EndoChor® Transblepharoplasty: Scarless Brow Lift Through the Eyelid — Dr. Karaaltın's Innovation

The Problem with Traditional Brow Lifts

For decades, patients seeking brow rejuvenation faced an uncomfortable trade-off: effective lifting required either a coronal incision (ear-to-ear across the scalp) or multiple endoscopic port incisions in the hairline. While these approaches deliver results, they carry limitations — visible scarring in patients with thin hair, potential hairline elevation, scalp numbness, and the need for a separate procedure if upper blepharoplasty is also required.

Prof. Dr. Mehmet Veli Karaaltın recognised that many patients presenting for upper blepharoplasty also had early-to-moderate brow ptosis contributing to their "heavy" or "tired" appearance. He developed the EndoChor® Transblepharoplasty technique to address both problems through a single, hidden incision.

What Is EndoChor® Transblepharoplasty?

The technique combines three surgical objectives in one operation:

1. Upper blepharoplasty — removal of excess eyelid skin and, when needed, orbital fat repositioning
2. Subperiosteal brow elevation — lifting the brow from beneath the periosteum (the membrane covering bone) for stable, long-lasting repositioning
3. EndoChor® implant anchoring — a biodegradable polycaprolactone (PCL) implant is placed in the subperiosteal pocket above the orbital rim to maintain the elevated brow position

All three steps are performed through the natural upper eyelid crease incision — the same incision that would be used for standard blepharoplasty alone.

The EndoChor® Implant: How It Works

The EndoChor® implant is a CE-certified biodegradable device made from medical-grade polycaprolactone (PCL). Unlike permanent implants, it is engineered to:

• Provide immediate structural support — holding the elevated brow in its new position from day one
• Stimulate collagen remodelling — as the PCL scaffold gradually resorbs, the body replaces it with organised native collagen
• Fully resorb in 18–24 months — leaving behind only the patient's own tissue as the permanent support structure
• Leave no foreign material — unlike permanent mesh or screws, nothing remains long-term

Surgical Technique: Step by Step

1. Marking & Anaesthesia

The upper eyelid crease is marked in the standard blepharoplasty fashion. The procedure is performed under local anaesthesia with sedation — general anaesthesia is rarely needed.

2. Upper Blepharoplasty

Excess upper eyelid skin (and redundant orbicularis muscle, if needed) is excised. Herniated orbital fat pads are conservatively addressed — often repositioned rather than removed to maintain periorbital volume.

3. Subperiosteal Access

Through the same incision, the periosteum is identified at the superior orbital rim and carefully incised. A subperiosteal pocket is developed superiorly and laterally using blunt dissection, releasing the brow from its attachments and allowing it to be repositioned.

4. EndoChor® Implant Placement

The pre-shaped EndoChor® implant is introduced into the subperiosteal pocket and positioned to create the desired lifting vector. The implant's design allows it to be trimmed or contoured to each patient's specific anatomy.

5. Closure

The eyelid crease incision is closed with fine sutures. No drains are required. The entire procedure typically takes 60–90 minutes.

Why This Technique Is a Game-Changer

No Scalp Scars

Unlike endoscopic or coronal brow lifts, there are absolutely no incisions in the scalp or hairline. This is particularly valuable for male patients or women with thin hair where scalp scars would be visible.

Two Procedures, One Recovery

Patients who would otherwise need both blepharoplasty and a brow lift can achieve both through a single surgery with a single recovery period — saving time, cost, and cumulative anaesthesia exposure.

No Permanent Foreign Material

The biodegradable nature of the EndoChor® implant means patients benefit from initial structural support without the long-term risks associated with permanent hardware (screws, plates, or mesh).

Natural, Long-Lasting Results

Because the lift is achieved at the deep subperiosteal level — not by pulling on skin — the results are stable and natural-looking, avoiding the "surprised" appearance sometimes associated with aggressive brow lifts.

Recovery Timeline

• Days 1–3: Mild swelling and bruising around the eyes, controlled with cold compresses
• Days 5–7: Suture removal
• Week 2: Most patients return to work and social activities
• Month 1–3: Progressive settling and refinement of brow position
• Month 3–6: Final results as collagen remodelling completes

Ideal Candidates

The EndoChor® transblepharoplasty is ideal for patients who:

• Have upper eyelid redundancy combined with mild-to-moderate brow ptosis
• Want brow elevation without scalp scars
• Prefer a single procedure with one recovery period
• Are concerned about permanent implant materials
• Seek natural, non-overdone rejuvenation of the upper face

Why Choose Prof. Dr. Karaaltın?

As the inventor of this technique and a triple board-certified surgeon (Plastic Surgery, Hand Surgery, Maxillofacial Surgery) with EBOPRAS Fellowship, Prof. Dr. Karaaltın brings unparalleled expertise to every case. His Istanbul clinic operates in JCI-accredited facilities, and international patients from the UK, Ireland, USA, and beyond benefit from all-inclusive surgical packages.

Book Your Consultation

Interested in the EndoChor® transblepharoplasty? Contact Prof. Dr. Karaaltın's team for a personalised assessment and learn whether this innovative technique is right for you.