Endoscopically assisted forehead lift / 中华医学美学美容杂志

ObjectiveTo avoid the complications such as scar,alopecie,scalp numbness,hematoma etc,resulted from the conventional coronal incision rhytidectomy,and to explore and solve the issues about endoscopic frontal and temporal rhytidectomy.MethodsThrough 3-5 short incisions in hairline,we dissected under frontal periosteum or gales aponeurotica and in superficial layer of deep temporal fascia.The frontal and temporal cavitites were feedthrough at temporal crest.The corrugator supercilii muscle,superciliary depressor muscle,frontal muscle and orbicularis oculi were treated.Sufficient dissection was done under the periosteum of os orbitale.ResultsThis method had been applied in 186 patients with forehead lift.After operation,transient paralysis of facial nerve frontal branch were found in 3 patients.The depression of glabellum and lateral canthus were found in 5 patients.The depressions were corrected by autologous fat injection. Other 178 patients' results were satisfactory.ConclusionsEndoscopic frontal and temporal rhytidectomy has some advantages,such as minute invasion,less hemorrhage,few complications,and stable operation result,etc.Compared to the conventional coronal incision rhytidectomy,this method will be used more widely.

Subcutaneous Forehead Lift

PURPOSE: The purpose is to present an useful and simple surgical method to improve the aging of upper third face in patients with high frontal hairline as well as low frontal hairline. METHODS: Forty eight female patients were treated with subcutaneous forehead lift using an anterior hairline incision over 14 years. This surgical technique is performed under direct vision utilizing a beveled incision made 4 to 5mm into the anterior hairline with subcutaneous dissection, which is continued near to eyebrow, sometimes extended to supraorbital rim to remove corrugator and procerus muscles. In patients with high frontal hairline, excess forehead skin anterior to incision line is removed. On the contrary in the patients with low frontal hairline, scalp posterior to incision line is removed. RESULTS: This technique provided constant and good results with the forty six patients, who were satisfied with eyebrow elevation and removal of wrinkles in forehead and glabellar region. However two patients were undercorrected, and focal alopecia developed in another two patients. One patient complained of pruritus over one year, but subsided spontaneously without any treatment. Temporary paresthesia developed in the forehead and frontal scalp of all cases after operation but permanent sensory loss never occurred in all the patients. CONCLUSION: Subcutaneous forehead lift using an anterior hairline incision is suggested to be one of the effective surgical methods to improve the aging of upper third face in the patients with high frontal hairline as well as low frontal hairline.

Wound Infiltration in Patients with Chronic Pain after Forehead Lift Surgery: A case report / 대한통증학회지

Local infiltration in surgical wounds can reduce postoperative pain with very few side effects. We experienced two cases of chronic pain after forehead lift surgery. A 41-year-old male patient was suffering from a headache at the crown of the head and pain from the posterior neck. A 54-year-old female patient had pain around the forehead, worsened by psychological stress. They underwent forehead lift surgery 10 years and 8 months ago, respectively. Conservative treatments such as medication and physical therapy were not effective. After wound infiltration with 1% lidocaine more than ten times, pain significantly resolved in both patients.

Endoscopic Forehead Lift Using Endotine(R)

Brow lift is the most effective method of brow ptosis correction. For brow lifting, suprabrow incisions have not been widely used yet because they lead to prominent scars above the eyebrow especially in orientals. Although classic brow lift using coronal scalp incisions has so far been performed as an alternative to brow lift using suprabrow incisions, it is being increasingly replaced with endoscopic brow lift due to more less postoperative complications such as scalp scars and paresthesia, However, many facial plastic surgeons may abandon this operation after initially unsatisfactory surgical outcome because the learning curve of endoscopic operation is relatively painful. Endoscopic brow lift is an effective surgical treatment that can achieve a good surgical outcome if we fully understand basic anatomical structures and the surgical principles of the operation. Release and fixation are of utmost importance in this operation. We can obtain successful postoperative results if we adequately release the retaining ligamentous attachments which anchor the facial soft tissue to the facial skeleton and the depressor muscles which retract the soft tissue inferiorly and, fix the soft tissue firmly to the facial skeleton in the elevated position. Many techniques and principles for releasing the ligaments and the muscles have been described based on anatomical knowledge. In addition to them, various fixation techniques have been developed for the past decade including using fibrin glue, internal screws or plates, external screws, absorbable screws, and cortical tunnels, but some drawbacks have been reported in these fixation techniques. The Endotine forehead device, an absorbable fixation device, was developed in order to solve the drawbacks several years ago and has since been widely used in clinical practice. Brow lift using the Endotine forehead device has several advantages over other surgical procedures. First of all, the surgical time is short because this operative procedure is simple. This operative procedure can minimize patient discomfort postoperatively. And then this device can prevent relapse of brow ptosis after surgery. We describe herein our 2-year experience with endoscopic brow lift.

Frontoplastia endoscópica: três anos de experiência / Endoscopic frontoplasty: 3-year experience

A frontoplastia endoscópica (FE) representa um significativo avanço para a elevação das sobrancelhas, tendo substituído a técnica coronal clássica. OBJETIVO: Demonstrar a casuística e avaliar os resultados e complicações com a técnica de FE no Serviço de Otorrinolaringologia da Universidade Federal de Uberlândia. PACIENTES E MÉTODOS: De janeiro de 2001 a janeiro de 2004, 67 pacientes foram submetidos à FE, sendo que 7 à "técnica dos triângulos". As idades variaram entre 38 a 59 anos (média de 48,3 anos), sendo 65 (97 por cento) do sexo feminino. RESULTADOS: Destes, 56 pacientes apresentaram resultado satisfatório, 2 apresentaram déficit estético notado pelo cirurgião e pelo paciente. Dos 7 pacientes submetidos à "técnica dos triângulos", todos apresentaram resultado satisfatório. Todos apresentaram melhora da ptose lateral do terço lateral e glabelar das sobrancelhas e diminuição das rugas verticais e frontais. A cirurgia revisional foi necessária em 2 pacientes nos quais ocorreu recorrência da ptose. Houve um paciente que apresentou paralisia do ramo frontal do nervo facial unilateral. Com a "técnica dos triângulos", 5 pacientes apresentaram cicatriz visível no local das incisões. CONCLUSÃO: A FE é uma técnica que produz resultados satisfatórios na grande maioria dos casos, com baixo índice de complicações.

Endoscopic forehead lift (EFL) represents a significant progress, even replacing the classic coronal and pretriquial techniques. AIM: To demonstrate a series of cases and to evaluate results and complications with EFL in the Department of Otorhinolaryngology of the Federal University of Uberlândia. MATERIALS AND METHODS: From January 2001 to January 2004, 67 patients were submitted to EFL, and 7 of these were submitted to the so called "triangles technique". Their ages ranged between 38 and 59 years; and 65 (97 percent) were females. RESULTS: Of these, 56 patients presented satisfactory result and 2 presented aesthetic deficits noticed by the surgeon and the patient. Of the 7 patients submitted to the "trianglesÆ technique", all showed satisfactory results. All the patients had improvements on their ptosis of the lateral and glabellar third of the brows and reduction in vertical and frontal wrinkles. Revision surgery was necessary in 2 patients that had ptosis recurrence. There was one unilateral paralysis of the front branch of the facial nerve. With the "trianglesÆ technique", 5 patients presented visible scars. CONCLUSION: EFL is a technique that produces satisfactory results in the great majority of patients, with low complication rates.

Correction of Frontal Sinus Hypertrophy by Frontal Bone Remodeling and Forehead Lift

A patient with frontal sinus hypertrophy complained about an bossing in eyebrow region, increased width of the upper nasal pyramid, inferior displacement of the eyebrow and deep furrows in his forehead, etc. This case report illustrated a method of correction for frontal sinus hypertrophy. Surgery was performed via the bicoronal incision. After the anterior wall of the frontal sinus was removed, we tried a frontal bone remodeling by dividing it into three pieces, trimmming each piece at the margin and fixed with microplate. Bilateral thick bony portions around the frontal sinus were shaved with a surgical burr. At the same time, a 1cm-forehead lift and frontal muscle partial resection was performed. A satisfactory aesthetic result with a smooth and wide forehead could be obtained by employing this technique.