Endoscopic browlift with deep temporal fixation only

Abstract

Endoscopic browlifting techniques have been progressively refined through experience and improvements in equipment. In general, the temporal dissection and temporal fixation have been standardized; however, different options for forehead dissection are available. Subperiosteal dissection with release (elevation, incision, and spread) of the periosteum, or subgaleal dissection and release of brow depressor musculature to the supraorbital rim are both effective techniques used in endoscopic browlifts. Methods of bony fixation remain a controversial topic since there are numerous methods. Some of these methods include absorbable and nonabsorbable screws, bone tunnels with sutures, fixation to soft tissue using absorbable attachment devices such as Endotine or Ultratine (MicroAire, Charlottesville, VA), and fibrin glue. In many, particularly younger patients, we advocate deep temporal fixation only (DTFO) without bone fixation.