What if it was done via endoscopic brow lift?

The short version: endoscopic brow lift is a heavier surgery than picking a sliver, and the evidence here does not compare it to simpler removal.

The retrieved studies cover endoscopic forehead surgery for cosmetic and reconstructive goals, not for removing gold needles. One case series of five patients used endoscopic subgaleal undermining to close scalp defects and place implants [3]. That shows the approach can reach the plane where your needles sit, but it also shows the trade: one patient had partial wound dehiscence, another needed a second procedure [3]. A larger review of brow lift techniques lists temporary forehead numbness and poor scars among the known complications [1, 2]. None of these studies removed a susuk needle, so the specific risk of endoscopic removal is unmeasured.

The real question is whether the endoscope buys you anything. Your needles are small, roughly splinter-sized, and not very deep. A direct small incision over each needle, guided by imaging, reaches them with less dissection. The endoscope adds ports, wider undermining, and a longer recovery to solve a problem that is mostly about precision, not access. The one thing the endoscope genuinely helps with is seeing around corners, which matters if a needle sits near the supraorbital nerve or a vessel. That is exactly why imaging before surgery matters more than the choice of tool.

The evidence does not support endoscopic removal as safer. It supports the opposite: more dissection, more tissue disruption, more recovery, for a foreign body that a direct approach can reach. The burden of proof is on the heavier intervention, and nothing here meets it.

My call: choose direct small incisions with imaging, not an endoscopic brow lift, unless imaging shows a needle tucked where direct access would endanger a nerve. Confidence: moderate, because no study in this retrieval compares the two approaches for needle removal.