Customized Endoscopic Male Forehead/Eyebrow Lift.

[BACKGROUND] Higher hairline, thicker/heavier skin, and stronger eyebrow depressor muscles make the male forehead/eyebrow lift (FEL) challenging.

[OBJECTIVES] The aim is to demonstrate senior author's 20-year experience with customized endoscopic FEL techniques in male subjects.

[METHODS] This is a surgical technique demonstration and chart review study on consecutive male subjects with customized endoscopic FEL (2007-2022). The customized technique was selected based upon the presence and severity of high hairline, thick/heavy forehead skin, forehead wrinkles, and subjects' perspective on the magnitude of the lift effect and skin incisions. Different scalp incisions and selective pull and fix techniques were used for zone 1 (central forehead), 2 (paramedian), and 3 (temporal) lifts. Last follow-up patient's satisfaction (visual analogue score, VAS) was recorded.

[RESULTS] Out of 895 FEL procedures during the study time frame, 107 (13.2%) were male with a mean age of 47.9 (27-79). Conventional endoscopic lift was performed in 48 (44.8%) and open pretrichial FEL in 38 (35.5%). Customized endoscopic FEL was performed in 21 (19.6%) in whom the most common scalp incision was retrotrichial vertical (57.1%) for the zone 1, pretrichial skin excision (71.4%) for the zone 2, and retrotrichial skin excision (90.4%) for the zone 3 lift. Simultaneous upper blepharoplasty was performed in all but one patient. Mean satisfaction score was 97.5 (100-VAS) at mean follow-up of 25.2 months.

[CONCLUSIONS] A customized endoscopic FEL technique is required in almost 20% of male subjects requesting a FEL procedure which resulted in high patient satisfaction.

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