Direct brow lift for the correction of unilateral brow ptosis due to frontal branch injury following cutaneous surgery in the frontotemporal region

Voth, Harald; Grunewald, Sonja; Miller, Benjamin; Simon, Jan C.; Kendler, Michael

doi:10.1111/ddg.12708

Cited by 3 publications

(7 citation statements)

References 6 publications

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“…Marking is performed with the patient in an upright sitting or standing position. 1,17-20 One method involves holding the relaxed brow at the desired position and marking the distance the brow falls upon its release. Performed at multiple points along the length of the brow, the marks are then connected to denote the superior border of the ellipse.…”

Section: Direct Supraciliary Brow Lift Techniquementioning

confidence: 99%

“…Some authors advocate for slight overcorrection as descent is anticipated with final healing. 15,18,20-22 To improve the appearance of the postoperative scar, the inferior border of the incision is designed within the margin of the brow cilia, 1 more specifically, inside the first 2 rows of brow hairs. 15…”

Section: Direct Supraciliary Brow Lift Techniquementioning

confidence: 99%

“…While some perform direct perpendicular incision, 2,8,24,25 most advocate for a beveled incision within the brow hairs to minimize follicle disruption. 1,18,20-22 Feinendegen described beveling at an even steeper angle of around 20° for even better growth of hair through the resultant scar. 15…”

Section: Direct Supraciliary Brow Lift Techniquementioning

confidence: 99%

“…1,21 Deeper sutures may be used to fixate the brow to periosteum in cases of facial palsy. 2,8,19,20,24,28 The authors herein do not routinely perform soft tissue suspension.…”

Section: Direct Supraciliary Brow Lift Techniquementioning

confidence: 99%

“…Most authors advocate for the use of nonabsorbable monofilament (ie, polyamide, polypropylene, or silk) in size 4-0, 5-0, or 6-0. 1,2,14,15,17,18,20,22,27 Johnson advocates for vertical mattress skin closure to optimize wound edge eversion, 1 while others use subcuticular, 2,24 interrupted, 1,20,21 or running cutaneous closure techniques. 14,15,19 Superficial sutures are removed between postoperative day 3 and day 10.…”

Section: Direct Supraciliary Brow Lift Techniquementioning

confidence: 99%

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Nuances of the Direct Brow Lift: Oculoplastic Surgeons’ Perspective

Homer¹,

Zhou

Watson

et al. 2020

Am J Cosmet Surg

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The direct supraciliary brow lift is an effective procedure to treat brow ptosis, limited by risk of a cosmetically undesirable scar. We performed a comprehensive literature review of direct supraciliary brow lift techniques and provide a summary of the key considerations. The optimal direct brow lift is initiated with thoughtful incision design and a carefully beveled supraciliary incision. Subcutaneous tissue debulking and wound edge undermining optimize wound eversion and approximation. A layered meticulously executed skin closure is essential for optimal cosmesis. The senior author’s personal technique, incorporating these concepts, is described and illustrated. We reviewed 76 patients (141 brows) who underwent our refined technique. At the time of final follow-up visit (average 4.9 months), 72 patients (94.7%) reported complete satisfaction with results. Adverse outcomes were found in 4 patients (5.3%) and included transient paresthesias (n = 3) and hypertrophic scarring (n = 1). Postoperative care routinely included the use of topical steroids and additional treatment with microneedling and 5-fluorouracil in 2 patients (2.6%) to optimize healing. The direct supraciliary brow lift is a minimally invasive and effective procedure to correct brow ptosis and may yield excellent cosmesis when key principles are utilized.

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Section: Direct Supraciliary Brow Lift Techniquementioning

confidence: 99%

Section: Direct Supraciliary Brow Lift Techniquementioning

confidence: 99%

Section: Direct Supraciliary Brow Lift Techniquementioning

confidence: 99%

“…1,21 Deeper sutures may be used to fixate the brow to periosteum in cases of facial palsy. 2,8,19,20,24,28 The authors herein do not routinely perform soft tissue suspension.…”

Section: Direct Supraciliary Brow Lift Techniquementioning

confidence: 99%

Section: Direct Supraciliary Brow Lift Techniquementioning

confidence: 99%

See 3 more Smart Citations

Nuances of the Direct Brow Lift: Oculoplastic Surgeons’ Perspective

Homer¹,

Zhou

Watson

et al. 2020

Am J Cosmet Surg

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Dynamic Brow Restoration Using a Soft Tissue Expander in Adult Patients With Arteriovenous Malformation

et al. 2020

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Background Impaired brow function in adult patients with arteriovenous malformation is a serious disability that can even influence the field of vision. Brow reanimation techniques are used to recover a more natural appearance and brow function. Many static procedures have been set to augment brow elevation, but only dynamic procedures can lead to better functional results. In this study, the experience of a single surgeon addressing the challenge of brow restoration with dynamic procedures is presented. Methods A retrospective review was performed using the records of 4 adult patients who underwent dynamic procedures using a soft tissue expander for brow restoration after arteriovenous malformation excision in the unilateral site of the forehead with the expander on the contralateral side. Movement and electrodiagnostic examinations were performed postoperatively at 2 months. Results The patients included 3 males and 1 female (mean age, 20.5 ± 4.04 years). Brow improvement was noted in all patients. The results of the electrodiagnostic examination showed synchronous and spontaneous motor unit potentials and compound muscle action potentials with the contralateral forehead. Conclusions Dynamic procedures using a soft tissue expander can provide both static and dynamic functional brow elevation of the contralateral frontalis and skin.

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Precise extratemporal pattern and intramuscular distribution of the facial nerve

Uruwan

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An arborization of the branches of the facial nerve has the most complexity and variability. Moreover, knowledge of the facial nerve has great importance for surgical and non-surgical interventions in the face region. However, few studies have attempted to determine the entire course and pattern of terminal branching of the facial nerve in the extratemporal and intramuscular parts of the face. Therefore, the purpose of this study was to investigate the precise detail of the facial nerve in extratemporal and intramuscular parts. This study was conducted in forty-two hemifaces of embalmed cadavers by conventional dissection, fourteen hemi-faces of�embalmed cadavers by histological study, and sixteen hemi-faces of soft cadavers by Sihler's staining technique to investigate the characteristics of the branches of the facial nerve. The results revealed that the mean number of the temporal, zygomatic, buccal, marginal mandibular, and cervical branches of the facial nerve were 2.57 ?0.83, 1.83 ?0.69, 3.10 ?0.82, 1.36 ?0.49, and 1.07 ?0.26 branches respectively. The branches of the facial nerve were distributed deep to the parotido-masseteric fascia, temporo-parietal fascia, superficial musculo-aponeurotic system, and platysma muscle depending on each branch of the facial nerve. In conclusion, a caution area of each branch of the facial nerve should be carefully performed based on intensive nerve distribution to prevent complications and unexpected outcomes.� � � �

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Direct brow lift for the correction of unilateral brow ptosis due to frontal branch injury following cutaneous surgery in the frontotemporal region

Cited by 3 publications

References 6 publications

Nuances of the Direct Brow Lift: Oculoplastic Surgeons’ Perspective

Nuances of the Direct Brow Lift: Oculoplastic Surgeons’ Perspective

Dynamic Brow Restoration Using a Soft Tissue Expander in Adult Patients With Arteriovenous Malformation

Precise extratemporal pattern and intramuscular distribution of the facial nerve

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