Upper facial surgery: simultaneous hairline-lowering surgery during endoscopic forehead lifting

Background Endoscopic forehead lifting is one of the most common procedures in the field of upper facial surgery. The upper third of the face determines the facial expression and plays a key role in the appearance of facial youth. After the forehead, a high hairline is one of the most important features of the upper third of the face contributing to age identification. The combined evaluation of these two features should be a basic premise of upper facial surgery. Methods The authors present a surgical sequence in which endoscopic forehead lifting and lowering of the high hairline by means of a scalp flap advancement are carried out during the same operation. The incision line is located along the hairline. After the scalp and forehead flap are moved, they are fixed using the bone tunnel fixation method. Results In total, 194 patients were treated with endoscopic forehead lifting and simultaneous hairline lowering between August 2018 and July 2020. On average, the patients’ hairlines were 18 mm lower and their eyebrows were 5 mm higher. No patients had serious complications. Conclusions Endoscopic forehead lifting and simultaneous hairline lowering surgery make it possible to address the entire upper third of the face in a single facial rejuvenation operation.