The ENDOTINE Forehead is a resorbable soft tissue fixation system that has revolutionised brow lifting.

Coapt Systems' patented Multipoint technology ensures unrivalled fixation strength whilst the copolymer of poly-lactic and poly-glycolic acids means the device will totally resorb once periosteal readherence has occurred.

Performing a brow lift with the ENDOTINE Forehead couln't be simpler and because the need for cumbersome fixation sutures is eliminated, the procedure is very fast. Placement of the ENDOTINE forehead device can be achieved in under 1 minute by an experienced ENDOTINE user and the entire browlift procedure can be completed in around half an hour.

The ENDOTINE forehead device can be used in open and endoscopic brow lift procedures meaning you don't have to alter your method to take advantage of the many benefits offered by the Forehead device.

Brow Lifting with the ENDOTINE Forehead

In order to perform a brow lift with the ENDOTINE Forehead device you will first need to select the device that is most suitable for your patient. Device options are explained below.

Next, perform your usual sub-periosteal dissection of the brow. This is commonly done by making either three or five small incisions around 3cm behind the hairline. One in the midline, two paramedian incisions and sometimes one at each temple.

Once the brow has been released you will need to mark out where to drill the holes which will house the devices. The holes will be drilled towards the posterior end of the paramedian incisions. A good way to work out the ideal hole position is to elevate the brow to its desired post-op position. With the brow elevated, mark a spot on the skull at the anterior end of the incision. This is where you will drill. Now let the brow fall back to its natural position. You will see that the mark you made on the skull is now somewhere between the middle and the back of the incision. This will make the drill site easily accessible and will also ensure that when the device is placed and the brow is elevated, the tines will be under undamaged tissue.

Once the drill position is marked the hole can be drilled using the ENDOTINE Forehead drill bit. This bit will create a hole that is the correct size to lock the anchoring post in place. It also has a stop on it to ensure you don't drill too deep.

Once the hole is drilled, the device is picked up on the insertion tool and is placed into the hole by applying firm pressure. The flanges on the anchoring post will lock the device in place and frequently a popping sound can be heard as the device locks in place.

Once the device is placed, the brow tissue can be elevated and hooked onto the tines. The tissue is held onto the tines by applying downward pressure which causes the tines to puncture the periosteum and galea and holds the tissue firmly in place.

The incisions can be then closed using your standard technique.

Device Selection

There are three devices to choose from; The ENDOTINE Forehead, The Ultratine Forehead and the ENDOTINE Triple.

The ENDOTINE Forehead is the original ENDOTINE device. It comprises an anchoring post, a triangular platform which when placed sits flush with the skull and 5 spikes or tines. This device will resorb in approximately 9-12 months and is available in two sizes; the 3.0 and 3.5. The size of the device relates to the length of the tines and as a general rule, the 3.5 should be used where the patient has very heavy brow ptosis or has had previous brow surgery. For all other cases the 3.0 should be the device of choice.

The Ultratine Forehead is exactly the same design as the ENDOTINE Forehead however the Ultratine is made from a different formulation of the same co-polymer which means it will resorb much faster.Resorbtion time for the Ultratine is approximately 60-90 days and is therefore ideal if you want the benefits of ENDOTINE fixation but are concerned about the device remaining in place for a long period. It is important to note however that the Ultratine device is quite brittle and care should be taken when placing it to ensure it is not damaged. Device selection is the same as for the ENDOTINE forehead.

The ENDOTINE Triple was designed to provide an option suitable for patients with very thin tissue where device palpability may be an issue. The Triple is a smaller triangle with only three tines and comes preloaded on an insertion tool and is packed with a sterile drill bit.

Instrumentation Requirements

The instrumentation requirements for use of the ENDOTINE devices are small over and above what you will have on hand. You will need access to a low speed drill, preferably a manual drill, as well as a set of periosteal elevators and if you are using the ENDOTINE or Ultratine Forehead devices, you will also need the ENDOTINE Forehead instrument kit. This is a small kit comprising an insertion tool, two single use drill bits and a sterilising tray.

Ordering Codes

22202	ENDOTINE Forehead 3.0 (pair)
22102	ENDOTINE Forehead 3.5 (pair)
CFD-010-0167	ENDOTINE Triple
23202	Ultratine Forehead 3.0 (pair)
23102	Ultratine Forehead 3.5 (pair)
CFD-010-4320	ENDOTINE Forehead Instrument Kit
CFD-010-4313	ENDOTINE Forehead Drill Bit
CFD-899-4000	Coapt Manual Surgical Drill