Since the first published descriptions of the endoscopic browlift, there has been a strong trend toward approaching the upper third of the face via minimally invasive techniques. With botulinum toxin A currently available for glabellar and frontal rhytids, indications for browlift are changing. Despite considerable debate over the ideal plane of elevation for endoscopic brow lifts, we have continued to be satisfied with the long-term results of endoscopic subgaleal browlift in our patient population. The senior author's use of absorbable fixation anchors has added a useful dimension to the procedure, allowing greater ease of accurate brow positioning, secure fixation of the forehead flap during healing, and the advantage of an absorbable temporary device. Documented soft tissue mechanics of the various browlift procedures in previous cadaveric studies, as well as the longstanding clinical experience of the senior author, lead us to conclude that subgaleal approach to endoscopic browlifting with absorbable fixation is an excellent approach.
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