Background: Endoscopic forehead lift has become the standard of care for treatment of brow malposition. Different options on tissue fixation have been proposed in order to obtain adequate long-lasting results.

Purpose: To evaluate short and long-term results obtained with the fixation technique preferred at our institution.

Methods: After subperiosteal undermining at the forehead, periosteal release at the supraorbital rims and complete ablation of the brow depressor muscles, a fixation technique was performed in all patients undergoing endoscopic forehead lift between 1994 and 2004. An internal fixation system is placed with absorbable sutures by approximating the periosteum-galea unit at each incision point until achieving the desired level of elevation. An external fixation system is created by suture-loop approximation of anterior and posterior rows of staples at incision points. A minimum follow-up of 3 years is warranted for all patients. Preoperative and postoperative short and long-term pictures were reviewed and compared for determination of brow position.

Results: A total of 634 patients underwent endoscopic forehead lift during the time of the study. Postoperative morbidity was 5.8%. Only 1.5% of patients showed a relapse of brow ptosis at long-term follow-up. No patients showed signs of overcorrection.

Conclusions: A simple temporary fixation method is appropriate for obtaining correction of brow ptosis and achieving long-lasting results.