Endoscopically assisted biplanar forehead lift. 1995

O M Ramirez
Division of Plastic Surgery, Johns Hopkins University School of Medicine, Baltimore, Md., USA.

The standard subgaleal coronal incision used for brow lifting is limited to patients with low foreheads. The subcutaneous hairline brow lift used for patients with high foreheads has a high rate of vascular complications. However, the main advantage of the subcutaneous approach is preservation of sensation posterior to the incision line. The subperiosteal approach, on the other hand, allows a better periorbital remodeling. I have combined the subperiosteal and the subcutaneous approach to take advantage of and minimize the disadvantages of each individual approach. The advent of the endoscopic technique has allowed more accurate and controlled periorbital dissection and brow depressor muscle modification. The operation is indicated in every patient in whom the anterior hairline incision is indicated. It is a good method for decreasing the height of the forehead. The dissection is done initially in the subcutaneous plane, and about halfway on the forehead slit incisions through the galea-periosteal layer and through the temporoparietal fascia are made to continue the dissection in the deep plane. The periosteal dissection and release at the arcus marginalis is done under endoscopic control. Likewise, the brow depressor muscle modification is done under endoscopic magnification. Deep anchoring sutures fix the brow in the elevated position. Trimming and closure of the cutaneous layer are done with minimal tension. The biplanar subperiosteal-subcutaneous forehead lift has been used in 24 patients with very satisfactory results. Complications have been of a minor nature. Patients have maintained sensation posterior to the hairline incision. The height of the forehead has been decreased in every case. Frontalis muscle function has been preserved.

UI MeSH Term Description Entries
D008297 Male Males
D004724 Endoscopy Procedures of applying ENDOSCOPES for disease diagnosis and treatment. Endoscopy involves passing an optical instrument through a small incision in the skin i.e., percutaneous; or through a natural orifice and along natural body pathways such as the digestive tract; and/or through an incision in the wall of a tubular structure or organ, i.e. transluminal, to examine or perform surgery on the interior parts of the body. Endoscopic Surgical Procedures,Surgical Procedures, Endoscopic,Endoscopic Surgical Procedure,Endoscopy, Surgical,Surgical Endoscopy,Surgical Procedure, Endoscopic,Procedure, Endoscopic Surgical,Procedures, Endoscopic Surgical
D005260 Female Females
D005546 Forehead The part of the face above the eyes. Foreheads
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D015361 Rhytidoplasty Plastic surgery performed, usually by excision of skin, for the elimination of wrinkles from the skin. Face Lift,Rhytidectomy,Facelift,Platysmaplasty,Platysmotomy,Face Lifts,Facelifts,Lift, Face,Lifts, Face,Platysmaplasties,Platysmotomies,Rhytidectomies,Rhytidoplasties

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