Vertical Internal Brow Suspension: A Technique to Avoid Lateral Relapse After Endoscopic Brow Lift

Abstract 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 In this study I introduce and evaluate the vertical internal brow suspension (VIBS), a novel fixation technique designed to prevent lateral brow relapse following endoscopic brow lift. Methods A retrospective review was conducted on 118 consecutive endoscopic brow lift cases performed by the author between January 2019 and June 2024 with the VIBS technique. Additionally, a subgroup of 29 patients who underwent isolated endoscopic brow lifts with at least 1 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 < .001) were observed in the quantitative analysis subgroup. No significant change in forehead height was noted (P = .927). The VIBS technique also beneficially reduced apparent forehead height in patients with initially high foreheads. Frontal suture extrusions (6.8%) and temporary hair loss around scalp incisions (5.1%) were the most common complications observed in 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 long-standing challenges of the endoscopic brow lift surgery, representing a valuable advancement in upper face rejuvenation procedures. Level of Evidence: 4 (Therapeutic)