Endoscopic forehead rejuvenation for the oral and maxillofacial surgeon

Abstract

Ptotic brow position, upper lid skin redundancy, and forehead rhytids are among the most common complaints verbalized by patients seeking cosmetic rejuvenation of the upper face. Upper lid blepharoplasty, combined with numerous open forehead lifting techniques, has been used for years to obtain predictable surgical results. Unfortunately, many patients are hesitant to undergo extensive open lifting procedures. Failure to identify or treat the full range of problems associated with the aging upper face leads to less than optimal results and patient dissatisfaction. During the past decade, endoscopic forehead lifting has dramatically changed the surgical treatment of patients seeking cosmetic rejuvenation. The advantages are decreased postoperative morbidity, virtual elimination of visible scarring, and increased patient acceptance with comparable clinical results to open techniques. The oral and maxillofacial surgeon, using anatomic knowledge based on the coronal flap approach to NOE trauma and expertise in temporomandibular joint arthroscopic surgery can rapidly incorporate endoscopic forehead lifting into his or her cosmetic practice. Incorporating the use of Botox in the technique can minimize the amount of relapse seen with the endoscopic brow lift. As with most new techniques, diagnostic knowledge, patient selection, use of straightforward, reliable surgical techniques, prompt recognition, as well as management of complications lead to predictable surgical success.