ABSTRACT
Eyebrows play a significant role in an individual's expression of emotions and nonverbal communications. Nonendoscopic approaches to brow lifting include the coronal, pretrichial, direct, midforehead, and transblepharoplasty approaches. Endoscopic brow lift has become widely accepted as a procedure for restoring a youthful brow, hardly noticeable incisions of the scalp are needed for this subperiosteal dissection and final repositioning of the brow. The choice of incision and approach is based on the patient's forehead height and hairline position, and the patient's desired effect and surgeon's comfort and experience with a given procedure. Endoscopic brow lift is a predictable procedure for rejuvenation of the upper third of the face with minimal complications and obtains satisfactory aesthetic results.
ABSTRACT
Introdução: A descida das sobrancelhas faz parte do processo natural de envelhecimento do terço superior da face. A ação da musculatura glabelar é uma das causas desta ptose e de outros sinais de envelhecimento. Estes sinais devem ser diagnosticados e tratados de maneira adequada durante os procedimentos de blefaroplastia sob pena de piora da ptose e de resultado não satisfatório. Métodos: Ao longo dos últimos 17 anos, um total de 246 pacientes, portadores de alterações do terço superior da face e com indicação de blefaroplastia, foram submetidos à elevação transpalpebral das sobrancelhas pela técnica de McCord modificada, mediante ampla dissecção, maior número de pontos de fixação e miomectomias dos músculos corrugadores e prócerus. Os pacientes foram acompanhados com avaliações ambulatoriais e com registros fotográficos nos 6 e 12 meses de pós-operatório. Resultados: A intercorrência mais comum foi a parestesia temporária da região frontal e do couro cabeludo. Não ocorreram casos de hematomas pós-operatórios. Ao longo do tempo foram observados resultados consistentes, com manutenção da elevação das sobrancelhas e diminuição efetiva da ação da musculatura glabelar, sem cicatrizes no couro cabeludo. Conclusões: A elevação transpalpebral de sobrancelhas, associada à miomectomia glabelar, mostra-se uma alternativa adequada, segura e efetiva para tratamento dos sinais de envelhecimento do terço superior da face.
Introduction: The brows lowdown naturally occur as an aspect of the aging upper face process. The glabelar muscular action is one cause of this ptosis and also of others aging signs. These signs must be adequately treated during the blepharoplasty, to avoid the penalty of a limited final result. Methods: Along of the last 17 years, a total of 246 patients with aesthetic problems of the upper face and with blepharoplasty indication, were submitted to a transpalpebral browlift by modified McCord technique, based in a extended dissection, more fixation stitches and prócerus and corrugators muscles miomectomy. Out patients follow-up were in ambulatory conditions with photographic records after 6 and 12 months. Results: The most common intercurrence was a transient parestesia of the frontal region and of the scalp. No postoperative hematomas were registered. The results were consistent with maintenance of the eyebrows elevation and the effective reduction of the glabelar muscles action, without the necessity of any type of coronal incision. Conclusions: The transpalpebral brow elevation associated with glabellar myomectomy shows to be an adequate option, by its safe and effective procedures for the treatment of the upper face aging signs.
Subject(s)
Humans , Male , Adult , Middle Aged , Aged , Aged, 80 and over , History, 21st Century , Paresthesia , Surgical Procedures, Operative , Blepharoptosis , Case Reports , Blepharoplasty , Evaluation Study , Eyebrows , Eyelids , Paresthesia/surgery , Paresthesia/pathology , Surgical Procedures, Operative/methods , Blepharoptosis/pathology , Blepharoptosis/therapy , Blepharoplasty/adverse effects , Blepharoplasty/methods , Eyebrows/abnormalities , Eyelids/surgeryABSTRACT
Facial aging is a natural and unavoidable process for everyone. During the third decade of life and beyond, there is a gradual change in facial structure. Recently, the demand for facial rejuvenation has grown given the growth of an aging population that is in pursuit of a younger and fresher appearance that is more in line with their concept of aging. Facial plastic surgeons should understand the anatomical changes of the aging face and must be able to guide a patient through an appropriate rejuvenation strategy ranging from noninvasive, nonsurgical, and minimally invasive procedures to major surgical procedures.
Subject(s)
Humans , Aging , Rejuvenation , RhytidoplastyABSTRACT
The object of this study was to determine whether brow elevation occurs as a result of paralysis of brow depressors after botulinum toxin injection. This prospective study was designed with pretreatment and posttreatment outcome evaluation with statistical analysis. Twenty-seven consecutive patients were injected into brow depressor muscle directly. Botulinum toxin was injected into the glabellar area (5U), the supralateral eyebrow (2.5Ux2), the crow's feet (4Ux2). All patients were evaluated 2 weeks after treatment. The outcomes were measured by change in brow elevation; 1) brow to medial canthus, 2) brow to midpupil, 3) brow to lateral canthus, 4) interbrow distance, 5) brow to hairline. The average brow elevation were noted from the medial canthus (0.92mm+/-0.58mm, p<0.001), midpupil (1.42mm+/-0.61mm, p<0.001), lateral canthus(1.37mm+/-0.79mm, p<0.001). The average change were increased in interbrow distance(0.7mm+/-0.46mm, p<0.001) and decreased in brow to hairline(0.69mm+/-0.81mm, p<0.001). Botulinum toxin is a safe and effective treatment for chemical brow lift. The elevation in the medial, central and lateral brow can produce an aesthetically pleasing female brow with desirable shape and height. Although the endoscopic brow lift is more effective and able to predict the change of the brow shape and height, this procedure may be considered a simple and safe alternative to surgical brow elevation.