The Benefits of Combining Endoscopic Forehead Lift and Forehead Reduction

Hello! I am Dr. Kwon Joon-seong, a plastic surgeon at ATOP Plastic Surgery.

Today, I will discuss the reasons why I recommend forehead reduction when performing endoscopic forehead lift surgery.

Endoscopic forehead lift surgery is performed in the 20s and 30s to widen the distance between the eyebrows and eyes, improving the eye appearance. For middle-aged and older patients, it is performed to lift drooping eyebrows and improve forehead and glabellar wrinkles.

Endoscopic forehead lift involves making incisions inside the scalp, so over time, the scars become almost invisible. Although there is individual variation, after about two weeks, signs of the surgery are hardly noticeable, making it a suitable option for those who want to achieve a naturally beautiful look, in line with current trends.

However, one drawback of this forehead lift surgery is that it can make the forehead appear wider or may cause it to widen.

Q: Does the forehead widen after endoscopic forehead lift surgery?

A: The area of the forehead after forehead lift surgery can vary depending on the individual. In some cases, the forehead may widen, while in others, there may be little difference. The forehead lift surgery involves separating the forehead tissue from the underlying forehead bone and pulling it upward for lifting.

During this process, the forehead tissue is tightly pulled. If the skin on the forehead is elastic (tight skin), there will be no difference in the length of the forehead from the hairline to the eyebrows after surgery, and the forehead will not appear wider. However, if the forehead is more recessed, the hairline may rise, making the forehead look longer.

In cases where there are many wrinkles and reduced elasticity (loose skin), the forehead skin will stretch as it is pulled, resulting in an increased length from the eyebrows to the hairline, which can make the forehead appear wider.

If you want to undergo an endoscopic forehead lift but are worried about having a wide forehead or if you already have a wide forehead, combining it with forehead reduction surgery can help address these concerns.

Forehead reduction surgery involves making an incision along the hairline and pulling the scalp forward to shorten the length of the forehead. While it can be done as a standalone procedure, performing it simultaneously with a forehead lift can help prevent the forehead from widening after the lift.

Additionally, since the forehead is elevated, it allows for extra skin to be removed, providing the advantage of achieving a greater reduction compared to when only forehead reduction is performed.

Let’s take a look at before-and-after photos to see the changes after the combined forehead lift and reduction surgery.

These are the pre-surgery photos for the endoscopic forehead lift and forehead reduction.

The ratio between the midface and upper face is typically 1:1, and if the upper face is smaller than the midface, it gives the appearance of a smaller face, which is more ideal.

Before the surgery, the length of the midface (from the tip of the nose to the glabella) is 7 cm, and the length of the upper face (from the glabella to the hairline) is also 7 cm, resulting in a 1:1 ratio.

From the front view or based on measurements, the forehead does not appear wide, but since the forehead is recessed, it looks longer when viewed from the side.

Due to eyelid and eyebrow drooping, both endoscopic forehead lift and upper

blepharoplasty are necessary. However, if the hairline rises after the forehead lift, the forehead may appear wider, which is why I recommended performing forehead reduction simultaneously.

Forehead reduction surgery can achieve a greater reduction when the scalp is easily movable. However, since the scalp does not have good mobility, the expected reduction amount when performing only forehead reduction is 12 mm.

By performing both endoscopic forehead lift and forehead reduction simultaneously, the skin in that area is lifted, allowing for additional skin excision. As a result, a total of 18 mm was removed.

This is a photo taken one month after the surgery. Compared to the pre-surgery appearance, the hairline has moved forward.

*Bleeding, inflammation, scarring, side effects, swelling, and bruising are common occurrences after surgery and treatment,

and they can vary by individual. Other side effects may also occur, so caution is advised.

In particular, from the side view, you can clearly see that the hairline has been pulled forward. The previously recessed area of the forehead is now eliminated, and the hairline has been brought forward, dramatically reducing the forehead area.

Although an endoscopic forehead lift was performed, the forehead did not widen after the surgery due to the simultaneous forehead reduction; instead, it has actually decreased in size.

When the forehead is reduced, it creates the effect of a smaller and younger-looking face. The skin is tightened during the forehead lift, which has also improved forehead wrinkles and reduced the habit of raising the eyebrows when opening the eyes.

A total of 18 mm was excised, and while it is possible to remove an additional 1–2 mm, doing so could increase tension and worsen scarring, so we chose to safely excise just 18 mm.

Today, we discussed the differences before and after the endoscopic forehead lift and forehead reduction, and why it's important to perform both procedures simultaneously.

If you have a wide forehead or are concerned that it may widen after a forehead lift, undergoing forehead reduction at the same time can help address these issues.

Since the effects of endoscopic forehead lift and forehead reduction can vary from person to person, it’s advisable to consult with an experienced plastic surgeon.

Thank you very much!