part of a full (circular) facelift, so the face is rejuvenated evenly. As general information, a brow lift is sometimes combined with upper eyelid surgery when there is also excess eyelid skin; whether this is needed is decided at the consultation after examining the eyelids.

City Medical Centre performs surgical facelifts only: the SMAS facelift, the full (circular) facelift, the neck and lower face lift and the endoscopic brow and temple lift. The endoscopic lift is done through tiny incisions hidden in the hairline; it repositions the brows, smooths forehead and frown lines and opens up the look. At the consultation the surgeon assesses your upper face and advises whether a brow lift alone or a combination suits you best. You can read more on the facelift page.