Definition:  Lifting the eyebrows with improvement of frown lines and horizontal
lines of the forehead.

Age: Usually 35 and beyond.

Surgical technique: Elevation of the eyebrows, removing the frown muscles and smoothing the horizontal lines in the forehead. It can be done at the same time as laser resurfacing to erase the deeper wrinkles. Surgery may be performed with an endoscope (small telescope) - see Endotine Brow Lift section below - through small scalp incisions or using an open technique with an incision hidden behind the hairline. The open technique is useful if horizontal lines in the forehead require correction or if there is severe drooping of the eyebrows. The endoscopic technique is useful for the younger patient and those with thin hair.

Philosophy:  A natural but not surprised look.

Surgical time and recovery: Surgery takes an hour. Stitches or staples are
removed in 9 days. Swelling is resolved after about one week. The patient can
go back to work in 7-10 days.

Related procedures: None.

For Control of Fixation in Open and Endoscopic Brow Procedures

Soft tissue fixation remains the least controllable and least predictable part of the
forehead lift procedure. Until now, only suture based and percutaneous screw
fixation techniques were available, often with frustrating results.

The ENDOTINE Forehead offers a novel and effective solution for fixation of the scalp
tissue, addressing a primary challenge of the forehead lift procedure. The
ENDOTINE Forehead features sutureless MultiPoint Technology (MPT™), a
breakthrough platform technology designed to facilitate facial aesthetic procedures,
reduce operating time and improve surgical outcomes.

The device’s unique design provides multiple points of contact with the suspended
tissue, distributing tension to maximize fixation strength.

Fast The ENDOTINE Forehead allows fixation times approaching less than one
minute per side in the hands of experienced clinicians.

Designed for Simplicity and Predictability

The ENDOTINE Forehead is designed for optimal control of brow height and shape.

Benefits for Endoscopic and Coronal Application

- Sutureless Fixation Rapid deployment and prevention of tissue strangulation.
- Multiple Tines High structural integrity and balanced distribution of tension.
- Bioabsorbable Co-Polymer Unlike metallic screws, this device does not need to
  be removed.

Additional Benefits for Coronal Application

Tension Free Closure The absence of tension on the scalp closure minimizes scar widening and hypertrophy. Reduced Scalp Excision Fixation from the ENDOTINE Forehead devices reduces the need to excise hair bearing scalp in order to suspend the forehead. Minimal Alopecia Reduced tension on the scalp closure minimizes damage to hair follicles and resulting alopecia. ENDOTINE MultiPoint Fixation Stress concentration is much higher for single point than for multiple point fixation devices.

High concentrations of stress cause soft-tissue to deform, hair follicle loss and
failures of fixation that may be the cause of forehead re-descent and undesirable
results.  The ENDOTINE Forehead is designed to distribute tension allowing more
stable tissue shape, less distortion, and the prevention of high concentrations of
stress.

In the USA: 605 West Avenue Norwalk, CT USA 06850 Ph: (203) 838-8844 Fax:(203) 853-1862 Efax:(203) 286-1046 Email Prof. Kirwan Also in the USA at: 800 Fifth Avenue, Suite 202 (corner of 61st St.) New York, NY 10065 Ph: (212) 838 8844 Fax:(203) 853-1862 Efax:(203) 286-1046 Email Prof. Kirwan In the UK: 56 Harley Street London W1G 9QA Tel :  +44 (0) 20 7637 4455  (after 2:00 p.m. GMT from UK) Fax: +1 203 853-1862 Efax: +44 (0) 20 7504 8143 Email Prof. Kirwan