Vertıcal Internal Brow Suspensıon: A Technıque to Avoıd Lateral Relapse After Endoscopıc Brow Lıft.

Background: Endoscopic brow lift is an integral component of upper face surgical rejuvenation protocols. Lateral relapse is one of the leading causes of dissatisfaction after endoscopic brow lift.

Objectives: This study introduces and evaluates the Vertical Internal Brow Suspension (VIBS), a novel fixation technique designed to prevent lateral brow relapse following endoscopic brow lifts.

Methods: A retrospective review was conducted on 118 consecutive endoscopic brow lift cases performed by the author between January 2019 and June 2024, using the VIBS technique. Additionally a subgroup of 29 patients who underwent isolated endoscopic brow lifts, with at least one year of follow-up, were included in a quantitative analysis of long-term brow position and forehead height.

Results: Significant increases in brow height across all measurement levels (P<0.001) were observed in the quantitative analysis subgroup. No significant change in forehead height was noted (P=0.927). The VIBS technique also beneficially reduced apparent forehead height in patients with initially high foreheads. Frontal suture extrusions (6.8%) and temporary hairloss around scalp incisions (5.1%) were the most common complications observed from the retrospective analysis of 118 patients.

Conclusions: The VIBS technique effectively prevents lateral brow relapse, achieving stable lateral brow elevation. It is a safe technique with minor complications. It addresses one of the longstanding challenges of the endoscopic brow lift surgery, representing a valuable advancement in upper face rejuvenation procedures.