Brow lift - Endoscopic approach
Considerations
Anatomy
Facial nerve branches at risk
Frontal and temporal branches
Muscles
Dominant elevator
Frontalis muscle
Horizontal rhytids of forehead
Some consider the corrugator supercilii muscle as a brow elevator
Forehead depressors
Corrugator
Vertical rhytids of glabella
Procerus
Horizontal rhytids of the root of the nose
Orbicularis oculi
Horizontal rhytids at the lateral canthus, aka "crow's feet"
Depressor supercilii
neurovascular bundles
Supraorbital
Supratrochlear
Aesthetic concerns regarding brow position
Ideal brow position is subjective, varies among facial shapes/types, and varies between male versus female
However, certain ideal norms are published
Medial brow position
Aligns with vertical line through alar base
Lateral brow position
Aligns with oblique line from alar base through lateral canthus
Horizontal positions of medial and lateral brow are equal
Apex
Aligns with vertical line through lateral limbus, which corresponds to the medial 2/3 and lateral 1/3 junction
vs aligns with vertical line through lateral canthus
Female position
Above the supraorbital rim with prominent arch
Male position
At the supraorbital rim with less prominent arch and heavier
Relevant articles
1983: Transcoronal eyebrow lift with concomitant upper blepharoplasty
Technique
Preparation
Procedure
Sykes Bone Bridge, 2-0 Maxon
Drill name ***Acorn and bit ***
Post-op
High-Yield
Links
YouTube: 2008 (6:01) Endoscopic Brow Lift by Dr. Lee at Kaiser West LA
YouTube: 2010 (4:51) Endoscopic Brow Lift by Dr. Nassif
YouTube: 2013, 5 part series on Endoscopic Brow Lift by Dr. Bowden