Endoscopic Eyebrow and Forehead Lift

Endoscopic Eyebrow and Forehead Lift


Don O. Kikkawa
Sang-Rog Oh
Bobby S. Korn


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INTRODUCTION


The endoscopic eyebrow and forehead lift is one of several procedures utilized to correct ptosis of the upper face, as well as to reduce rhytids in the forehead and glabellar regions. In contrast to the open coronal lift, the endoscopic procedure accomplishes its aesthetic goals with smaller, localized incisions. Although the indications and outcomes are similar, the endoscopic eyebrow lift offers several advantages over the open coronal lift. The smaller incisions in the endoscopic approach decrease the risks of intraoperative hemorrhage, postoperative scarring and alopecia, postoperative hypesthesia, and speed recuperation. This approach can also be offered in patients with thinning hair because the scars can be hidden in selective areas and are less conspicuous than a coronal incision. The endoscopic approach, however, requires a higher level of training, particularly with respect to knowledge of the anatomy and the use of specialized equipment. Nonetheless, it is a powerful technique for the treatment of eyebrow and forehead ptosis and should be in the armamentarium of every oculofacial surgeon.


PREOPERATIVE EVALUATION


Eyebrow ptosis is present when the eyebrow rests below the level of the superior orbital rim.



Patients should be advised to stop aspirin and other blood-thinning agents for week prior to their surgery, unless contraindicated by their primary care physician or cardiologist. If anticoagulation cannot be suspended, it is our practice to defer elective surgery. Lastly, on the day of surgery, patients are asked to wear clothing that does not require removal over their heads since a head dressing is applied at the conclusion of the case.


SURGICAL TECHNIQUE


Markings and patient positioning


With the patient in the upright position, the amount of brow ptosis is assessed and the superior eyebrow margin marked. The eyebrows are then manually elevated to the desired position, and if concurrent blepharoplasty is to be performed, the amount of skin to be excised is determined. The desired contour of the brow is also evaluated.



Surgical equipment and instruments


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Figure 15-3A. The endoscope monitor is placed at the foot of the bed. This allows the surgeon to view the monitor easily while working.

Dec 28, 2017 | Posted by in General Surgery | Comments Off on Endoscopic Eyebrow and Forehead Lift
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