Endoscopic Forehead Lift in Periorbital Rejuvenation

To achieve a perfect rejuvenation of the upper third of the face, the eyebrows and upper eyelids should be considered as a continuum. As aging influences the whole face, most patients consulting for a blepharoplasty procedure have a component of eyebrow ptosis with or without asymmetry. Among the variety of surgical techniques to address eyebrow and forehead ptosis, endoscopic forehead lift results in natural results with a high patient and surgeon-reported satisfaction score. However, facial nerve paresis and undercorrection of eyebrow elevation significantly decrease short-term and long-term satisfaction, respectively. The majority of facial nerve paresis cases resolve in terms of weeks to months. Reoperation may be requested for undercorrection and alopecia. Undercorrection should not be regarded as an inherent, inevitable drawback of endoscopic forehead lift. Complete surgical release of tissue at superior and lateral orbital rims is the key to effective, long-lasting outcomes.