Brow lift results are supposed to look natural—i.e., there is no visible scar, the brows are positioned and reshaped based on critical factors such as gender and facial features, and the skin appears smooth with no or very minimal creases.
The traditional technique uses a long incision about 2-3 inches behind the hairline that goes from ear to ear. It allows the surgeon to remove a small piece of skin to correct the sagging appearance of the forehead and brow, eliminate the muscle tissue that is causing the creases, and reshape and reposition the brows.
But for additional support, experts at the California Surgical Institute suggest the use of fixation devices to re-suspend the forehead tissue and brow muscles. Some surgeons use Endotine (which is an absorbable prong-like device), permanent or absorbable sutures, or screws.
Endotine is particularly popular in Los Angeles plastic surgery due to its impressive safety record. This absorbable device has multiple prongs that secure the forehead tissue to the small hole in the forehead bone.
Before the body absorbs completely the Endotine system, a strong muscle adhesion is created between the brow tissue and the forehead bone. Hence, the results are perceived to be longer and more stable as compared to brow lift without any fixation device.
One of the disadvantages of this device is that it can be felt through the skin, at least temporarily. Also, it is a little more expensive than the other fixation devices.
Other surgeons prefer the use of permanent sutures to re-suspend the brow muscle and forehead tissue suggesting that this technique provides stronger support than Endotine and absorbable stitches.
Despite varying views on which provides the strongest support among the fixation devices, the truth is that the surgeon’s qualifications—i.e., board certifications, training, and experience—are more critical factors than his preferred “technologies” and techniques.
It is important to note that good brow lift results are primarily achieved by a high level of technical skills combined with artistic competence on the surgeon’s part. In addition, it is of critical importance that he understands the nuances between male and female surgeries and the gender-based ideals of beauty.
Medical literature suggests that the longevity of brow lift results greatly varies from patient to patient (3-10 years) not just because of the techniques utilized at the time of surgery. Skin elasticity, sun exposure, skin care regimen, diet, and smoking will all have their effects as well.