Question

Describe the planning and operative steps of endoscopic forehead lift.

Hint:

An endoscopic forehead lift offers a less invasive alternative to traditional brow lifts, with smaller incisions, quicker recovery, and minimal scarring, making it a preferred choice for many patients seeking facial rejuvenation.

Answer 1

An endoscopic forehead lift (also known as a brow lift) is a minimally invasive surgical procedure designed to lift and reposition the forehead skin, brows, and surrounding tissues to reduce the appearance of sagging, lines, and wrinkles, and rejuvenate the upper face.
Step 1: Preoperative Planning:
1. Patient Evaluation: A thorough evaluation of the patient’s facial anatomy, skin quality, and overall health is necessary. The surgeon assesses the degree of brow ptosis, forehead wrinkles, and any asymmetry that needs correction.
2. Discussion of Goals: The surgeon and patient discuss the expected outcomes of the procedure, the type of anesthesia to be used, and any risks or complications involved. The patient should have realistic expectations for the final results.
3. Surgical Marking: Before surgery, the surgeon marks the desired incision locations and the areas where lifting and repositioning are required. The incision is typically placed within the hairline to minimize visible scarring.
Step 2: Operative Steps:
1. Anesthesia: General anesthesia or local anesthesia with sedation is typically used for an endoscopic forehead lift. This ensures the patient is comfortable and pain-free during the procedure.
2. Incisions: Several small incisions (usually 3-5) are made within the scalp, behind the hairline. These incisions are small, and their placement ensures that any scarring is hidden within the natural hairline.
3. Insertion of Endoscope: The endoscope is inserted through one of the incisions. The camera at the end of the scope provides real-time visualization of the forehead and underlying muscles.
4. Dissection and Release of Tissue: Through the endoscopic camera, the surgeon carefully dissects and releases the tissues causing the brow to sag. The muscles responsible for forehead wrinkles and brow descent are also manipulated to lift the brow.
5. Repositioning and Fixation: The brow and forehead are repositioned to the desired height. Sutures or endoscopic fixation devices are used to secure the tissues in place.
6. Closure of Incisions: The small incisions are closed using absorbable sutures or staples. The patient’s hairline area is combed to conceal the incisions, and a dressing is applied to the area.
Step 3: Postoperative Care:
1. Immediate Care: Postoperative care includes applying cold compresses to reduce swelling, and the patient may be prescribed pain relievers and antibiotics to minimize discomfort and prevent infection.
2. Follow-up Appointments: The patient is typically seen in 1-2 weeks to remove any sutures and evaluate the healing process. Swelling and bruising usually subside within a few weeks, and the final results become more apparent after several months.
3. Avoidance of Strenuous Activity: Patients are advised to avoid strenuous physical activities, including heavy lifting, for several weeks to ensure proper healing.