Endoscopic forehead and brow-lift.

The endoscopic method of rejuvenating the brow-forehead complex has evolved into the procedure of choice for many aesthetic surgeons. Safe and reliable application of the endoscopic technique depends on several important factors. These include technical expertise with the endoscopic equipment, understanding of the surgical goals in patients seeking rejuvenation in the forehead region, and detailed comprehension of the steps involved in altering forehead anatomy during endoscopic lifting. In this article, the senior author reviews his experience with the endoscopic forehead-lift and delineates a stepwise approach to this technically challenging operation. The text also highlights important details with respect to patient care, endoscopic equipment, and surgical anatomy. "Keller's rules of fours" are introduced to summarize surgical pearls of the endoscopic forehead- and brow-lift.