Mid Forehead Brow Lift Workup

  • Author: Frank S Ciminello, MD; Chief Editor: Lars M Vistnes, MD, FRCSC, FACS   more...
 
Updated: Apr 5, 2012
 

Laboratory Studies

  • Preoperative laboratory tests are normally not required in the typical patient. A template bleeding time may be useful in patients with suggested anticoagulant use (eg, prescriptive, over-the-counter, herbal).
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Imaging Studies

  • Imaging is normally not required for this condition.
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Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Frank S Ciminello, MD  Director of Craniofacial Surgery, University Hospital, New Jersey Medical School

Frank S Ciminello, MD is a member of the following medical societies: American College of Surgeons and American Society of Plastic and Reconstructive Surgery

Disclosure: Nothing to disclose.

Coauthor(s)

Matthew J Trovato, MD  Fellow, Division of Plastic Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School

Disclosure: Nothing to disclose.

Specialty Editor Board

R C A Weatherley-White, MD  Associate Clinical Professor of Surgery (Plastic), University of Colorado; Medical Director, Department of Plastic Surgery, Columbia Rose Medical Center

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

Disclosure: Nothing to disclose.

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

Disclosure: Medscape Salary Employment

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 Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama

Disclosure: Nothing to disclose.

Nicolas (Nick) G Slenkovich, MD  Director, Colorado Plastic Surgery Center

Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and Colorado Medical Society

Disclosure: Nothing to disclose.

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.

References

  1. van den Bosch WA, Leenders I, Mulder P. Topographic anatomy of the eyelids, and the effects of sex and age. Br J Ophthalmol. Mar 1999;83(3):347-52. [Medline].

  2. Warren RJ. The modified lateral brow lift. Aesthet Surg J. Mar-Apr 2009;29(2):158-66. [Medline].

  3. Koch RJ, Pope K. Quantitative assessment of brow position: a new measurement system. Plast Reconstr Surg. Apr 1 2004;113(4):1290-1. [Medline].

  4. Frankel AS, Kamer FM. The effect of blepharoplasty on eyebrow position. Arch Otolaryngol Head Neck Surg. Apr 1997;123(4):393-6. [Medline].

  5. McKinney P, Mossie RD, Zukowski ML. Criteria for the forehead lift. Aesthetic Plast Surg. Spring 1991;15(2):141-7. [Medline].

  6. Knize DM. A study of the supraorbital nerve. Plast Reconstr Surg. Sep 1995;96(3):564-9. [Medline].

  7. Troilius C. A comparison between subgaleal and subperiosteal brow lifts. Plast Reconstr Surg. Sep 1999;104(4):1079-90; discussion 1091-2. [Medline].

  8. Honig JF, Frank MH, Knutti D, de La Fuente A. Video endoscopic-assisted brow lift: comparison of the eyebrow position after Endotine tissue fixation versus suture fixation. J Craniofac Surg. Jul 2008;19(4):1140-7. [Medline].

  9. Powell B, Younes A, Friedman O. Evaluation of the midforehead brow-lift operation. Arch Facial Plast Surg. Sep-Oct 2011;13(5):337-42. [Medline].

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

  11. Brennan HG, Rafaty FM. Midforehead incisions in treatment of the aging face. Arch Otolaryngol. Nov 1982;108(11):732-4. [Medline].

  12. Lemke BN, Stasior OG. The anatomy of eyebrow ptosis. Arch Ophthalmol. Jun 1982;100(6):981-6. [Medline].

  13. Patel BC. Surgical eyelid and periorbital anatomy. Semin Ophthalmol. 1996;11(2):118-137.

  14. Rafaty FM, Goode RL, Abramson NR. The brow-lift operation in a man. Arch Otolaryngol. Feb 1978;104(2):69-71. [Medline].

 
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Mid forehead brow lift. Transverse forehead incisions may be broken as shown to improve the appearance of the final result.
Mid forehead brow lift. Dissection is performed in the subcutaneous plane.
Mid forehead brow lift. Transverse incisions are made in the galea to access the corrugator and procerus muscles. These incisions are kept in the middle to prevent injury to the supraorbital nerve branches.
Mid forehead brow lift. Once exposed, the corrugator and procerus muscles are attenuated.
Mid forehead brow lift. The galea is shortened as desired and sutures are placed.
Mid forehead brow lift. Elevation of the cutaneous structures is obtained and appropriate trimming is performed.
Mid forehead brow lift. Meticulous subcuticular closure is achieved with no tension on the skin edges.
Several different incisions for mid forehead lifts have been proposed. Here, incisions are placed at different heights to prevent a long horizontal scar.
Mid forehead brow lift. Preoperative. A 68-year-old man with markedly overactive corrugator and procerus muscles. Note the particularly heavy sebaceous forehead skin and evidence of long standing overactivity of the orbital orbicularis oculi muscles, all conspiring to create a particularly menacing appearance. Such a patient would not do well with an endoscopic forehead lift.
Mid forehead brow lift. Postoperative. Note that even 5 months following the repair, some pinkness of the incision site is present. When a patient has a great degree of actinic keratosis and secondary telangiectatic vessels, such as in this man, such persistent pinkness in the incision site is not uncommon. However, a reasonable elevation of his brows and weakening of his uncommonly powerful corrugator and procerus muscles has been achieved.
Coronal section of scalp that shows layers of the scalp (From Snell RS, Clinical Anatomy for Medical Students, 5th ed).
Diagram of the sensory and motor supply of the face.
 
 
 
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