Endotine endoscopic lift in Switzerland: absorbable fixation explained

In an endoscopic brow or midface lift, lifting the tissues is only half the job. The other half is holding them in place during the weeks when they reattach to the bone. This is the role of fixation systems, and Endotine is one of the best known: a small absorbable device with tines that hooks the lifted tissues and then dissolves within a few months. This page is devoted to the endoscopic lift with Endotine: what the device is, why fixation matters so much, how the procedure is performed, what you feel under the scalp, its advantages and limitations compared with other methods, and how to organise your project from each of the 26 cantons.

Endotine is an absorbable fixation device, used mainly in the endoscopic brow lift, sometimes for the midface or through a blepharoplasty approach. It is fixed in a small socket drilled in the skull bone, beneath a scalp incision, and its tines hold the lifted tissues during healing. It can be felt to the touch for a few weeks to a few months, then gradually dissolves. It is only one fixation method among others: what matters most remains the diagnosis and mastery of the procedure. For an overview of brow and temple lifts, see our page on the brow and temporal-midface lift in Switzerland; for the budget, our page on Endotine endoscopic lift prices in Switzerland.

Endotine is a small fixation implant, the size of a lens a few millimetres across, designed for facial cosmetic surgery. It consists of a base, which is inserted into a socket drilled in the bone, and a platform lined with small angled tines. Once the device is in place, the surgeon lifts the tissues of the forehead or cheek and presses them onto the tines, which hook them like Velcro and prevent them from dropping back.

An absorbable material

The device is made from an absorbable copolymer, from the same family as the materials long used for absorbable sutures and some bone surgery plates. The body slowly breaks it down by hydrolysis into molecules that it eliminates naturally. Complete absorption generally takes several months, often around six months to a year, well beyond the time needed for the tissues to reattach firmly to the bone.

Several models

There are several models suited to different areas. The most widely used model is for the endoscopic brow lift. Other versions, in the form of small strips with tines, are designed for the midface, to lift the cheekbone, or for repositioning the eyebrow through a blepharoplasty incision. The surgeon chooses the model according to the area treated and the approach.

How many devices?

For an endoscopic brow lift, one device is generally placed on each side, beneath the paramedian incisions in the scalp, above the tail of the eyebrows. The number and exact position depend on anatomy and the desired correction.

During an endoscopic brow lift, the surgeon releases the forehead tissues from the bone down to the rim of the eye socket, then frees the attachments that hold the eyebrows down. At this stage, the forehead is mobile: it can be lifted, but it can also drop back. It takes several weeks for the tissues to reattach to the bone in their new position.

The critical phase of the first few weeks

During this period, the tissues are subject to forces that pull them down: gravity, the weight of the tissues and, above all, the action of the muscles that lower the eyebrows, engaged with every frown. If the fixation gives way before reattachment is solid, the eyebrow partly drops back and the result fades. This is one of the main causes of disappointing results in the medium term.

What good fixation provides

Solid fixation makes it possible to obtain a stable result without excessive overcorrection, to spread the tension over a sufficient surface and to limit recurrence. It must also be safe, discreet and, ideally, leave no permanent material. The different fixation methods seek to reconcile these objectives.

Fixation is not everything

The quality of tissue release matters as much as fixation: if the attachments holding the eyebrow are not sufficiently released, no device will be able to maintain a lasting lift. That is why the surgeon's experience with the endoscopic procedure as a whole is decisive, whatever fixation method they use.

Endotine is not the only way to fix an endoscopic lift. Surgeons use several methods, each with its advantages and limitations. None has shown clear and consistent superiority over the others; the choice depends largely on the surgeon's habits and experience.

Why some surgeons prefer Endotine

The device allows quick, reproducible fixation, spread over a surface rather than at a point, which is thought to limit the risk of tearing tissues under tension. It does not need to be removed, unlike screws, and it shortens the procedure compared with bone tunnels. It also allows the position of the tissues on the tines to be adjusted before the correction is finalised.

Why other surgeons prefer another method

Some surgeons consider bone tunnels just as reliable, without an implant and at no extra cost. Others prefer screws, which they have mastered for a long time. Some patients are also bothered by the feeling of small bumps under the scalp for several weeks. A surgeon who achieves good results with their usual method has no reason to change it.

Key takeaways

For a patient, the fixation method is something to understand, not a main selection criterion. Ask the surgeon which method they use, why, and what you will feel. But choose your surgeon first on the accuracy of their diagnosis, their experience with endoscopic lifts and their results.

The endoscopic brow lift

This is the main indication. After releasing the forehead endoscopically, the surgeon places a device on each side and hooks the lifted tissues onto it. The lift raises the whole of the eyebrows, softens forehead lines and can reduce frown lines by weakening the muscles that knit the eyebrows.

The endoscopic midface lift

Some models, in the form of a strip with tines, are used to lift the upper cheek and cheekbone, through a temporal incision or through the lower eyelid. They hold the cheek tissues lifted upwards during healing.

Repositioning the eyebrow through a blepharoplasty approach

During upper blepharoplasty, the surgeon can, through the same eyelid incision, slightly raise the eyebrow and secure it using a small device. This technique is suitable for moderate descent of the eyebrow tail, without an additional incision in the scalp.

Combinations

Endotine can be used during combined procedures: brow lift and blepharoplasty, brow lift and facelift, midface lift and fat transfer.

The endoscopic lift with Endotine fixation is intended for people whose eyebrows have descended, generally between forty-five and seventy, with skin and tissues of sufficient quality.

Favourable profiles

• Eyebrows that are low overall, making the eyelids heavy.
• Forehead lines linked to constantly raising the eyebrows.
• Pronounced frown lines.
• A forehead of normal height or short, which can accommodate a slight backward shift of the hairline.
• Hair dense enough to hide the small incisions.

Situations to discuss

A very high forehead may point towards another technique, such as a lift at the hairline. Significant baldness makes the incisions and devices harder to conceal. Very thin scalp skin may make the devices more perceptible. People who dislike the idea of feeling small bumps under their scalp for several weeks may prefer another fixation method.

Endoscopic lift or blepharoplasty?

As with any brow lift, the first question is whether the heaviness of the eyes comes from the eyebrow or the eyelid. If the excess skin disappears when the eyebrow is raised with the fingers, the eyebrow is the cause. Removing eyelid skin in this case would make the eyes look even heavier. Our page on blepharoplasty details this question.

Preparation

With you sitting up, the surgeon marks the current and desired position of the eyebrows, as well as the location of the incisions in the scalp. The hair is not shaved, or only along a very narrow strip.

The incisions

They generally make three to five small incisions of one to two centimetres behind the hairline: one in the middle, two on either side above the tail of the eyebrows, sometimes two in the temples.

Endoscopic release

Through these incisions, they introduce the endoscope and fine instruments. Guided by the image on the screen, they release the tissues of the forehead down to the rim of the eye socket, protecting the sensory nerves that emerge above the eyes. They free the attachments that hold the eyebrows and may weaken the muscles responsible for the frown lines.

Placing the Endotine

Beneath the paramedian incisions, they drill a small socket in the outer layer of the bone, using a drill with a safety stop that limits the depth. The base of the device is inserted into it.

Lifting and fixation

They lift the forehead tissues to the desired position, then press them onto the tines of the device, which hook them. They check symmetry and can adjust the position before finalising the correction.

Closure

The incisions are closed with staples or stitches. A light bandage may be applied for the first few hours. The procedure generally takes two to three hours, longer if other procedures are combined.

Anaesthesia and discharge

The procedure is usually performed under general anaesthesia, sometimes under local anaesthesia with deep sedation. Discharge is on the same day or the next day, depending on the anaesthesia and combined procedures. You must be accompanied home.

This is the question patients ask most often: will I feel the device? The honest answer is yes, to the touch, for a while.

The first few weeks

Beneath the incisions, you can feel one or two small bumps on each side, corresponding to the devices and the tissues hooked onto their tines. They cannot be seen, as they are hidden by the hair, but they can be felt when you run your hand over them or brush your hair. Local tenderness, or even slight discomfort when pressing, is common.

The following months

As the tissues heal and the device begins to dissolve, the bumps fade. Most patients no longer feel them after a few months. In people with a thin scalp, they may remain perceptible a little longer, until absorption is complete.

Everyday activities

During the first few weeks, avoid pressing hard on the device areas: no helmet, tight headband, compressive hat, vigorous scalp massage or vigorous brushing. Sleep on your back with your head raised. Shampooing is generally possible after forty-eight hours, gently.

In the first few days after an endoscopic lift with Endotine, many patients describe a feeling of a tight band around the forehead, sometimes moderate headaches. These are linked to swelling, stretching of the tissues and the presence of the devices under the scalp. Usual painkillers are generally enough, and these sensations decrease markedly after three to five days.

Sleeping with your head raised, applying cold to the forehead through a cloth and avoiding exertion all help. Pain that increases instead of decreasing, localised over a device, with redness or fever, may signal an infection and requires you to contact the team without delay.

Recovery from an endoscopic brow lift is generally simpler than from a lower facelift. It does, however, have its particular features: swelling moves down towards the eyes, the scalp remains numb for a while, and the devices can be felt to the touch.

Swelling that moves down

Two to three days after the procedure, swelling and small bruises from the forehead move down to the eyelids under the effect of gravity. The eyes may look puffy and bruised for a few days. This is expected and not serious.

Numbness

The forehead and scalp behind the incisions are often numb for several weeks to several months. Sensation gradually returns, sometimes with itching or tingling.

Expression

The eyebrows may look a little high at first, as the surgeon slightly overcorrects. The expression normalises within a few weeks.

Instructions specific to fixation

During the first few weeks, avoid frowning and strongly raising your eyebrows, wearing a helmet or tight headband, playing sports with a risk of head impact and vigorously massaging the scalp. These precautions protect the fixation while the tissues reattach.

The device slowly breaks down by hydrolysis: water in the tissues gradually cuts the long polymer chains into smaller and smaller fragments, which the body eliminates. This process is slow and silent.

During the first few weeks, the device retains its strength and fully performs its fixation role, when the tissues need it most. Its strength then gradually decreases, by which time the tissues have already reattached to the bone. The socket drilled in the bone fills with regrowing bone. After several months, the device has largely or entirely disappeared. No procedure is needed to remove it.

During absorption, a slight local inflammatory reaction is possible, showing as tenderness or slight swelling around the device. It is generally temporary. A persistent reaction, redness or discharge must be reported to the surgeon.

The endoscopic lift with Endotine shares the risks of any brow lift, plus a few effects specific to the device.

Perception of the devices

This is the most common effect: the devices can be felt to the touch for a few weeks to a few months. In some patients with a thin scalp, they may remain perceptible longer, until absorption.

Local discomfort

Tenderness or discomfort when pressing on the area, or with certain hairstyles, is possible during the first few weeks.

Inflammatory reaction

Rarely, a more marked inflammatory reaction around the device may occur during its absorption. It is generally treated simply; exceptionally, removal may be necessary.

Exposure or extrusion

Very rarely, particularly if the skin is thin or healing is difficult, the device may become visible through an incision. It is then removed or repositioned.

Eyebrows dropping again

If the tissues were not sufficiently released or if the fixation gave way, the eyebrows may partly drop again. Following the post-operative instructions limits this risk.

Risks common to brow lifts

Prolonged numbness, asymmetry, overcorrection giving a surprised look, hair loss along the incisions, haematoma, infection and, rarely, injury to the frontal branch of the facial nerve, usually temporary.

Warning signs

Sudden, painful swelling, spreading warm redness, discharge from an incision, fever, a device that has become visible or intense eye pain. Contact the team immediately; in an emergency, call 144.

An endoscopic brow lift requires an endoscopy tower, specific instruments and familiarity with the technique. In Switzerland, it is mainly performed in clinics and practices in the major cities. Depending on where you live, organisation will therefore differ. Here are the most common situations.

You live in a major city

In Zurich, Geneva, Lausanne, Basel, Bern, Lucerne, St. Gallen or Lugano, several surgeons perform endoscopic lifts, and some use Endotine. You can compare several opinions without travelling far, and check-ups, including staple removal around the tenth day, are a few minutes away by public transport. This is the simplest situation.

You live in the area around a major city

From Winterthur, Zug, Baden, Nyon, Morges, Liestal or Thun, the nearest hub is less than an hour away. Organisation remains simple: someone to accompany you home, then check-ups that are easy to fit in. Fees can vary considerably between the centre and the outskirts.

You live in a medium-sized town far from the major hubs

In Neuchâtel, Fribourg, Sion, Chur, Aarau or Schaffhausen, local provision sometimes exists, but the endoscopic technique and Endotine are not always available. Check with the practices which technique and fixation method they use, or consult in the nearest major centre.

You live in the countryside

In rural areas of the Plateau, the Jura or Eastern Switzerland, the journey to the hub can be close to an hour or more. A photo-based pre-assessment allows you to target a surgeon before travelling, and your family doctor can sometimes remove the staples according to the instructions.

You live in the mountains

From the Engadine, Upper Valais, the Oberland or the Ticino valleys, journeys often take more than two hours. For a procedure under general anaesthesia, plan a night at the clinic or near the practice, then a return home with a companion. In winter, plan for transport disruptions.

You live in a bilingual region

In Fribourg, Biel/Bienne or Valais, you can compare surgeons from both language regions, which widens the choice and sometimes means shorter waiting times.

This table positions 55 Swiss cities: the hub where endoscopic lifts are generally available, the indicative travel time by public transport, the most practical way to arrange staple removal around the tenth day, and the usual price difference compared with Geneva. These are trends, to be checked with the practices.

There is no official fee schedule: each surgeon sets their fees freely. The cost of an endoscopic lift depends on the surgeon's and anaesthetist's fees, clinic costs, endoscopic equipment and, where applicable, the fixation device. The following table compares the options with one another, taking as a base of 100 an endoscopic brow lift fixed with bone tunnels.

The extra cost of the device is relatively constant from one city to another; it is mainly the fees and facility costs that make the bill vary between Geneva, Zurich and medium-sized towns. Details of the quote breakdown and ways to save are on our page on Endotine endoscopic lift prices in Switzerland.

These profiles are fictitious, inspired by requests received from all over Switzerland. They illustrate how the decision around the endoscopic lift and its fixation is made.

Catherine, 56, Lausanne: low eyebrows and a lined forehead

Catherine had eyebrows that had dropped overall and deep horizontal lines. The surgeon proposed an endoscopic brow lift fixed with Endotine, explaining that she would feel small bumps under her scalp for a few weeks. She appreciated not having to have screws removed.

Andreas, 59, Zurich: another fixation method

Andreas consulted two surgeons in Zurich. The first used Endotine, the second bone tunnels. Both proposed a comparable endoscopic brow lift. Andreas chose the second, with whom he had a better rapport, understanding that the fixation method was not the main criterion.

Monique, 63, Geneva: the eyes and the cheekbone

Monique had tired eyes, low eyebrows and a descended cheekbone. The surgeon proposed an endoscopic brow and midface lift, with two devices on each side. The procedure, under general anaesthesia, was followed by a night at the clinic.

Pia, 52, Bern: moderate descent

Pia mainly had excess eyelid skin and a slight drop of the eyebrow tail. The surgeon proposed upper blepharoplasty with repositioning of the eyebrow through the same incision, fixed with a small device, without an incision in the scalp.

Jean-Luc, 66, Sion: a thin scalp

Jean-Luc had early baldness and a thin scalp. The surgeon explained that the devices might remain more perceptible in his case and that the incisions would be harder to hide. He proposed a temporal lift with sutures, better suited to his situation.

Valentina, 48, Lugano: a keen skier

Valentina wanted an endoscopic brow lift. As helmets are not advised for several weeks, she scheduled the procedure in spring, after the ski season, so that she could resume her activities with peace of mind in the autumn.

"It is a permanent implant"

Endotine is absorbable: it slowly breaks down and disappears over several months.

"You can see it under the skin"

It cannot be seen, as it is placed under the scalp, behind the hairline. It can be felt to the touch for a while.

"It has to be removed"

No, except in exceptional circumstances. It dissolves by itself.

"Endotine guarantees a better result"

The fixation method matters, but the result depends above all on the diagnosis, tissue release and the surgeon's experience.

"Drilling into the skull is dangerous"

The socket is drilled in the outer layer of a thick bone, with a drill fitted with a safety stop. The procedure is superficial and controlled.

"An endoscopic lift leaves no scars"

It leaves a few small scars hidden in the hair, very discreet but very real.

"After Endotine, nothing more can be done"

Once the device has dissolved, any later procedure remains possible.

The brow lift has undergone major changes. For a long time, it was performed through a long incision from one ear to the other across the top of the head: the surgeon removed a strip of scalp and closing the incision provided the lift. Fixation was therefore provided by the skin itself, at the cost of a long scar and extensive numbness.

With the arrival of endoscopy in the 1990s, incisions became short, and other ways had to be found to hold the lifted tissues. Surgeons used temporary screws, tunnels drilled in the bone, sutures and glues. In the early 2000s, specific absorbable devices such as Endotine were developed to offer quick, distributed fixation without the need for removal.

Today, these different methods coexist. Studies show good results with several of them, and the debate is less about the method than about the overall quality of the procedure. This evolution illustrates a general trend in cosmetic surgery: shorter incisions, greater precision and materials that disappear once their job is done.

Beyond the forehead, some models of absorbable devices are used to lift the upper cheek and cheekbone. This indication addresses a common problem: descent of the cheekbone, which lengthens the distance between the lower eyelid and the cheek and gives a hollow-eyed look.

The temporal approach

Through an incision in the hair of the temple, often combined with the endoscopic brow lift, the surgeon releases the tissues down to the cheekbone, lifts them and secures them using a strip with tines anchored in the temporal region.

The eyelid approach

Through a lower blepharoplasty incision, below the lashes, the surgeon can also access the midface and lift the cheek tissues using a suitable device.

What you can expect

The cheekbone regains a higher position, the transition between eyelid and cheek shortens, and the eyes look less hollow. The effect is often combined with blepharoplasty or fat transfer.

Limitations

This technique treats neither the jowls nor the neck. If laxity mainly affects the lower face, a neck and face lift or a deep plane facelift will be more appropriate. See our pages on the deep plane facelift and the neck and face lift.

In patients who mainly need upper blepharoplasty, with moderate descent of the eyebrow tail, the eyebrow can be raised slightly through the same incision as the blepharoplasty, in the eyelid crease. The surgeon releases the tissues beneath the eyebrow, then secures them higher using a small absorbable device or sutures.

The advantage is that there is no incision in the scalp and recovery is similar to that of blepharoplasty alone. The lift obtained is, however, more limited than with an endoscopic or temporal lift. This technique is therefore suitable for moderate descent. For more significant descent, a temporal or endoscopic lift remains preferable. Our page on blepharoplasty in Switzerland details this procedure.

Geneva

Several Geneva surgeons perform endoscopic brow lifts; some use Endotine, others bone tunnels or screws. Proximity makes staple removal and check-ups very simple. Patients from La Côte can compare Geneva and Lausanne.

Vaud

Lausanne concentrates provision in Vaud. From Yverdon, Payerne or the Pays-d'Enhaut, arrange for someone to accompany you home. Check-ups in the first few weeks are easy to organise from the Riviera and La Côte.

Neuchâtel

Local provision for endoscopic lifts is limited; many Neuchâtel residents consult in Lausanne or Bern. Check with the practices which technique and fixation they offer.

Jura

Jura residents consult in Basel or Biel/Bienne. The family doctor can sometimes remove the staples according to the surgeon's instructions, saving a journey.

Fribourg

Lausanne and Bern, half an hour away, offer a wide choice; patients often choose according to language. A few surgeons practise in the city.

Valais

French-speaking Valais looks to Lausanne, Upper Valais to Bern. After general anaesthesia, a night in the valley is more comfortable than returning to the mountains.

Bern

Bern offers a solid choice, Biel/Bienne a bilingual alternative. From the Oberland, the journey home is reasonable by train, with a companion.

Zurich

The widest choice of surgeons performing endoscopic lifts, with several fixation methods. The canton's municipalities are less than forty minutes from the centre.

Lucerne

Lucerne groups the provision of Central Switzerland. A few surgeons perform endoscopic lifts; Zurich remains accessible to widen the choice.

Uri

Uri residents consult in Lucerne. From Andermatt, a night in Lucerne after the procedure is recommended.

Schwyz

The north of the canton looks to Zurich, the south to Lucerne.

Obwalden

Lucerne is about twenty minutes from Sarnen.

Nidwalden

Lucerne, a quarter of an hour from Stans, makes organisation very simple.

Glarus

Zurich or St. Gallen, about an hour away; group the consultation and check-up together to limit journeys.

Zug

Zurich and Lucerne, half an hour away, offer a wide choice.

Solothurn

The Olten hub makes it possible to compare Bern, Basel, Lucerne and Zurich.

Basel-Stadt

Basel has several surgeons who perform these techniques, a few minutes away by tram.

Basel-Landschaft

Patients consult in Basel, less than half an hour away.

Schaffhausen

Zurich or Winterthur, about forty minutes away.

Appenzell Ausserrhoden

St. Gallen, close by, is the reference centre; some patients widen their search to Zurich.

Appenzell Innerrhoden

St. Gallen, about three-quarters of an hour away, then Zurich if necessary.

St. Gallen

St. Gallen has several surgeons; check the availability of endoscopy and of the fixation method you want.

Graubünden

For an endoscopic lift, many Graubünden residents consult in Zurich. From the Engadine or Davos, a night near the clinic is essential.

Aargau

Zurich, twenty minutes from Baden, and Basel for the west of the canton complement the provision in Aarau and Baden.

Thurgau

Winterthur, St. Gallen or Zurich; Winterthur is a quarter of an hour from Frauenfeld.

Ticino

Lugano concentrates provision; consultations are held in Italian. Patients from the upper valleys should allow for a longer journey.

The endoscopic lift requires specific familiarity with endoscopy and good knowledge of the anatomy of the forehead and temples. The choice of surgeon takes precedence over the choice of fixation method.

• Does my problem come from the eyebrow, the eyelid or both?
• How long have you been performing endoscopic lifts, and how many do you perform each year?
• Which fixation method do you use, and why?
• What will I feel in my scalp, and for how long?
• Where will the incisions be placed, given my hair and my forehead?
• At what height and with what shape will you position my eyebrows?
• What anaesthesia, and will I go home the same day?
• What happens if the eyebrows drop again?
• Can you show me results at more than six months?
• What does your quote include?

Check the surgeon's specialist title in the federal MedReg register. Be wary of a promise of a guaranteed result, a pitch that makes the fixation method the main selling point, or pressure to decide quickly.

Eight weeks before

This is the right time to stop smoking and nicotine in all its forms, so that the scalp heals in good conditions. If you play a sport that involves a helmet, find a two-month window in your calendar with no competitions or major outings.

Four weeks before

Have the tests requested by the anaesthetist carried out. If you regularly have injections in the forehead, the last one must be long enough ago for the surgeon to see the natural position of your eyebrows; they will tell you the interval. Warn your hairdresser and postpone colouring until after the procedure.

Ten to fifteen days before

With your doctor's agreement, suspend blood-thinning products. Prepare a wedge pillow, a soft brush and sunglasses, and arrange for someone to accompany you.

The day before

Wash your hair thoroughly, without styling products. Do not wear hairpins or hair ties the next day. Strictly follow the fasting instructions given by the anaesthetist.

The next day

The forehead feels tight, as if under an invisible headband. Lightly touching the scalp, you can feel the areas where the tissues are hooked onto the tines. Rest sitting up or half sitting up.

The third day

The eyelids swell in turn, as the swelling from the forehead moves down. Bruises appear under the eyes. It is dramatic but temporary.

The fifth day

The swelling starts to go down. You can go out for a few minutes, wearing sunglasses, avoiding crowds and sudden movements.

The seventh day

Most patients feel well and resume quiet activities. The device areas remain tender to the touch: brush your hair gently, without pressing.

Skiing and snowboarding

The helmet presses exactly on the device area. A fall during the reattachment phase could also strain the fixation. Schedule the procedure so as to leave at least two months between the operation and your first time back on the slopes.

Cycling and mountain biking

The same rule applies to cycling helmets, whose strap and shell press on the forehead. Indoor training sessions, without a helmet, can resume earlier with the surgeon's agreement.

Hiking

Walking on flat ground is recommended from the first few days. Hikes at altitude have to wait until the swelling has gone and require strict sun protection for the forehead.

Swimming

A tight swimming cap and chlorinated water have to wait until the incisions are fully closed, generally three to four weeks.

Absorbable devices used in surgery are made from polymers derived from acids naturally present in the body, such as lactic acid and glycolic acid. These molecules are assembled into long chains that form a solid material, which can be moulded into screws, plates or small devices with tines.

How the material disappears

In contact with the body's fluids, the chemical bonds linking the molecules are gradually broken: this is hydrolysis. The long chains become shorter and shorter, and the material first loses its strength, then its mass. The small molecules released are metabolised and eliminated, notably as water and carbon dioxide.

A timetable adapted to healing

The composition of the copolymer is chosen so that the device keeps its strength during the period when it is useful, namely the first few weeks, then breaks down once the tissues have reattached. It is this gap between the length of fixation needed and the length of absorption that makes these materials worthwhile.

Long experience in surgery

These polymers have been used for decades for absorbable sutures, then for plates and screws in facial and cranial surgery, particularly in children. This experience explains their good general tolerance. As with any material, a local inflammatory reaction remains possible during absorption.

The muscles that lower the eyebrows, notably those that knit the brows and the outer part of the muscle surrounding the eye, pull the tissues downwards. During the reattachment period after an endoscopic lift, their activity strains the fixation.

That is why some surgeons offer a botulinum toxin injection into these muscles a few days or weeks before the procedure, or shortly afterwards, to rest them during healing. Others weaken these muscles directly during the procedure, endoscopically. After the healing period, occasional injections can maintain the result on forehead and frown lines. Our page on botulinum toxin injections presents these uses.

Hair density

Dense hair easily hides the incisions. Fine or thinning hair requires more careful placement of the incisions and may make the device areas more perceptible to the touch.

A thin scalp

In some people, particularly older people, the scalp is thin: the devices may then be felt more clearly and for longer. The surgeon may propose another fixation method.

Baldness

Frontal baldness makes the incisions and devices harder to conceal. A temporal lift or repositioning through a blepharoplasty approach may be preferred.

Hairstyles

Tight hairstyles, tight buns, hair ties and clips that press on the device areas should be avoided during the first few weeks.

Hair loss

Localised hair loss along the incisions is possible, usually temporary. Smoking increases this risk.

Shampooing is generally allowed after forty-eight to seventy-two hours, with a mild product and without rubbing the incisions. Dry your hair in the air or with a hairdryer on a warm setting. Hard brushes, tight hair ties and hairstyles pulled back should be avoided for a few weeks, as they pull on the scalp held by the devices. Colouring and perms have to wait until healing is complete, generally a month.

The endoscope used for the forehead is a rigid tube about four to five millimetres in diameter, containing an optical system and connected to a camera and a cold light source. It is often mounted on a retractor that lifts the tissues and creates a working space. The image appears magnified on a screen facing the surgeon.

This view makes it possible to identify and preserve the sensory nerves that emerge from the rim of the eye socket above the eyes, to precisely release the attachments of the eyebrow at the orbital rim and temple, and to judge how much to weaken the muscles between the eyebrows. Endoscopy has thus made it possible to obtain results comparable to those of open techniques, with much shorter incisions, less numbness and a lower risk of hair loss.

Choosing on the fixation method

Endotine is a good method, but not a main selection criterion. Choose your surgeon on their diagnosis and experience.

Neglecting the question of eyebrow and eyelid

If the eyelid alone is the cause, a brow lift will not solve the problem; if the eyebrow is the cause, blepharoplasty alone will make it worse.

Wearing a helmet again too soon

A helmet that presses on the fixation areas during reattachment can compromise the result.

Worrying about the small bumps

They are expected and gradually disappear. Only redness, discharge or exposure of the device should be a cause for concern.

Judging too soon

The slightly surprised look and swelling of the first few weeks mask the result. Wait at least three months.

"Will you have something in your head?"

A small absorbable device is fixed in the superficial layer of the bone, under the scalp. It disappears within a few months.

"Will it show?"

In the first few days, the swelling and bruising around the eyes, yes. After that, more open eyes, with no visible scar.

"How can I help you?"

By accompanying you on the day of the procedure, helping you in the first few days and reminding you not to go back to cycling or skiing too soon.

"What if it drops again?"

Fixation and following the instructions limit this risk. If the eyebrows drop again, a touch-up is possible after a few months.

Your family doctor

They can prescribe the pre-operative check-up, review your treatments, remove the staples according to the surgeon's instructions and see you if you have any doubts. Give them the operative report.

Your insurer

The cosmetic procedure is not reimbursed. If the drooping eyebrow reduces your field of vision, a prior cost approval request can be sent to the insurer, with an eye examination and a medical report. Also ask how care related to a complication would be covered.

Your documents

Keep the operative report, which mentions the device used, as well as prescriptions, instructions and the invoice. Tell any doctor who follows you during its absorption about the device.

The surgeon chooses according to your examination. The same patient may also benefit from a combination, for example a temporal lift with blepharoplasty. For the overview, see our page on the brow and temporal-midface lift in Switzerland.

Admission

You arrive having fasted, accompanied, without make-up and with clean hair. The nurse settles you in, the anaesthetist sees you again and the surgeon answers your final questions before you sign the consent form.

The markings

With you sitting up, the surgeon marks the current position of the eyebrows, the desired position, the path of the sensory nerves to be protected and the location of the incisions and devices.

The procedure

Under anaesthesia, they make the incisions, release the forehead under endoscopic guidance, free the attachments, place the devices, lift and hook the tissues, then check symmetry before closing.

Waking up

You wake up with a tight forehead and sometimes a light bandage. After a period of monitoring, you go home accompanied, or spend the night at the clinic depending on the anaesthesia and combined procedures.

Men often seek advice for eyes that look tired or stern, pronounced forehead lines or deep frown lines. The endoscopic lift may suit them, with several precautions. The male eyebrow must remain low and horizontal; excessive lifting feminises the eyes. Present or future baldness determines the placement of the incisions and devices: in a man whose hairline is receding, the incisions may become visible over time. A thin scalp also makes the devices more perceptible. In these situations, a temporal lift or repositioning through a blepharoplasty approach may be preferred. Finally, weakening the frown muscles often gives a more serene look, which is much appreciated.

Hypertension

It must be well controlled to limit the risk of haematoma.

Blood-thinning treatments

They are managed with the prescribing doctor and the anaesthetist; never stop them on your own.

Eye problems

Dry eyes, glaucoma or previous eye surgery must be reported.

Diabetes

Well-controlled diabetes allows the procedure; poorly controlled diabetes slows healing.

Autoimmune diseases

They can affect healing and tolerance of materials; an opinion from the specialist who follows you is useful.

Smoking reduces the blood supply to the scalp and increases the risk of widened scars, hair loss around the incisions and infection. Stopping completely, at least four weeks before and after the procedure, is strongly recommended. Nicotine replacement products also affect the blood vessels; discuss this with your surgeon.

If your eyebrows have been redefined with permanent make-up or microblading, tell the surgeon. The lift moves the eyebrows, and the pigment with them. A design placed higher than the hairs to compensate for a drooping eyebrow could end up too high after the procedure. The surgeon takes this into account in planning. It is often advisable to wait until the result has stabilised, after a few months, before redoing permanent make-up adapted to the new position. Poorly placed pigment can be faded with laser tattoo removal.

For residents of the Engadine, Upper Valais, the Oberland, or the valleys of Uri or Ticino, an endoscopic lift requires particular organisation. After general anaesthesia, a long journey home to the mountains on the same day is not advisable: a night at the clinic or near the practice is preferable. In winter, plan for transport disruptions. Staple removal can often be entrusted to your family doctor, according to the surgeon's written instructions, and some check-ups can be done using photos. Finally, if you ski, schedule the procedure outside the season, as helmets are not advised for several weeks.

Once the device has dissolved, no material remains under the scalp. The forehead tissues are firmly reattached to the bone in their new position. The result lasts many years, with ageing resuming from a more favourable position. Occasional botulinum toxin injections can maintain the effect on lines, and regular sun protection preserves skin quality. If, years later, a new correction is wanted, it can be carried out without any constraint from the first procedure.

Before 45

Descent of the eyebrow is often modest. Botulinum toxin can slightly raise the tail of the eyebrow and soften lines. An endoscopic lift is mainly discussed for people with naturally low eyebrows.

Between 45 and 55

The tail of the eyebrow descends, then the whole eyebrow, and forehead lines deepen. This is often the age at which an endoscopic or temporal lift brings the most benefit, with a quick recovery.

Between 55 and 70

The eyebrows are lower, often combined with excess eyelid skin and a descended cheekbone. An endoscopic brow and midface lift, with blepharoplasty, gives harmonious rejuvenation of the eye area.

After 70

In a person in good health, the procedure remains possible. A thinner scalp and possible baldness may point towards a simpler technique or another fixation method.

The anaesthetist sees you in consultation before the procedure. They assess your health, treatments and medical history, choose the type of anaesthesia with you and give you instructions on fasting and taking your medication. During the procedure, they continuously monitor your vital signs, particularly blood pressure, whose control limits bleeding and the risk of haematoma. When you wake up, they manage pain and nausea. Their fees are sometimes billed separately from the surgeon's: check this on your quote.

These durations are indicative. Perception also depends on the position of the devices and each person's healing. If this perception worries you, the surgeon can propose another fixation method.

Many patients are worried about the idea of a small hole being drilled in the skull bone. It is useful to recall a few facts. The frontal bone, where the device is placed, is several millimetres thick and made up of two layers separated by spongy tissue. The socket is drilled only in the outer layer, a few millimetres deep, using a drill fitted with a safety stop that prevents it from going further. The brain and its membranes are not involved. This type of superficial bone procedure is routinely performed in facial surgery. Once the device has dissolved, the socket gradually fills with bone.

The endoscopic lift requires an endoscopy tower, specific instruments and, often, general anaesthesia. It is therefore performed in a clinic or facility with an equipped operating theatre, a recovery room and, if necessary, overnight monitoring. Ask where the procedure will take place, how monitoring is organised and how any complications would be managed. An appropriate facility is part of safety, just as much as the surgeon's experience.

Activities that increase pressure in the head or expose the forehead to impacts are those that require the most patience. Walking resumes from the first few days; the exercise bike and light running after two to three weeks; swimming once the incisions have fully healed; contact sports, skiing and horse riding after about six weeks, with the surgeon's agreement. Head-down positions, in yoga for example, should be avoided during the first month, as they increase swelling of the forehead.

A remote first opinion is only worthwhile if the photos show what matters for a brow lift. A few simple rules allow the surgeon to judge the position of your eyebrows, the height of your forehead and the quality of your hair.

• Stand facing a window, with the camera at eye level, without flash.
• Pull your hair back to fully reveal your forehead and hairline.
• Take a front view with your eyebrows relaxed, then one with them raised as high as possible.
• Add a view with your eyes closed, without squeezing them, to assess the eyelids.
• Complete with both profiles and both three-quarter views.
• If you have one, include an older photo in which your eyebrows were in their original position.

Also mention your treatments, any recent injections in the forehead and any sports you do with a helmet: this information guides the choice of technique and fixation.

Identify what bothers you

A tired look, heavy eyes, forehead lines, frown lines: write it down in your own words.

Understand the cause

Eyebrow, eyelid or both: this is the key to choosing the procedure.

Compare approaches

Two consultations allow you to compare diagnoses, techniques and fixation methods.

Organise your recovery

Ten to fourteen days, someone to accompany you, a break from helmets and intense sport.

Be patient

The result is judged at three or six months; absorption continues beyond that.

Absorbable copolymer. A synthetic material that slowly breaks down in the body.

Endoscope. A fine camera introduced through a small incision, connected to a screen.

Endotine. An absorbable fixation device with tines used in the endoscopic lift.

Hydrolysis. The chemical reaction by which water breaks the polymer chains.

Endoscopic lift. A lift performed using an endoscope through small incisions.

Bone socket. A small cavity drilled in the outer layer of the bone to anchor the device.

Tines. Small points on the device that hook the lifted tissues.

Reattachment. The reattachment of the released tissues to the bone during healing.

Orbital rim. The bony edge of the eye socket, a reference point for eyebrow position.

Bone tunnels. A fixation method using sutures passed through small tunnels drilled in the bone.

Temporary screws. Anchoring screws removed after a few weeks.

• It does not remove excess skin originating in the upper eyelid itself: blepharoplasty then remains necessary.
• It does not treat bags under the eyes or pigmented dark circles.
• It does not correct jowls or laxity of the neck, which call for a lower facelift.
• It does not restore lost volume at the temples or cheekbones; fat transfer can complement it.
• It does not always completely erase lines deeply etched into the skin.
• It does not improve skin texture, pigment spots or fine lines.

Knowing these limitations allows you to build a coherent plan with the surgeon, combining other procedures if necessary, in the same session or later. See our page on facial fat transfer and our guide to facelifts.

Brushing your hair

In the first few weeks, the brush meets small bumps under the scalp. A soft brush and gentle movements avoid pressing on them.

Sleeping

Sleeping on your back, with your head raised, is more comfortable. On your side, the temple presses on the pillow, which may be tender.

Washing your hair

The numb scalp cannot sense water temperature well: use lukewarm water and a mild shampoo.

Wearing glasses

The arms must not press on the temporal incisions; an adjustment by the optician can help.

Over the months

The bumps fade, the numbness recedes, and itching signals nerve regrowth. Most patients forget about the devices after a few months.

After an endoscopic lift, the scalp behind the incisions is often numb for several weeks to a few months, because small sensory nerves are stretched. Recovery is gradual, often with itching or tingling, signs that the nerves are regenerating. It is advisable not to scratch and to use a mild shampoo.

During this period, the numb skin is less sensitive to heat: avoid very hot hairdryers, harsh colouring and prolonged unprotected sun exposure. A small area of numbness may persist long term in a minority of patients; it is rarely bothersome day to day.

After a brow lift, the position of the eyebrows relative to the frames changes. Many patients discover that frames that hid their drooping eyebrows no longer suit them or, conversely, that finer frames now enhance their eyes. Wait until the result has stabilised, around three months, before changing your glasses, and ask your optician for advice on a frame that follows the new line of the eyebrows without hiding it.

This change is often one of the small pleasures of recovery: rediscovering your eyes and choosing accessories that enhance them.

In an older person in good health, an endoscopic lift remains possible. A thinner scalp may make the devices more perceptible, and baldness may make the incisions harder to hide. The surgeon adapts the eyebrow height to the person's age for a coherent result, and may propose a simpler technique, such as a temporal lift or a direct brow lift. If the drooping eyebrow impairs vision, an eye examination can document this with a view to a coverage request.

Tell the surgeon in your own words what bothers you and what you want: more open eyes, a less stern look, a smoother forehead. Bring photos of yourself when younger that show the natural position of your eyebrows. Ask for a mirror simulation of the planned height. Also say what you do not want: a surprised look, overly arched eyebrows, feeling the devices for too long. If the latter concerns you, ask whether another fixation method would be possible. A clear dialogue before the procedure is the best guarantee of a result that looks like you.

Cyclists and skiers

The helmet is the main constraint: it is not advised for several weeks. Plan the procedure outside the season.

Water sports

Swimming generally resumes after three to four weeks, once the incisions have healed well. A tight swimming cap has to wait a little longer.

Public-facing professions

Actors, presenters and people who frequently speak in public: allow a margin of at least a month before an important event.

Physical jobs

Intense exertion and carrying heavy loads have to wait two to three weeks, according to the surgeon's advice.

Spring and autumn, outside the ski and intensive cycling seasons, are often the most comfortable: the helmet restriction is less of a problem, the summer heat that encourages swelling is avoided, and the sun is less intense on the forehead. School holidays, which vary from canton to canton, can help limit the number of days off. As autumn is very popular, it is wise to book early.

Endoscopic lift and upper blepharoplasty

The forehead is lifted first, then the remaining excess skin on the eyelids is removed. This is the most common combination for rejuvenating the eyes. See our page on blepharoplasty.

Endoscopic lift and fat transfer to the temples

Hollow temples accentuate the drop of the eyebrow; restoring their volume softens the face. See our page on facial fat transfer.

Brow and midface lift

The eyes and cheekbone are lifted in the same session, often with devices adapted to each area.

Brow lift and lower facelift

Combined with a neck and face lift or a deep plane facelift, it allows all three levels of the face to be rejuvenated under a single anaesthetic.

Horizontal forehead lines result from repeated contraction of the frontalis muscle, which raises the eyebrows. When the eyebrows descend, the muscle works harder to clear the field of vision, often without you realising, and the lines deepen. By raising the eyebrows, the endoscopic lift relieves this muscle, which gradually softens the lines.

Frown lines, the vertical lines between the eyebrows, are etched by the muscles that knit the brows. Through the endoscope, the surgeon can weaken these muscles in a targeted way, which lastingly softens the lines and gives a more serene look. Weakening them too much could push the eyebrows apart; the surgeon judges the procedure carefully. Lines deeply etched into the skin may require complementary treatment later: injections, laser or a peel.

Tissue thickness

A forehead with thick tissues is heavier and harder to lift lastingly than one with thin tissues.

Strength of the depressor muscles

Muscles that knit the eyebrows strongly pull more on the fixation during healing.

Quality of release

The more carefully the attachments of the eyebrow are released, the more stable the lift.

Following instructions

Avoiding impacts, helmets and excessive frowning in the first few weeks protects the fixation.

Lifestyle

Smoking, sun exposure and weight fluctuations affect tissue quality and how long the result lasts.

The temporal region supports the tail of the eyebrow. When it becomes hollow with age, the tail of the eyebrow loses its support and drops more easily. The endoscopic lift can lift the tissues of the temple, often through additional temporal incisions, but it does not restore lost volume. Filling with fat transfer or hyaluronic acid, at a later stage, then completes the result. Our page on hyaluronic acid injections presents this option.

For patients who live far from the practice, some check-ups can be done remotely. After staple removal, which can often be carried out by the family doctor according to the surgeon's written instructions, photos taken under standardised conditions allow the surgeon to monitor the position of the eyebrows and healing. An in-person check-up remains useful at three or six months for the review. If in doubt, do not hesitate to contact the practice, which will tell you whether you need to come in.

The position of the eyebrows strongly influences perceived expression. Low eyebrows drawn together suggest annoyance, a drooping tail sadness or tiredness. With age, descending eyebrows can thus give the face a permanent expression that no longer matches the person's real state of mind. Many patients say that people often ask them whether they are tired or cross. A well-judged endoscopic lift corrects this mismatch: the eyes open up and the expression softens, without the face losing its identity.

What happens under the scalp after an endoscopic lift explains the recovery instructions.

First week

The released tissues are held by the devices. A thin layer of healing tissue begins to form between the forehead and the bone. The fixation bears most of the load: this is the most sensitive period.

Second to fourth week

The internal scar gradually strengthens. The tissues begin to adhere firmly in their new position. Avoiding impacts, helmets and excessive frowning remains important.

Fifth to eighth week

Reattachment becomes solid. Fixation plays a less and less important role, just as the device begins slowly to lose its strength.

Beyond

The tissues are permanently reattached. The device continues to dissolve with no mechanical role, until it disappears.

The height of the forehead influences the choice of technique. An endoscopic lift raises the forehead upwards, which can move the hairline back slightly. In a person with a short or average forehead, this effect is imperceptible, or even welcome. In a person whose forehead is already high, it may be a drawback: the surgeon may then propose a lift at the hairline, which raises the eyebrows while slightly shortening the forehead, or a limited temporal lift, which changes the hairline very little. During the consultation, they measure the distance between the hairline and the eyebrows to advise you.

Eyebrows are never perfectly symmetrical. With age, one side often drops more than the other, sometimes because you usually sleep on the same side or because of muscular or bony asymmetry. The endoscopic lift allows one side to be raised more, and adjusting the tissues on the tines makes this fine-tuning easier. Asymmetry due to laxity can thus be clearly improved. Significant bony asymmetry, however, does not disappear completely. The surgeon will show you in the mirror what is realistic for each side.

Between the seventh and fourteenth day, the staples or stitches in the scalp are removed, at the practice or by your family doctor, according to the instructions. The procedure is quick and causes little pain. It is also an opportunity to check the healing of the incisions, the absence of infection and how the swelling is progressing. After removal, hair care becomes simpler, but the precautions concerning helmets, impacts and tight hairstyles remain valid for several weeks.

• Two pillows or a wedge pillow to sleep with your head raised.
• Cold compresses, according to the surgeon's instructions.
• Sunglasses for your first outings.
• A mild shampoo and a soft brush.
• Clothes that open at the front.
• Your medication and the prescribed painkillers.
• The practice's number and your written instructions to hand.

At around six months, the surgeon sees you again for a review. Photos are taken under the same conditions as before the procedure, allowing an objective measurement of the lift of the eyebrows, symmetry and changes in the lines. The devices are generally barely or no longer perceptible. It is also the time to discuss any maintenance treatments, such as occasional botulinum toxin injections, or a small touch-up if a defect persists.

Taking front and profile photos before the procedure and then at one, three and six months, in the same light and position, helps you judge the result objectively. In the first few weeks, the swelling and the deliberately slightly high position of the eyebrows may be worrying; the photos then clearly show the change towards a natural position. They are also useful during check-ups, particularly remote ones, to discuss any asymmetry with the surgeon.

Switzerland offers an interesting feature for patients considering an endoscopic lift: surgical schools and habits vary slightly from one region to another, particularly in the choice of fixation methods. A patient from Fribourg, Biel/Bienne or Valais can thus consult a surgeon in Lausanne and one in Bern, and compare two different approaches to the same problem.

This comparison is useful if it focuses on what matters: the diagnosis, experience with endoscopy, the planned position of the eyebrows and the organisation of follow-up. The fixation method, Endotine or another, should be just one element among others. If the two surgeons propose different approaches, ask each to explain why theirs seems best suited to your forehead.

Follow-up after a procedure in another region

If you have surgery far from home, arrange from the outset for your family doctor to take over staple removal and local care, and agree with the surgeon how to send them photos at key stages. The six-month check-up, which assesses eyebrow height and absorption, is ideally done at the practice.

Some patients seek a brow lift a few years after upper blepharoplasty. Their eyes have become heavy again, or never really opened up, because the eyebrow, already low, continued to descend. This situation requires particular attention: if a lot of skin was removed during the blepharoplasty, raising the eyebrow significantly could interfere with eyelid closure.

The surgeon therefore measures the amount of skin remaining between the eyebrow and the lashes, checks that the eyes close completely and adapts the extent of the lift. The endoscopic lift, which allows precise height adjustment on the tines, is then often a good option, provided it remains measured. Bring the report from your blepharoplasty.

• Which fixation method do you usually use, and why?
• How many devices will you place, and where?
• What will I feel under my scalp, and for how long?
• Is my scalp thick enough for the devices to remain discreet?
• What happens if a device becomes bothersome or visible?
• Do you offer a botulinum toxin injection to protect the fixation?
• When will I be able to wear a helmet and play sport again?

An experienced surgeon willingly answers these questions and explains what, in your case, justifies their method.

Thinking the bumps are abnormal

The small bumps under the scalp are expected: they correspond to the devices and the hooked tissues. Only redness, discharge or exposure should be a cause for concern.

Thinking the eyebrows are too high for good

The initial overcorrection is intentional. The eyebrows settle within a few weeks.

Interpreting numbness as a complication

Numbness of the scalp behind the incisions is usual and gradually subsides.

Wearing a helmet again because everything feels fine

Even if you feel perfectly well, reattachment is not complete for several weeks. Respect the interval given.

With declining hormones and accumulated sun exposure, the skin of the forehead thins and loses its elasticity after fifty. The deep tissues relax, the eyebrows descend faster and the lines deepen. The endoscopic lift repositions the deep tissues, which suits this situation well, but it does not restore the quality of the skin itself. Suitable skincare, daily sun protection and, later on, surface treatments usefully complement the procedure.

An endoscopic brow lift does not involve pulling the skin. The surgeon works deep down, in precise anatomical planes, which explains both the discretion of the scars and the need for fixation to the bone.

The subperiosteal plane, in the centre

In the middle of the forehead, the release is usually performed beneath the periosteum, the thin membrane covering the bone. The whole forehead — skin, muscles and periosteum — is thus lifted in one piece. It is this block that will then be hooked onto the tines of the device.

The temporal plane, at the sides

In the temples, the surgeon works above the deep fascia of the temporalis muscle, a plane that protects the nerve branch controlling the frontalis muscle. They then join the central area by releasing a strong line of adhesion that separates the two regions.

Release at the orbital rim

At the level of the eyebrows, the periosteum is attached to the bony rim of the eye socket. The surgeon incises or releases it across its whole width, otherwise the eyebrow could not be raised. This is the step that determines the extent of the correction.

The muscles between the eyebrows

Through the same approach, they can weaken the muscles that knit the eyebrows, while preserving the sensory nerves that run nearby.

Once these releases have been made, the forehead is mobile. Without fixation, it would drop back. It is at this point that the devices, placed in the bone beneath the incisions, take up the tension during healing.

After the procedure, the eyebrows often look slightly too high. This overcorrection is intentional and calculated. During the weeks of reattachment, the tissues hooked onto the tines are subject to gravity and the action of the muscles that lower the eyebrows: a small part of the lift is lost. By placing the tissues a few millimetres above the desired position, the surgeon anticipates this drop.

The extent of overcorrection depends on tissue thickness, the strength of the depressor muscles and the surgeon's experience with their fixation method. A device with tines allows this height to be set precisely before closing. That is why eyebrow height should not be judged before two to three months.

These differences in comfort say nothing about the quality of the result. They may nevertheless matter in your choice: if the idea of feeling small bumps bothers you, discuss it with the surgeon before the procedure.

Forehead height

They measure the distance between the hairline and the eyebrows. A short or average forehead lends itself well to endoscopy; a high forehead points towards other techniques.

Hair density and quality

The incisions and devices must remain hidden. Fine hair or early baldness is an important factor in the decision.

Scalp thickness

A thin scalp makes the devices more perceptible; the surgeon may then prefer another form of fixation.

Strength of the depressor muscles

Muscles that knit the eyebrows strongly put more strain on the fixation; a botulinum toxin injection before the procedure may be proposed.

Position and shape of the eyebrows

They observe which part of the eyebrow has descended — the head, body or tail — in order to choose the location of the devices and the direction of the lift.

Medical tests

The device is not metallic. It does not interfere with X-rays, CT scans or MRI, and does not set off security gates. Simply mention it if you have head imaging.

Travel

No particular precautions are needed for travelling by train or plane. During the first few weeks, just avoid sleeping with your head leaning against a window.

Hair care

Vigorous scalp massage, tight hairstyles and appliances that get very hot should be avoided while the areas remain tender.

A blow to the head

During the reattachment phase, a blow to the forehead can strain the fixation. In the event of a significant impact, tell the surgeon, even if everything seems normal.

Endotine devices are placed under the scalp, above the temples or at the top of the forehead. During the weeks when they can be felt, it is best to avoid tight helmets, sports headbands and hairbands that would press on them. Prescription glasses or sunglasses can be worn normally, as their arms sit lower down.

For cycling, skiing or work activities that require a helmet, ask your surgeon when you can resume; it depends on the position of the devices and the rate of absorption, often four to six weeks. A slightly loosened helmet with soft padding is generally tolerated earlier than a rigid, tight one.

Budget

Price differences between cities and cantons, the quote breakdown and ways to save are detailed on our page Endotine endoscopic lift: prices in Switzerland.

Related procedures

• Neck and face lift in Switzerland
• Deep plane facelift in Switzerland
• Double chin: FaceTite and J-Plasma in Switzerland
• Brow and temporal-midface lift in Switzerland
• Rhinoplasty in Switzerland

Our guides

• Facelift in Switzerland
• Cosmetic surgery in Switzerland

Answers to the questions most often asked by patients living in Switzerland about the endoscopic lift and Endotine fixation. Budget questions are detailed on our page on Endotine endoscopic lift prices in Switzerland.

The Endotine device

What is Endotine? It is a small absorbable fixation device used in facial cosmetic surgery, mainly in the endoscopic brow lift. It consists of a base inserted into a small socket drilled in the skull bone and a platform fitted with tines. The surgeon hooks the lifted forehead tissues onto it, holding them in place while they reattach to the bone. The device then slowly dissolves, with no need to remove it. It is one fixation method among others; most of the result depends on the diagnosis and the quality of the surgery.

What is Endotine made of? It is made from an absorbable copolymer, from the same family as the materials used for some absorbable sutures and some bone surgery plates. The body gradually breaks it down by hydrolysis and eliminates the fragments. These materials have been used in surgery for many years and are generally well tolerated. The surgeon can tell you the exact reference of the device, which also appears in the operative report.

How long does Endotine take to dissolve? Complete absorption takes several months, often around six months to a year depending on the model and the person. During the first few weeks, the device retains its full strength, at the time when fixation is most needed. Its strength then decreases, by which time the tissues have already reattached to the bone. Throughout this period, no particular precautions are needed beyond the first few weeks of healing.

Does Endotine need to be removed? No, in the vast majority of cases. The device is designed to dissolve by itself. Removal is only considered in exceptional situations, for example in the event of a persistent inflammatory reaction or exposure through an incision. If discomfort persisted beyond the expected absorption time, a consultation would identify the cause.

How many devices are placed? For an endoscopic brow lift, one is generally placed on each side, beneath the incisions above the tail of the eyebrows. The number and exact position depend on anatomy, the desired correction and the surgeon's habits. The surgeon may sometimes add some in the temples, depending on the extent of the correction and the area to be held.

How is Endotine fixed to the bone? The surgeon drills a small socket a few millimetres deep in the outer layer of the skull bone, using a drill with a safety stop that limits the depth. The base of the device is inserted into it and holds by press-fit. The skull bone is thick at this point, and the procedure only reaches its superficial layer. It is performed under direct vision, and the depth is limited by the drilling device itself.

Do the tines damage the tissues? The tines are designed to hook the tissues without tearing them, spreading the tension over a surface rather than a single point. Slight local tenderness is common during healing, but the tissues are not permanently damaged. As the tension is spread over several tines, the tissues are better protected than with a single fixation point.

Are there several Endotine models? Yes. The most widely used model is designed for the brow lift. Other models, in the form of small strips with tines, are designed to lift the midface or to reposition the eyebrow through a blepharoplasty incision. The surgeon chooses according to the area treated and the approach. The operative report specifies the model used, which is useful for any later follow-up.

Has Endotine been used for long? The device has been used in facial cosmetic surgery since the early 2000s. It therefore has a substantial clinical track record, and many surgeons around the world have incorporated it into their endoscopic lift practice. This track record means its advantages, limitations and side effects are well known.

Is Endotine authorised in Switzerland? Medical devices used in Switzerland must comply with Swiss regulations, under the supervision of Swissmedic. The surgeon should be able to tell you which device is used and give you its reference, which also appears in the operative report. Do not hesitate to ask which device is used and how long the surgeon has been using it.

Is Endotine better than other fixation methods? Not demonstrably. Studies and surgeons' experience show good results with several methods: Endotine, bone tunnels, temporary screws, temporal sutures. The choice depends mainly on the surgeon's habits and your anatomy. What matters most is the quality of tissue release and the practitioner's experience. The main criterion therefore remains the surgeon's experience with endoscopic lifts.

Why does a surgeon choose Endotine? For its speed of placement, the distribution of tension over a surface, the possibility of adjusting the position of the tissues on the tines, and the fact that it does not need removing. It often shortens the procedure compared with bone tunnels. These practical advantages explain its adoption by many teams.

Why does a surgeon prefer another method? Some surgeons achieve excellent results with bone tunnels, without an implant and at no extra cost, or with screws they have mastered for a long time. Others take into account the discomfort some patients may feel from being able to feel the devices. These choices are legitimate. This choice should not worry you: several methods give good results.

Does Endotine increase the price of the procedure? Yes, generally, as the device has a cost that is added to the fees and clinic costs. This difference is partly offset by a sometimes shorter operating time. Our page on Endotine endoscopic lift prices in Switzerland details these differences in percentage terms. Always compare complete quotes, with equivalent techniques and combined procedures.

Can Endotine cause an allergy? True allergic reactions to absorbable copolymers are exceptional. A local inflammatory reaction during absorption is possible but generally temporary. Tell the surgeon about any previous reaction to an implant or absorbable sutures. Any history of reaction to sutures is worth mentioning during the consultation.

Can Endotine be seen? No, it cannot be seen, as it is placed under the scalp, behind the hairline. It can, however, be felt to the touch as small bumps for a few weeks to a few months. Most patients no longer notice it after a few months.

Does Endotine interfere with a CT scan or MRI? The device is made of a non-metallic polymer material. In principle, it poses no problem for a CT scan or MRI. Nevertheless, tell the radiologist it is there and give them the operative report. The operative report can be useful to the radiologist for head imaging.

What happens to the socket drilled in the bone? As the device dissolves, the small socket drilled in the outer layer of the bone gradually fills with bone. Generally, no perceptible trace remains. This bone regrowth is a natural process requiring no intervention.

Can Endotine migrate? Once inserted into its bone socket, the device stays in place. Displacement is very rare and tends to occur after a significant impact or a healing problem. This is another reason to avoid helmets and impacts during the first few weeks. That is why impacts and wearing a helmet must be avoided in the first few weeks.

Can a brow lift be repeated after a first lift with Endotine? Yes. Years later, the device will have dissolved, and a new lift can be performed with whichever fixation method is chosen. Bring the report from the first procedure to the surgeon. The surgeon simply adapts the procedure to tissues that have already been operated on.

The procedure

What is an endoscopic lift? It is a lift performed using an endoscope, a fine camera introduced through small incisions and connected to a screen. The surgeon sees a magnified image of the deep structures being operated on, allowing precise release of the tissues without a large incision. For the forehead, three to five incisions of one to two centimetres in the scalp are enough. It has largely replaced techniques with a long incision across the top of the head.

Does an endoscopic lift leave scars? Yes, but they are short and hidden. Three to five incisions about one to two centimetres long are placed behind the hairline; two of them are also used to place the devices. Once healed, they blend into the scalp. In people with very fine hair or a receding hairline, their position should be discussed before the procedure.

How long does the procedure take? An endoscopic brow lift with Endotine generally takes two to three hours. The duration increases if other procedures are combined, such as blepharoplasty, a midface lift or fat transfer. A longer duration often reflects the precision of the work and the extent of the combined procedures.

What anaesthesia is used? Usually general anaesthesia, sometimes local anaesthesia combined with deep sedation. The choice is made with the anaesthetist according to your health, the planned duration and your preferences. The anaesthetist sees you in consultation before the procedure to discuss it.

Do I need to stay at the clinic? Depending on the anaesthesia and combined procedures, discharge is on the same day or the next day. You must be accompanied home. If you live far away, a night near the clinic can make the journey home more comfortable.

Does the hair need to be shaved? Generally, no. The hair is simply parted, sometimes shaved along a very narrow strip along the incisions. Once combed back, nothing shows. Once the hair is combed back, the incisions are practically invisible.

Does an endoscopic lift treat frown lines? Yes, it can soften them lastingly: through the endoscope, the surgeon can weaken the muscles that knit the eyebrows. A line deeply etched into the skin may require additional treatment. Occasional injections can then maintain the effect.

Does an endoscopic lift erase forehead lines? It softens them indirectly. When the eyebrows are lifted and held in place by the fixation, the frontalis muscle no longer needs to compensate for their drop, and the horizontal creases deepen less. The effect develops over several months. A line etched into the skin for a long time often leaves a trace, which can later be treated with injections or laser.

Does an endoscopic lift move the hairline back? A slight backward shift is possible, as the forehead is lifted upwards. In most patients, it is imperceptible. In people whose forehead is already high, the surgeon may propose another technique. The surgeon measures the height of your forehead during the consultation to take this into account.

Can the surgeon adjust the height of the eyebrows during the procedure? Yes. With Endotine, the surgeon lifts the tissues and hooks them onto the tines, then checks symmetry and height. They can reposition the tissues before finalising the correction, allowing fine adjustment. This fine adjustment helps achieve a natural, symmetrical position.

Can an endoscopic lift treat both sides differently? Yes. If one eyebrow is lower than the other, the surgeon can lift one side more. Perfect symmetry is not always achievable, however, as eyebrows are never strictly identical.

Can blepharoplasty be combined? Yes, it is a common combination. The surgeon first lifts the forehead, then removes the remaining excess eyelid skin. This order avoids removing too much skin. The order of the steps prevents too much eyelid skin from being removed.

Can a midface lift be combined? Yes. Some Endotine models are designed to lift the upper cheek and cheekbone, through a temporal incision or through the lower eyelid. This combination rejuvenates both the eyes and the upper face. This type of combination requires general anaesthesia and sometimes a night at the clinic.

Can a facelift be combined? Yes. An endoscopic brow lift can be combined with a neck and face lift or a deep plane facelift, to rejuvenate all three levels of the face under a single anaesthetic. A single anaesthetic and a single recovery period are then enough.

Is an endoscopic lift suitable for men? Yes, with precautions: the male eyebrow must remain low and horizontal, and present or future baldness must be taken into account when placing the incisions and devices.

What about baldness? Frontal baldness makes the incisions and devices harder to conceal. The surgeon may then propose a temporal lift or repositioning of the eyebrow through a blepharoplasty approach. The probable progression of baldness is also taken into account.

Is an endoscopic lift suitable for a high forehead? In a person with a very high forehead, the slight backward shift of the hairline may be a drawback. A lift at the hairline, which can even shorten the forehead, is often preferable. The surgeon chooses the technique that best preserves the proportions of the face.

At what age can an endoscopic lift be performed? It is mainly performed between forty-five and seventy, but age counts for less than the position of the eyebrows, tissue quality and general health.

Is smoking a contraindication? It is not an absolute contraindication, but a serious risk factor. Nicotine reduces the blood supply to the undermined scalp, which weakens the healing of the incisions, increases the risk of localised hair loss and may encourage a reaction around the devices. Most surgeons ask you to stop for several weeks, including nicotine replacement products.

Can I get a first opinion without travelling? Yes. A pre-assessment based on photos — front at rest, with eyebrows raised, eyes closed, profile and three-quarter views — allows a surgeon to tell you whether an endoscopic lift seems appropriate. This preliminary opinion does not replace the clinical examination, but it is a useful step in preparing the consultation.

Recovery and sensations

Will I feel the Endotine? Yes, to the touch. During the first few weeks, you can feel one or two small bumps on each side under the scalp, at the incisions. They cannot be seen, as they are hidden by the hair. They fade as the tissues heal and the device dissolves, and most patients no longer feel them after a few months. These sensations do not interfere with daily activities and are nothing to worry about.

Are the devices painful? They are not generally painful at rest. Tenderness or slight discomfort when pressing on the area, brushing your hair or sleeping on your side is common in the first few weeks. It gradually decreases. If pain appears or increases, tell the surgeon.

How long is the recovery? The visible period lasts about two weeks, while the swelling that has moved down towards the eyes subsides. The period of precautions is longer: until the tissues have firmly reattached to the bone, the fixation must be protected, which means no helmet, no impacts and no strenuous effort for several weeks.

Why do the eyes swell? Two to three days after the procedure, swelling and small bruises from the forehead move down to the eyelids under the effect of gravity. The eyes may look puffy and bruised for a few days. This is normal and temporary.

Does the scalp stay numb? Often, yes, for a while. During endoscopic release, the small sensory nerves running up from the rim of the eye socket to the top of the head are stretched. The area behind the incisions may remain numb or tingly for weeks, or even a few months, then sensation returns from the forehead towards the back of the head.

When can I wash my hair? The surgeon generally allows the first wash after two days. Let lukewarm water run over without rubbing the device areas, apply a mild shampoo with your fingertips, rinse thoroughly and dry on a low heat: the numb scalp will not signal excessive heat.

Can I brush my hair? Yes, with a soft brush and gentle movements, avoiding catching the incisions and pressing on the device areas during the first few weeks.

When are the staples removed? Staples or stitches in the scalp are generally removed between the seventh and fourteenth day, at the practice or, according to the instructions, by your family doctor. If you live far away, this can save a journey.

Can I wear a helmet? No, not during the first few weeks. A cycling, ski or motorcycle helmet presses on the forehead and temples, where the devices and the reattaching tissues are. Your surgeon will tell you when you can wear one again. The surgeon will tell you the exact timing based on how your healing progresses.

Can I wear a hat or headband? Avoid anything that squeezes the forehead during the first few weeks. A loose, light, wide-brimmed hat that does not compress is often allowed sooner for sun protection. A hat that does not squeeze is enough to protect you from the sun.

Can I sleep on my side? It is advisable to sleep on your back, with your head raised, for one to two weeks. Sleeping on your side presses on the temples and can be uncomfortable where the devices are.

When can I resume sport? It all depends on the type of activity. Walking is beneficial from the first few days. Moderate endurance activities, without a helmet or risk of falling, can resume around the third week. Anything involving a helmet, a possible blow to the head or straining with a closed glottis has to wait until the fixation has consolidated, generally one to two months depending on the surgeon.

When can I go back to work? If you work at a screen, a return to work from home is often possible at the end of the first week. Returning to the workplace, facing clients or colleagues, is more likely after two weeks, once the bruising around the eyes has cleared. A job requiring a hard hat or physical effort needs more time.

Should I avoid frowning? Yes, as far as possible during the first few weeks. Frowning or strongly raising the eyebrows puts strain on the tissues that are reattaching. Some surgeons offer a botulinum toxin injection before or after the procedure to rest these muscles. This precaution protects the fixation during the critical reattachment period.

My eyebrows look too high: is this normal? It is even intended to some extent. When hooking the tissues onto the tines, the surgeon often places the eyebrows slightly above their final position, as they drop slightly during reattachment. For the first few weeks, the eyes may therefore look surprised; they gradually settle at the right height.

When is the result final? The position of the eyebrows can be judged around the third month, when reattachment is solid and the swelling has gone. The final review is more likely to take place between six months and a year, by which time the device will have largely dissolved and sensation in the scalp will have returned.

How long does the result last? Once the tissues have reattached to the bone in their new position, the result is stable for many years. Fixation only matters during healing; after that, it is the internal scar that holds the forehead in place. Natural ageing continues, but from a more favourable starting point.

Can I colour my hair? Colouring and highlights generally have to wait four to six weeks, until the incisions have healed well. Warn your hairdresser so that they do not pull near the incisions or press on the devices. Choose a hairdresser who knows about the procedure.

Can I have a scalp massage? Not during the first few weeks. A vigorous massage could press on the devices and the reattaching tissues. Ask your surgeon before resuming. Your surgeon will tell you when it is safe to resume.

Will those close to me notice the procedure? During the first week, swollen, discoloured eyes will draw attention. After that, nothing betrays the procedure: the incisions and devices are under the hair. Those around you generally notice a less tired or less stern face, often without being able to say what has changed.

Risks and safety

What are the risks specific to Endotine? Being able to feel the devices for several weeks is the most common effect. More rarely, prolonged local discomfort, an inflammatory reaction during absorption or, exceptionally, exposure of the device through an incision can occur. These situations are generally treated simply. The surgeon will explain how these situations are managed.

What are the risks of an endoscopic lift in general? Apart from the effects specific to the device, there are the risks common to forehead procedures: reduced scalp sensation, a slight difference in height between the two eyebrows, a correction considered too strong or too weak, hair loss at the edge of an incision, bleeding, infection and, rarely, temporary weakness of the muscle that raises the eyebrow.

Can the device become infected? Infection around the device is rare. It shows as redness, swelling, increasing pain or discharge. Antibiotic treatment is often enough; exceptionally, removal of the device is necessary. Redness or discharge must always be reported promptly.

What if the device becomes visible? Contact the surgeon. Exposure is exceptional and occurs mainly with thin skin or difficult healing. The device is then repositioned or removed, generally with no consequence for the result if tissue reattachment is already well advanced. This situation remains exceptional in patients who heal normally.

Can the eyebrows drop again? A partial drop is possible if tissue release was insufficient or if the fixation gave way during healing. Following the instructions — avoiding impacts, helmets and excessive frowning in the first few weeks — limits this risk. A touch-up is possible if necessary, generally after six months.

Can I lose the ability to raise my eyebrows? It is rare. The nerve that controls the frontalis muscle runs through the temporal region, outside the plane of release used in endoscopy. Stretching can, however, cause temporary weakness on one side. In the vast majority of cases, movement returns spontaneously within a few weeks to a few months.

Can I lose hair? Thinning of the hair may appear right at the edge of the incisions, especially if they were closed under tension or if the patient smokes. It is usually temporary: the follicles, put to rest by the trauma, start growing again within a few months. The short incisions of endoscopy limit this phenomenon.

Is drilling the bone dangerous? The socket is drilled in the outer layer of the skull bone, which is thick at this point, with a drill fitted with a safety stop that limits the depth. The procedure is controlled and does not involve deep structures. The surgeon will explain the procedure precisely during the consultation.

Is an inflammatory reaction serious? Generally not. Tenderness or slight swelling around the device during its absorption is usually temporary. A persistent reaction, with redness or discharge, must be reported to the surgeon. It generally disappears as the device dissolves.

Which signs should alert me? Call the practice without delay if swelling suddenly increases on one side, pain intensifies instead of decreasing, there is warm redness around an incision or device, discharge or fever, or if a device becomes visible. A visual disturbance or intense eye pain warrants an emergency consultation or a call to 144.

Do I need to stop certain medicines? Yes, some. Products that encourage bleeding, such as aspirin, anti-inflammatories, some herbal supplements or high doses of omega-3, are generally suspended one to two weeks beforehand, but only with the doctor's agreement. Anticoagulant treatment prescribed for an illness is managed in consultation with the prescribing doctor.

Does smoking increase the risks? Yes, at several levels: slower healing of the scalp incisions, an increased risk of hair loss at the edges, and a less favourable environment around the devices during their absorption. Stopping clearly improves these parameters; ask your surgeon how long they recommend.

Is a haematoma possible? It is possible but uncommon after an endoscopic brow lift, as the release takes place in a plane with few blood vessels. It shows as tense, painful swelling, generally on one side, in the first few hours or days, and warrants an immediate call to the practice.

Can the result look artificial? Yes, if the eyebrows are raised too high or in the wrong direction. The ability to adjust the position of the tissues on the tines helps the surgeon find the right height, but planning remains essential. A mirror simulation before the procedure helps set the desired height.

What if I am not satisfied? First let time do its work: eyebrow height changes during reattachment and swelling is deceptive. If, at six months, asymmetry or insufficient correction persists, the surgeon may propose a touch-up, sometimes limited to one side. Reference photos taken before the procedure help assess the result objectively.

Who should perform the procedure? A doctor holding an appropriate specialist title, usually in plastic, reconstructive and aesthetic surgery, sometimes in oculoplastic or maxillofacial surgery, who regularly performs endoscopic forehead surgery. The MedReg register allows you to check the title; experience is checked by asking precise questions during the consultation.

Is the procedure safe after 70? In a person in good health, yes, after an appropriate check-up. A thinner scalp may make the devices more perceptible; the surgeon may propose another fixation method or a simpler technique. The surgeon may also propose a simpler, shorter technique.

Are complications covered by insurance? It depends on your policy and the nature of the complication. For a purely cosmetic procedure, the after-effects may not be covered by basic insurance. In an emergency, you will always be treated; the question concerns billing. Ask your insurer in writing and ask the surgeon what their fee covers.

Can I go through security gates? Yes. The device is made of non-metallic polymer and does not set off metal detectors. No particular precautions are therefore needed when you travel.

How can I reduce my risks? Choose an experienced surgeon, stop smoking, report your medical history and treatments, rest, avoid helmets, impacts and excessive frowning in the first few weeks, and attend your check-ups. Attending the check-ups allows any abnormality to be detected quickly.

Organising your procedure in Switzerland

Where can I have an endoscopic lift with Endotine in Switzerland? Endoscopic lifts are mainly performed in the major cities: Zurich, Geneva, Lausanne, Basel, Bern, Lucerne, St. Gallen and Lugano. Not all surgeons use Endotine; ask which fixation method is used. A photo-based pre-assessment can help you target a suitable surgeon.

How much does an endoscopic lift with Endotine cost? Each surgeon sets their fees freely. The device represents an additional material cost, which generally places the procedure slightly above fixation with bone tunnels. Our price page expresses these differences, and those between cities, in percentage terms.

Does LAMal reimburse the procedure? Not when the aim is to rejuvenate the eyes. If, however, the drooping eyebrow obscures part of the field of vision, an ophthalmologist can measure it, and a prior cost approval request can be sent to the insurer before the procedure. Approval is never automatic.

I live far from a major centre: what should I do? A photo-based pre-assessment helps you target a suitable surgeon. Arrange for someone to accompany you home, possibly a night near the clinic, and ask whether your family doctor can remove the staples. Your family doctor can provide part of the local follow-up.

How many days off should I plan for? Allow about two weeks if your work puts you in front of other people, a little less if you can work remotely. These days are in principle taken as holiday, as a cosmetic procedure is not considered an illness.

What is the best time of year? Autumn and late winter, outside the ski season, are often the most comfortable, as helmets are not advised for several weeks and the sun must be avoided on the forehead.

What should the quote contain? It should name the fixation device used, itemise the surgeon's and anaesthetist's fees, facility and endoscopic equipment costs, cost each combined procedure separately and specify VAT, the check-ups included and the conditions for any touch-up.

Should I consult several surgeons? It is advisable, to compare diagnoses, techniques and fixation methods. If the proposals differ, ask each surgeon to explain their choice.

Can my family doctor help me? They know your file: they can carry out the preliminary tests, adjust a treatment in liaison with the anaesthetist and, if the surgeon allows, remove the staples close to home. Tell them about the devices, which is useful if they examine you during the months of absorption.

Can I be followed up in my own language? Endoscopic lifts are performed in centres in all three main language regions. If you live in a bilingual region, you can choose a surgeon who consults in your language, or in English in most major cities.

How many check-ups should I plan for? Usually four to five: a first one in the days after the procedure, one for staple removal, then spaced check-ups up to the six-month review, which checks the height of the eyebrows and the progress of absorption.

What should I prepare at home? A wedge pillow, cold compresses, a soft-bristled brush, a neutral shampoo, sunglasses and button-up clothes. Also put helmets, tight hats and headbands out of reach so you are not tempted to wear them too soon.

Do I need someone with me? Yes. After general anaesthesia or sedation, you must not drive or go home alone. Having a trusted person with you for the first night is strongly recommended.

Which documents should I keep? The operative report, which specifies the device used, prescriptions, instructions and the invoice. Tell any doctor who follows you during its absorption about the device.

Are waiting times long? They vary by city and practitioner. The busiest surgeons in Zurich or Geneva often offer a first appointment several weeks ahead. If you are aiming for a specific period, such as late spring before the cycling season, get in touch two to three months in advance.

Can other procedures be combined? Yes: blepharoplasty, midface lift, fat transfer or lower facelift. The surgeon assesses whether the combination is reasonable for your health. The surgeon assesses whether the total duration remains reasonable for you.

Should I see an ophthalmologist beforehand? Not systematically. It is recommended if you have dry eyes, have previously had eye surgery or if the drooping eyebrow impairs your upward vision, in which case a visual field test can support an insurance request.

Can I get an estimate before consulting? Yes. From a few photos, a surgeon can indicate whether an endoscopic lift seems relevant and give a rough idea of the budget. This estimate is indicative and will be refined after the examination.

What if I need an X-ray? The polymer device is barely visible or invisible on X-ray and does not interfere with tests. Mention it if you have head imaging. The operative report can be passed on to the radiologist if necessary.

How can I get a personalised opinion? Use the form on this page: attach photos from the front, with eyebrows at rest and then raised, eyes closed, in profile and at three-quarters, together with your medical history. A surgeon analyses your eyes and proposes an approach and a budget range. The opinion is free and without obligation.

Send us photographs — front at rest, with eyebrows raised, eyes closed, profile and three-quarter views, in natural light — together with your medical history. A surgeon reviews your file and tells you whether an endoscopic lift is suitable, which approach would be considered and what budget to plan for. Free, no obligation, no administration fees.