This article describes new innovations in the endoscopic treatment of the ptotic brow and temple. Extensive release of upper midface ligamentous structures and wide undermining of the orbicularis oculi are maneuvers that have been added to the standard brow lift procedure. Suspension sutures have improved brow tail and cheek fat elevation. Radiofrequency instrumentation and fibrin glue have allowed the minimization of tissue trauma during depressor muscle lysis and brow and temple fixation. Brow lowering techniques also have been developed to reverse the effects of aggressive endoscopic and coronal brow lifting.
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