Hypothesis: For most patients, an endoscopic browlift is preferable to a traditional open approach.
Aging of the upper one third of the face is primarily the result of gravity and loss of elastic tissue support caused by collagen changes in the dermis. This leads to brow ptosis, which can give a crowded or angry appearance to the eye and brow complex. In addition to brow ptosis, the aging brow and forehead may display "hyperkinetic" or "dynamic" facial lines. These furrows are caused by the repeated pull on the skin of underlying facial mimetic muscles. Chronic upward contraction of the frontalis muscle leads to horizontal forehead creases. Repeated frowning overuses the procerus and corrugator supercilii muscles, which causes the development of horizontal creases at the root of the nose and vertical interbrow furrows, respectively.
Koch RJ. Endoscopic Browlift Is the Preferred Approach for Rejuvenation of the Upper Third of the Face. Arch Otolaryngol Head Neck Surg. 2001;127(1):87-90. doi:10.1001/archotol.127.1.87