Endoscopic periosteal brow lift: evaluation and follow-up of eyebrow height.

BACKGROUND: Endoscopic brow lift has become widely accepted as a method for rejuvenation of the upper third of the face, mainly to achieve eyebrow elevation. In this study, the authors quantified eyebrow elevation after videoendoscopic subperiosteal technique and followed up the heights of the eyebrows at different postoperative intervals. METHODS: Seventy-two patients were submitted to endoscopic subperiosteal brow lift, and photographic evaluation was performed preoperatively and at different intervals postoperatively. From an interpupillary line, three different measurements on each side were obtained up to the superior border of both eyebrows. The distance between the medial eyebrows was also measured. Results were analyzed statistically by using the t test. RESULTS: Comparing preoperative values and those obtained at 5 months postoperatively, significant augmentation in medial, central, and lateral height of both eyebrows was noted (p < 0.05). Analyzing a group of 38 patients with mean postoperative times of 8.5 and 3.5 months, it was noted that there is spontaneous and significant augmentation in the medial height of both eyebrows (p < 0.05). A third group (24 patients) was analyzed at mean postoperative times of 3.5 and 24 months. The later follow-up showed continuous and significant elevation of the medial, central, and lateral height of both eyebrows (p < 0.05). The distance between medial eyebrows did not show any statistical difference. CONCLUSION: Subperiosteal endoscopic brow lift showed clinical and statistical effectiveness in correcting eyebrow ptosis, promoting also a spontaneous and progressive elevation of eyebrows, without enlarging the interbrow distance.

Mastopexy after massive weight loss: extended chest wall-based flap associated with a loop of pectoralis muscle.

Mammaplasty for patients who have experienced massive weight loss involves some concepts that differ from those that apply to mammaplasty for normal patients. Breast anatomic characteristics make this procedure a very challenging situation. The authors present their experience with a new mammaplasty technique using an extended thoracic wall flap associated with a loop of pectoralis. This procedure is a simple and reproducible method for patients with massive weight loss that results in a pleasing breast shape and long-lasting results.