Anatomical Insights into Frontal Branch Preservation in Minimally Invasive Brow Lift Techniques: A Comparative Analysis of Anatomical Lift Prantl's Suture Suspension (ALPS) Versus Gliding Brow Lift (GBL). 2025

Lukas Prantl, and Alexandra M Anker, and Lena Hamoshi, and Vanessa Brébant, and Andreas Kehrer, and Silvan M Klein, and Marc Ruewe, and Andreas Siegmund, and Anna Wiesmeier, and Jasmin Lenhard, and Niklas Biermann
Department of Plastic, Reconstructive and Hand Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany. lukas.prantl@ukr.de.

The brow region plays a crucial role in facial expression and appearance, making it a key aspect of facial rejuvenation procedures. This study focuses on minimally invasive brow lift techniques including the Anatomical Lift Prantl's Suture Suspension (ALPS) and the Gliding Brow Lift (GBL). Based on a cadaveric dissection and a clinical case presentation, the study identifies the technical nuances of these procedures and highlights anatomical danger zones, with a particular focus on the frontal branch of the facial nerve. During both the ALPS and GBL procedures on fresh-frozen cadaveric specimens, sutures were placed and their relation to critical anatomical structures, such as the frontal branch of the facial nerve, was assessed. Results indicated that ALPS technique, which uses fewer sutures and employs a periosteal approach, reduces the risk of nerve entrapment and injury. In contrast, the GBL technique utilizes multiple percutaneous sutures for skin stabilization, which were observed to be in closer proximity to the frontal branch of the facial nerve. In clinical studies using the GBL technique, however, no nerve injuries have been observed so far, and if they do occur, they are only temporary with complete recovery. Nevertheless, this study highlights the importance of understanding anatomical relationships in the brow region to ensure safety and efficacy in brow lift procedures. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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