Laboratory Studies

Perform routine preoperative studies, as indicated by an anesthesiologist and/or hospital guidelines.

Imaging Studies

Routine preoperative photographs are as follows:

Frontal view
Three-quarter view (bilateral)
Lateral view (bilateral)
Frowning view (frontal)

Other Tests

Perform appropriate tests as indicated by the medical history.

Diagnostic Procedures

Visual field testing can be performed if lateral hooding with superior visual field deficit secondary to brow ptosis is suspected.

Treatment & Management

Hafezi F, Naghibzadeh B, Nouhi A, Naghibzadeh G. Eliminating frown lines with an endoscopic forehead lift procedure (corrugator muscle disinsertion). Aesthetic Plast Surg. 2011 Aug. 35(4):516-21. [QxMD MEDLINE Link].
Patel BC, Malhotra R. Mid Forehead Brow Lift. StatPearls. 2021 Jan. [QxMD MEDLINE Link]. [Full Text].
Angelos PC, Stallworth CL, Wang TD. Forehead lifting: state of the art. Facial Plast Surg. 2011 Feb. 27(1):50-7. [QxMD MEDLINE Link].
Guillot JM, Rousso DE, Replogle W. Forehead and scalp sensation after brow-lift: a comparison between open and endoscopic techniques. Arch Facial Plast Surg. 2011 Mar-Apr. 13(2):109-16. [QxMD MEDLINE Link].
Vasconez LO, Core GB, Gamboa-Bobadilla M, Guzman G, Askren C, Yamamoto Y. Endoscopic techniques in coronal brow lifting. Plast Reconstr Surg. 1994 Nov. 94(6):788-93. [QxMD MEDLINE Link].
Puig CM, LaFerriere KA. A retrospective comparison of open and endoscopic brow-lifts. Arch Facial Plast Surg. 2002 Oct-Dec. 4(4):221-5. [QxMD MEDLINE Link].
Dyer WK Jr., Yung RT. Botulinum toxin-assisted brow lift. Facial Plast Surg. 2000 Aug. 8(3):343-54.
Byrne PJ. Efficacy and safety of endotine fixation device in endoscopic brow-lift. Arch Facial Plast Surg. 2007 May-Jun. 9(3):212-4. [QxMD MEDLINE Link].
Honig JF, Frank MH, Knutti D, de La Fuente A. Video endoscopic-assisted brow lift: comparison of the eyebrow position after Endotine tissue fixation versus suture fixation. J Craniofac Surg. 2008 Jul. 19(4):1140-7. [QxMD MEDLINE Link].
Romo T 3rd, Sclafani AP, Yung RT, McCormick SA, Cocker R, McCormick SU. Endoscopic foreheadplasty: a histologic comparison of periosteal refixation after endoscopic versus bicoronal lift. Plast Reconstr Surg. 2000 Mar. 105(3):1111-7; discussion 1118-9. [QxMD MEDLINE Link].
Massoud KS, Aboelatta YA. Concentric double cables fixation as an alternative suspension method for the endoscopic forehead lift. J Plast Surg Hand Surg. 2015 Jun. 49 (3):141-6. [QxMD MEDLINE Link].
Jones BM, Lo SJ. The impact of endoscopic brow lift on eyebrow morphology, aesthetics, and longevity: objective and subjective measurements over a 5-year period. Plast Reconstr Surg. 2013 Aug. 132(2):226e-238e. [QxMD MEDLINE Link].
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Media Gallery

Endoscopic forehead lift. Normal female brow position with the brows at or slightly above the orbital rim at the medial aspect and arching superior to varying degrees at the lateral aspect.
Endoscopic forehead lift. Normal male brow position with the brows at or slightly above the orbital rim with less of an arch than that of the brows in females.
Endoscopic forehead lift. Worried or angry look and brow asymmetry.
Endoscopic forehead lift. Deep glabellar frown lines and hooding with a superior visual field deficit.
Endoscopic forehead lift. The brow is manually held at the desired level of elevation. (See Images 6-7 for continuation of the marking procedure.)
Endoscopic forehead lift. Continuing from Image 5, the brow is then released and allowed to drop with gravity while the surgeon holds the marking pen against the skin. The resulting mark indicates the desired elevation. (See Images 5-7 for the beginning and end of the marking procedure.)
Endoscopic forehead lift. Continued from Image 6, the marking is repeated across the brow to determine the desired amount of elevation, medially and laterally and also right and left. (See Image 5 for the beginning of the marking procedure.)
Endoscopic forehead lift. Photos of a patient prior to (left) and 1 year after (right) the procedure.
Endoscopic forehead lift. Photos of a patient prior to (left) and 1 year after (right) the procedure.
Endoscopic forehead lift. Photos of a patient prior to (left) and 1 year after (right) the procedure.
Endoscopic forehead lift. Photos of a patient prior to (left) and 1 year after (right) the procedure.
Endoscopic forehead lift. Photos of a patient prior to (left) and 1 year after (right) the procedure.
Endoscopic forehead lift. Photos of a patient prior to (left) and 1 year after (right) the procedure.

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Author

Keith A LaFerriere, MD Clinical Professor, Fellowship Director, Department Otolaryngology-Head and Neck Surgery, University of Missouri-Columbia School of Medicine

Keith A LaFerriere, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, Missouri State Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Matthew A Kienstra, MD Clinical Faculty, Department of Otolaryngology/Head and Neck Surgery, University of Missouri; Director, Facial Trauma Services, St John's Health System; Consulting Physician in Facial Plastic Surgery, St John's Clinic

Matthew A Kienstra, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Rhinologic Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Dean Toriumi, MD Associate Professor, Department of Otolaryngology, University of Illinois Medical Center

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan, Ryte, Neosoma, MI10<br/>Received income in an amount equal to or greater than $250 from: , Cliexa;;Neosoma<br/> Received ownership interest from Cerescan for consulting; for: Neosoma, eMedevents, MI10.

Additional Contributors

Jennifer P Porter, MD Assistant Professor, Department of Otorhinolaryngology, Division of Communicative Science, Chevy Chase Facial Plastic Surgery

Jennifer P Porter, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, Texas Medical Association

Disclosure: Nothing to disclose.

Acknowledgements

Timothy F Kelley, MD Assistant Clinical Professor, Department of Otolaryngology-Head and Neck Surgery, University of California at Irvine Medical Center

Timothy F Kelley, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery and American Academy of Otolaryngology-Head and Neck Surgery

Disclosure: Nothing to disclose.