Skip to main content
Top
Published in: European Journal of Plastic Surgery 3/2018

01-06-2018 | Original Paper

Forehead and brow rejuvenation: definition of a surgical algorithm

Authors: Luca Piovano, Marco D’Ettorre

Published in: European Journal of Plastic Surgery | Issue 3/2018

Login to get access

Abstract

Background

Ptosis of the eyebrows, or a very high and wrinkled forehead, may be found in both young adults and the elderly. Static wrinkles can be effectively addressed by surgery in which the approach varies from endoscopic to open procedures. The absence of a unanimously accepted treatment algorithm creates difficulty in selecting the best option in every case. The aim of this study is to find the optimal treatment, given differently featured patients who are all seeking forehead rejuvenation.

Methods

We carefully reviewed the literature on forehead and brow rejuvenation. Furthermore, 123 brow lift cases in the first author’s practice have been analyzed; as such, the algorithm we proposed here was applied.

Results

In a 10-year follow-up period, seven endoscopic cases have shown relapse. Scarring, the inevitable outcome of any surgical procedure, resulted in pathology in two cases, necessitating a “touch-up” to ameliorate some aesthetic issues. The relatively low complication rate suggests that proper indications have been conveyed; our algorithm demonstrated a high degree of effectiveness.

Conclusions

According to our experience, each technique is more applicable for certain patients. In this sense, our updated algorithm should be extremely helpful to young surgeons who are willing (and technically able) to handle forehead rejuvenation cases.
Level of Evidence: Level V, therapeutic study.
Literature
1.
go back to reference Ellenbogen R (1983) Transcoronal eyebrow lift with concomitant upper blepharoplasty. Plast Reconstr Surg 71:490–499CrossRef Ellenbogen R (1983) Transcoronal eyebrow lift with concomitant upper blepharoplasty. Plast Reconstr Surg 71:490–499CrossRef
2.
go back to reference Neto JNR, Pedroso DB, Vasconcelos FRP et al (2012) Forehead reduction using precapillary incision: experience report and indications. Rev Bras Cir Plast 27(2):238–242CrossRef Neto JNR, Pedroso DB, Vasconcelos FRP et al (2012) Forehead reduction using precapillary incision: experience report and indications. Rev Bras Cir Plast 27(2):238–242CrossRef
4.
go back to reference Ramirez OM (1995) Endoscopic forehead and face-lift: step by step. Open Tech Plast Reconstr Surg 2:116–126CrossRef Ramirez OM (1995) Endoscopic forehead and face-lift: step by step. Open Tech Plast Reconstr Surg 2:116–126CrossRef
5.
go back to reference Matarasso A, Terino EO (1994) Forehead-brow rhytidoplasty: reassessing the goals. Plast Reconstr Surg 93:1378CrossRef Matarasso A, Terino EO (1994) Forehead-brow rhytidoplasty: reassessing the goals. Plast Reconstr Surg 93:1378CrossRef
6.
go back to reference De Cordier BC, De la Torre JI, Al-Hakeem MS et al (2002) Endoscopic forehead lift: review of technique, cases, and complications. Plast Reconstr Surg 110(6):1558–1568PubMed De Cordier BC, De la Torre JI, Al-Hakeem MS et al (2002) Endoscopic forehead lift: review of technique, cases, and complications. Plast Reconstr Surg 110(6):1558–1568PubMed
7.
go back to reference Cuzalina A (2004) Facial aesthetic surgery: forehead and brow procedures. In: Miloro M, Ghali GE et al (eds) Peterson’s principles of oral and maxillofacial surgery Ed 2, Vol 2, part 9, section 6–7. BC Decker Inc, Philadelphia, pp 1–18 Cuzalina A (2004) Facial aesthetic surgery: forehead and brow procedures. In: Miloro M, Ghali GE et al (eds) Peterson’s principles of oral and maxillofacial surgery Ed 2, Vol 2, part 9, section 6–7. BC Decker Inc, Philadelphia, pp 1–18
8.
go back to reference Gold AH, Bernard RW, Hamas RS et al (2003 May) Brow lift fixation. Aesthet Surg J 23(3):217–219CrossRef Gold AH, Bernard RW, Hamas RS et al (2003 May) Brow lift fixation. Aesthet Surg J 23(3):217–219CrossRef
9.
go back to reference Malata CM, Abood A (2009 Dec) Experience with cortical tunnel fixation in endoscopic brow lift: the “bevel and slide” modification. Int J Surg 7(6):510–515CrossRef Malata CM, Abood A (2009 Dec) Experience with cortical tunnel fixation in endoscopic brow lift: the “bevel and slide” modification. Int J Surg 7(6):510–515CrossRef
10.
go back to reference Castañares S (1964) Forehead wrinkles, glabellar frown and ptosis of the eyebrows. Plast Reconstr Surg 34:406–413CrossRef Castañares S (1964) Forehead wrinkles, glabellar frown and ptosis of the eyebrows. Plast Reconstr Surg 34:406–413CrossRef
11.
go back to reference Liva EL (1983) The surgical correction of brow droop in the aging face. Adv Ophtalm Plast Reconstr Surg 2:169–176 Liva EL (1983) The surgical correction of brow droop in the aging face. Adv Ophtalm Plast Reconstr Surg 2:169–176
12.
go back to reference Pires Viana G, Pires Viana GA (2009) Approach to eyebrow ptosis through the modified technique of Castanares. Indian J Plast Surg 42:58–62CrossRef Pires Viana G, Pires Viana GA (2009) Approach to eyebrow ptosis through the modified technique of Castanares. Indian J Plast Surg 42:58–62CrossRef
13.
go back to reference Caccialanza E (2011) “Lift”frontale e “lift” sopraccigliare. In: Gasparotti M, Campisi A (eds) Scienza ed Arte nella Chirurgia e Medicina Estetica del Viso. Verduci Editore, Roma, pp 1288–1293 Caccialanza E (2011) “Lift”frontale e “lift” sopraccigliare. In: Gasparotti M, Campisi A (eds) Scienza ed Arte nella Chirurgia e Medicina Estetica del Viso. Verduci Editore, Roma, pp 1288–1293
14.
go back to reference Brennan HG, Rafaty FM (1982) Midforehead incisions in treatment of the aging face. Arch Otolaryngol 108:732–734CrossRef Brennan HG, Rafaty FM (1982) Midforehead incisions in treatment of the aging face. Arch Otolaryngol 108:732–734CrossRef
15.
go back to reference Powell B, Younes A, Friedman O (2011) Evaluation of the midforehead brow-lift operation. Arch Facial Plast Surg 13(5):337–342CrossRef Powell B, Younes A, Friedman O (2011) Evaluation of the midforehead brow-lift operation. Arch Facial Plast Surg 13(5):337–342CrossRef
16.
go back to reference Ortiz-Monasterio FG, Olmedo A (1978) The coronal incision in rhytidectomy: the brow lift. Clin Plast Surg 5:167PubMed Ortiz-Monasterio FG, Olmedo A (1978) The coronal incision in rhytidectomy: the brow lift. Clin Plast Surg 5:167PubMed
17.
18.
go back to reference Abul-Hassan HS, Van Drasek AG, Acland RD (1986) Surgical anatomy and blood supply for the fascial layers of the temporal regions. Plast Reconstr Surg 77:17PubMed Abul-Hassan HS, Van Drasek AG, Acland RD (1986) Surgical anatomy and blood supply for the fascial layers of the temporal regions. Plast Reconstr Surg 77:17PubMed
19.
go back to reference Savani A (1994) Physiopathology of the aging face. In: Psillakis JM (ed) Deep face-lifting techniques. Thieme, New York, pp 11–23 Savani A (1994) Physiopathology of the aging face. In: Psillakis JM (ed) Deep face-lifting techniques. Thieme, New York, pp 11–23
20.
go back to reference De la Plaza R, Valiente E, Arroya JM (1991) Supraperiosteal lifting of the upper two thirds of the face. Br J Plast Surg 4:325–332CrossRef De la Plaza R, Valiente E, Arroya JM (1991) Supraperiosteal lifting of the upper two thirds of the face. Br J Plast Surg 4:325–332CrossRef
21.
go back to reference Tirkanits B, Daniel RK (1990) The biplanar forehead lift. Aesthet Plast Surg 14:111CrossRef Tirkanits B, Daniel RK (1990) The biplanar forehead lift. Aesthet Plast Surg 14:111CrossRef
22.
go back to reference Eaves FF, Barton FE, Knize DM, Paul MD, Rohrich RJ (1997) Comparative methods for brow lift. Aesthet Surg J 17:397–403CrossRef Eaves FF, Barton FE, Knize DM, Paul MD, Rohrich RJ (1997) Comparative methods for brow lift. Aesthet Surg J 17:397–403CrossRef
23.
go back to reference Elkwood A, Matarasso A, Rankin M, Elkowitz M, Godek CP (2001) National plastic surgery survey: brow lifting techniques and complications. Plast Reconstr Surg 108:2143–2150CrossRef Elkwood A, Matarasso A, Rankin M, Elkowitz M, Godek CP (2001) National plastic surgery survey: brow lifting techniques and complications. Plast Reconstr Surg 108:2143–2150CrossRef
24.
go back to reference Knize DM (2000) Muscles that act on glabellar skin: a closer look. Plast Reconstr Surg 105:350CrossRef Knize DM (2000) Muscles that act on glabellar skin: a closer look. Plast Reconstr Surg 105:350CrossRef
25.
go back to reference Gunter JP, Antrobus SD (1997) Aesthetic analysis of the eyebrows. Plast Reconstr Surg 99:1808CrossRef Gunter JP, Antrobus SD (1997) Aesthetic analysis of the eyebrows. Plast Reconstr Surg 99:1808CrossRef
26.
go back to reference Knize DM (2009 Dec) Anatomic concepts for brow lift procedures. Plast Reconstr Surg 124(6):2118–2126CrossRef Knize DM (2009 Dec) Anatomic concepts for brow lift procedures. Plast Reconstr Surg 124(6):2118–2126CrossRef
27.
go back to reference Graham DW, Heller J, Kurkjian TJ et al (2011) Brow lift in facial rejuvenation: a systematic literature review of open versus endoscopic techniques. Plast Reconstr Surg 128:335e–341eCrossRef Graham DW, Heller J, Kurkjian TJ et al (2011) Brow lift in facial rejuvenation: a systematic literature review of open versus endoscopic techniques. Plast Reconstr Surg 128:335e–341eCrossRef
28.
go back to reference Byun S, Mukovozov I, Farrokhyar F, Thoma A (2013) Complications of browlift techniques: a systematic review. Aesthet Surg J 33:189–200CrossRef Byun S, Mukovozov I, Farrokhyar F, Thoma A (2013) Complications of browlift techniques: a systematic review. Aesthet Surg J 33:189–200CrossRef
29.
go back to reference Bracaglia R, D’Ettorre M, Gentileschi S et al (2014) Was the surgeon a satisfactory informant? How to minimize room for claims. Aesthet Surg J 34(4):632–635CrossRef Bracaglia R, D’Ettorre M, Gentileschi S et al (2014) Was the surgeon a satisfactory informant? How to minimize room for claims. Aesthet Surg J 34(4):632–635CrossRef
Metadata
Title
Forehead and brow rejuvenation: definition of a surgical algorithm
Authors
Luca Piovano
Marco D’Ettorre
Publication date
01-06-2018
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Plastic Surgery / Issue 3/2018
Print ISSN: 0930-343X
Electronic ISSN: 1435-0130
DOI
https://doi.org/10.1007/s00238-017-1355-2

Other articles of this Issue 3/2018

European Journal of Plastic Surgery 3/2018 Go to the issue