Closed, Nonendoscopic, Small-Incision Forehead Lift

As endoscopic techniques made inroads into surgery, one of the first procedures they were adapted to by plastic surgeons was the forehead lift. The “closed” forehead lift procedure has since achieved wide acceptance and exists as a viable alternative to open procedures for many patients. Experience has shown, however, that it is not necessary to use an endoscope to mobilize and release the forehead and modify the corrugator supercilii muscles in “closed” procedures if the anatomy is understood, the operation is appropriately planned, and the corrrugator muscles are modified using a transpalpebral approach. In addition, transpalpebral corrugator myectomy, when used in conjunction with closed mobilization and resuspension of the forehead, provides not only a scheme for the performance of closed foreheadplasty without the need for an endoscope, but a method by which medial brow elevation can be minimized or avoided. This may, indeed, be one the procedure's most important advantages over the endoscopic technique.