Forehead and Brow lift
A drooping forehv.rd results in drooping eyebrow r.c brow lateral upper eyelid fullness 01 hooding.11(1 accentuated upper ‘eyelid bagginess. skin. with blepharoplasty alone docs not adequately address this problemif the brows are also ptotic. The normal or youthful eyebrow has the lower edge posif ioned ator slightly above the palpated bony ‘,upraorbital rim. The
ideal esthetic female brow gently arches above the orbital rim lateral to the iris (Fig. 26·8,_ The peak of the brow’sarch should be aligned over the junction of the lateral edge of the iris and the “Sclera. Women often pluck their brows to reproduce this pattern. Male brows are general- Iy flatter without an arch. Elevation of the brows to a • rejuvenated position may eliminate or reduce the need to remove upper eyelid -skin with blepharoplasty, Often a forehead and brow lift and upper lid blepharoplasty are combined during a single operation. Brow lifting reduces upper lid hooding by elevating the brow. Additionally brow lifting reduces forehead and nasal bridge creases. Most brow elevation surgeries are presently performed end oscopically with video camera assistance. This approach uses multiple small scalp incisions for access. After the scalp is undermined and mobilized, the forehead soft tissues are suspended and anchored in theirnew position. (Fig. 26-9). A continuous full-thickness : scalp incision within or at the hairline (i.e., pretrichial approach) is still used when required, such as with extreme brow ptosis or when on-e does not wish to elevate the hairline (Fig. 26-10). Care is taken to. prevent injury ‘to the scalp’s sensory nerves (i.e., supraorbital, supratrochlear) and facial nerve branches supplying motor in-: nervation to the eyebrow region.
Postoperative recovery is 7 to 10 days (see Fig. 26-7, A and B).7 Possible complications of brow lifting include asymmetric ,appearance, paresthesia, facial nerve deficits, and excessive lifting resulting in a “surprised” look.
