Forehead Lift With Cross-frontal Scalp Anchorage.

Background: Over the past decade, facial aesthetics has gained popularity, with a notable increase in upper facelift procedures. Despite the popularity of brows and forehead lifts, the optimal fixation technique remains controversial. Common methods involve suturing of the temporal fascia or using monocortical miniscrews anchored to the frontal bone. Other options include the use of microscrews, percutaneous fixation posts, Kirschner wires, Mitek anchors, Endotine devices, bone tunnels, miniplates, and fibrin glue.

Objectives: The aim of this study was to present a method in which pulling force is transmitted directly to the brow/forehead skin through subperiosteal dissection, utilizing the scalp as a suspension point.

Methods: This retrospective study included 129 patients who underwent surgery between May 2022 and June 2023. Patients with less than 12 months of follow-up, irregular follow-up, or a history of botulinum toxin or brow contouring were excluded. Preoperative and 12-month postoperative photographs were evaluated with the Brow Positioning Grading Scale.

Results: No persistent dimples were observed; on average, dimples resolved within 4 weeks. Postoperative edema, erythema, and bruising resolved within 6 days. Complications, including chemosis, stitch-site infections, muscle weakness, paresthesia, and asymmetry, were all resolved. Significant improvements in eyebrow height and Brow Positioning Grading Scale scores were noted at the 12-month follow-up visit.

Conclusions: This technique offers a natural upper face rejuvenation option that is particularly suitable for patients with lower brow positions or of advanced age.

Level of evidence: 4 (therapeutic):