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Endoscopic Brow Lift Workup

  • Author: Jorge I de la Torre, MD, FACS; Chief Editor: Lars M Vistnes, MD, FRCSC, FACS  more...
 
Updated: Mar 28, 2014
 

Laboratory Studies

As with all surgical procedures, obtain routine studies (eg, CBC).

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Other Tests

Obtain routine ECG and chest radiograph based on patient's history and age and the preoperative protocol.

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Contributor Information and Disclosures
Author

Jorge I de la Torre, MD, FACS Professor of Surgery and Physical Medicine and Rehabilitation, Chief, Division of Plastic Surgery, Residency Program Director, University of Alabama at Birmingham School of Medicine; Director, Center for Advanced Surgical Aesthetics

Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, American Society for Reconstructive Microsurgery, Association for Academic Surgery, Medical Association of the State of Alabama

Disclosure: Nothing to disclose.

Coauthor(s)

Luis O Vasconez, MD 

Luis O Vasconez, MD is a member of the following medical societies: American Head and Neck Society, American Society of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Aesthetic Plastic Surgery, American Society for Surgery of the Hand, American Society of Maxillofacial Surgeons, American Society for Reconstructive Microsurgery, American Surgical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Lars M Vistnes, MD, FRCSC, FACS Professor of Surgery, Emeritus, Stanford University Medical Center

Lars M Vistnes, MD, FRCSC, FACS is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Additional Contributors

R C A Weatherley-White, MD MA (Cantab), FACS, FAAP, FRSM, Associate Clinical Professor in Surgery (Plastic), University of Colorado School of Medicine; Medical Director, Cleft Palate/Craniofacial Center, Rose Medical Center

R C A Weatherley-White, MD is a member of the following medical societies: American Society of Plastic Surgeons, American Cleft Palate-Craniofacial Association, American College of Surgeons, American Society for Aesthetic Plastic Surgery, Colorado Medical Society, Royal Society of Medicine

Disclosure: Nothing to disclose.

References
  1. Core GB, Vasconez LO, Graham HD 3rd. Endoscopic browlift. Clin Plast Surg. 1995 Oct. 22(4):619-31. [Medline].

  2. Lee CH, Lee C, Trabulsy PP, et al. A cadaveric and clinical evaluation of endoscopically assisted zygomatic fracture repair. Plast Reconstr Surg. 1998 Feb. 101(2):333-45; discussion 346-7. [Medline].

  3. Eich BS 2nd, Fix RJ. New technique for endoscopic sural nerve harvest. J Reconstr Microsurg. 2000 May. 16(4):329-31. [Medline].

  4. Freund RM, Nolan WB 3rd. Correlation between brow lift outcomes and aesthetic ideals for eyebrow height and shape in females. Plast Reconstr Surg. 1996 Jun. 97(7):1343-8. [Medline].

  5. Gunter JP, Antrobus SD. Aesthetic analysis of the eyebrows. Plast Reconstr Surg. 1997 Jun. 99(7):1808-16. [Medline].

  6. Janis JE, Ghavami A, Lemmon JA, et al. Anatomy of the corrugator supercilii muscle: part I. Corrugator topography. Plast Reconstr Surg. 2007 Nov. 120(6):1647-53. [Medline].

  7. Janis JE, Ghavami A, Lemmon JA, et al. The anatomy of the corrugator supercilii muscle: part II. Supraorbital nerve branching patterns. Plast Reconstr Surg. 2008 Jan. 121(1):233-40. [Medline].

  8. Knoll BI, Attkiss KJ, Persing JA. The influence of forehead, brow, and periorbital aesthetics on perceived expression in the youthful face. Plast Reconstr Surg. 2008 May. 121(5):1793-802. [Medline].

  9. Griffin GR, Kim JC. Ideal female brow aesthetics. Clin Plast Surg. 2013 Jan. 40(1):147-55. [Medline].

  10. Matarasso A. Endoscopically assisted forehead-brow rhytidoplasty: theory and practice. Aesthetic Plast Surg. 1995 Mar-Apr. 19(2):141-7. [Medline].

  11. Trinei FA, Januszkiewicz J, Nahai F. The sentinel vein: an important reference point for surgery in the temporal region. Plast Reconstr Surg. 1998 Jan. 101(1):27-32. [Medline].

  12. Kelly CP, Yavuzer R, Keskin M, et al. Functional anastomotic relationship between the supratrochlear and facial arteries: an anatomical study. Plast Reconstr Surg. 2008 Feb. 121(2):458-65. [Medline].

  13. Miller TA, Rudkin G, Honig M, et al. Lateral subcutaneous brow lift and interbrow muscle resection: clinical experience and anatomic studies. Plast Reconstr Surg. 2000 Mar. 105(3):1120-7; discussion 1128. [Medline].

  14. Hamas RS. Reducing the subconscious frown by endoscopic resection of the corrugator muscles. Aesthetic Plast Surg. 1995 Jan-Feb. 19(1):21-5. [Medline].

  15. Foustanos A, Zavrides H. An alternative fixation technique for the endoscopic brow lift. Ann Plast Surg. 2006 Jun. 56(6):599-604. [Medline].

  16. Ramirez OM. Endoscopic subperiosteal browlift and facelift. Clin Plast Surg. 1995 Oct. 22(4):639-60. [Medline].

  17. Vasconez, LO, de la Torre, JI. Fine-tuning the endobrow lift. Aesthetic Surg J. 2002. 22:69-71.

  18. De Cordier B, de la Torre JI. A retrospective analysis of 400 endoscopic forehead lifts. Plast Reconst Surg. 2002. 110:1558-1568.

  19. Iblher N, Manegold S, Porzelius C, Stark GB. Morphometric long-term evaluation and comparison of brow position and shape after endoscopic forehead lift and transpalpebral browpexy. Plast Reconstr Surg. 2012 Dec. 130(6):830e-840e. [Medline].

  20. Graham DW, Heller J, Kirkjian TJ, Schaub TS, Rohrich RJ. Brow lift in facial rejuvenation: a systematic literature review of open versus endoscopic techniques. Plast Reconstr Surg. 2011 Oct. 128(4):335e-341e. [Medline].

  21. Guillot JM, Rousso DE, Replogle W. Forehead and scalp sensation after brow-lift: a comparison between open and endoscopic techniques. Arch Facial Plast Surg. 2011 Mar-Apr. 13(2):109-16. [Medline].

  22. Angelos PC, Stallworth CL, Wang TD. Forehead lifting: state of the art. Facial Plast Surg. 2011 Feb. 27(1):50-7. [Medline].

  23. Romo T 3rd, Sclafani AP, Yung RT, et al. Endoscopic foreheadplasty: a histologic comparison of periosteal refixation after endoscopic versus bicoronal lift. Plast Reconstr Surg. 2000 Mar. 105(3):1111-7; discussion 1118-9. [Medline].

  24. Graham DW, Heller J, Kurkjian TJ, Schaub TS, Rohrich RJ. Brow lift in facial rejuvenation: a systematic literature review of open versus endoscopic techniques. Plast Reconstr Surg. 2011 Oct. 128(4):335e-341e. [Medline].

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An aesthetic brow. A-B Lateral brow is at or above medial brow. C-D Brow peak is at lateral limbus of the iris or at junction of medial and lateral thirds of brow. A-E Head of medial brow begins at vertical line extending from nasal ala. B-E Lateral brow may extend to a line drawn from ala through lateral canthus of eye (Gunter JP, Antrobus SD: Plast Reconstr Surg 1997; 99(7): 1808).
Cross section illustrating anatomy of temporal region and close relationship between sentinel vein and temporal branch of the facial nerve (VII).
Diagram showing surface anatomy relationship between sentinel vein and temporal branch of facial nerve. Caution zone 10 mm in diameter is drawn at intersection of 2 lines: one extending from the mental foramen to lateral edge of the orbit, and another from the superior edge of the orbit to the junction of the ear helix and zygomatic arch. Perform dissection in this area under endoscopic vision (Trinei, 1998).
Intraoperative photograph, endoscopic brow lift surgery. In balding patients or patients with high foreheads, obtain endoscopic access with small horizontal incisions directly on the forehead.
Endoscopic brow lift. Preoperative photograph of 63-year-old woman.
One year after endoscopic brow lift, no fixation performed.
Prior to endoscopic brow lift surgery, 65-year-old woman with severe corrugator rhytides and brow ptosis.
Postoperative view (2 y), endoscopic brow lift surgery. Patient has improved rhytides and improved brow position; however, note that brow shape has changed little despite medial release. Patient also had laser resurfacing of lower lids. No upper eyelid surgery was performed.
Selective elevation of lateral brow can be accomplished by leaving the periosteum intact centrally between the brows.
Elevating one brow more than the other requires an asymmetric dissection. As illustrated, dissection on patient's left brow stops at the transition zone, which allows a more permanent elevation of the right brow compared with the left.
Fifty-nine-year-old woman at rest, with active corrugator function and asymmetric brow (right lower than left) before endoscopic brow lift surgery.
Postoperative photo 2 years after endoscopic brow lift surgery with improvement in glabella and symmetry. Dissection on the right was complete, with dissection on the left not extending past the transition zone, creating an asymmetric lift.
Elevating entire brow symmetrically requires complete release of brow down to zygomatic arches, including transition zones at insertion of temporalis muscles.
Fifty-five-year-old woman before endoscopic brow lift surgery.
Five months after endoscopic brow lift surgery with temporary fixation (9 d), upper blepharoplasty, and facelift.
 
 
 
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