Preservation Brow Lift (003): 18 Years of Experience With a Limited Incision, Nonendoscopic, Corrugator-Sparing Technique for Correction of Brow Ptosis

Background: Endoscopic brow lift is presently the procedure of choice for forehead lifting. It includes brow-depressor muscle resection, utilizes 4 to 5 incisions, and uses an endoscope. A recent trend among patients interested in any aesthetic surgery is to seek less invasive interventions while maintaining acceptable results. Objectives: A preliminary report of a short (45 min), minimally invasive, and safe brow lifting surgical technique with durable results, titled preservation brow lift "003," is presented as a possible mini-invasive alternative to the conventional endoscopic brow lift. Methods: The preservation brow lift "003" name refers to "0" muscle resection, "0" endoscope use, and "3" short incisions. All patients who underwent preservation brow lift "003," by a single surgeon (N.F.) over an 18-year period, were reviewed retrospectively. In this article, the forehead surgical anatomy is first presented in a simplified and practical manner. Secondly, the step-by-step surgical approach is revealed. Thirdly, the results are analyzed, and the examples are demonstrated. Results: There were a total of 381 cases reviewed. The mean age was 56.5 years. The mean follow-up period was 20.8 months. The mean operative time was ∼45 min. The overall surgical outcome was favorable. There were no major complications. There were no incidences of temporal branch paresis or paralysis. There were no cases of hematomas necessitating a return to the operating room. Five hypertrophic scars (1.3%), 6 cases of dehiscence of incisions (1.5%), 2 cases of persistent scalp paresthesia (0.5%), and 9 cases of temporary scalp paresthesia (2.4%) were encountered. Finally, 2 cases of partial relapse of brow ptosis (0.5%) were revised. The majority of patients (93%) reported being satisfied (62%) or very satisfied (31%) with their overall results, according to their feedback at the most recent visit. Conclusions: The preservation brow lift "003" is a short, muscle-preserving, and safe technique for forehead lifting, consistently producing long-term results, with limited adverse events. It deserves to be considered as an alternative to the endoscopic brow lift approach.