The Impact of Endoscopic Brow Lift on Eyebrow Morphology, Aesthetics, and Longevity: Objective and Subjective Measurements over a 5-Year Period

Background: The longevity of a brow lift, its morphology, and its contribution to overall facial aesthetics have not been addressed in previous studies using both objective measurements and validated subjective aesthetic scoring systems. Methods: Thirty-one patients with a 5.4-year follow-up after subperiosteal endoscopic brow lift were assessed by (1) objective measurements using computer software, (2) validated regional aesthetic scoring systems, and (3) global aesthetic scoring systems. Results: In part 1, objective measurements confirm a subtle elevation of the brows at less than 5 mm (p < 0.001) that persisted at 5.4 years after surgery in all areas except the tail of the eyebrow. In part 2, subjective regional aesthetic scoring indicated that the dimensional change is small but apparent to observers, and is maintained at 5.4 years; that depressor muscle resection with a brow lift provides a statistically significant reduction in glabellar lines, which is maintained at 5.4 years; and that a brow lift provides temporary improvement in forehead lines but that this improvement relapses to baseline at 5.4 years. In part 3, global aesthetic scores suggest that 64 percent patients are still judged as appearing better 5.4 years after a brow lift than before surgery. Conclusions: This is the first study to provide evidence from both objective measurements and validated subjective aesthetic scoring systems regarding the morphology, benefits, and longevity of endoscopic brow-lift surgery. This demonstrates that a brow lift produces a subtle elevation, with a natural eyebrow morphology close to the original, and with minimal long-term relapse except at the tail of the eyebrow.