Endoscopic Temporal Brow Lift: Surgical Indications, Technique, and 10-Year Outcome Analysis.

BACKGROUND Brow-lift techniques have evolved from the most invasive approach, such as a coronal brow lift, to a minimally invasive technique, such as an endoscopic brow lift over the past century. Although an endoscopic brow lift offers the advantage of being minimally invasive, it suffers from a high recurrence rate. The authors present their experience of combining an endoscopic and temporal brow lift approach for long-lasting results, and discuss the surgical indication, techniques, and outcome of an endoscopic temporal brow lift. METHODS A retrospective review was performed of patients who underwent brow rejuvenation from 2008 to 2018. Demographic, surgical procedure, complication, and outcome data were collected. RESULTS Of the 159 patients who underwent a brow lift from 2008 to 2018, the mean patient age was 59.1 years, and 96 percent were women. Of the 159 patients, 71 underwent endoscopic temporal brow lift; their average age was 56.6 years, with an average body mass index of 22.9 kg/m, and 99 percent were women. The average brow elevation was 1.8 ± 1.7 mm at the midpupil, 1.9 ± 1.8 mm at the medial canthus, and 1.8 ± 1.7 mm at the lateral canthus. There was no difference in the amount of brow elevation at the three locations (p = 0.48). The complication rate for endoscopic temporal brow lift was 1.4 percent, with a mean postoperative follow-up of 231.7 days; one relapse required a repeated procedure. CONCLUSIONS The authors' study reveals that an endoscopic temporal brow lift can elevate the medial and lateral brow effectively, with a low complication rate of 1.4 percent. This technique is an evolution from the more aggressive coronal brow lift and combines the strength of endoscopic and temporal techniques with less invasive incisions. The authors recommend this technique for patients with mild to moderate brow ptosis. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.