Trans Coronal Open Eyebrow Surgery Is Still Regarded As The Gold Standard In The Browplasty
A sagging eyebrows areas, whether due to aging
, genetics or sun exposure can make you look sad, angry, tired, even when you do not feel that way at all.
Eyebrow surgery can revive your face, revealing a more refreshingly youthful appearance.
Improvements from Brow Surgery:
Elevate Drooping Eyebrows
Enhance sagging, hooded upper eyelids
Smooth deep horizontal furrows and wrinkles from the forehead
Eyebrow position is the most prominent feature in facial expressions and brow lift surgery can modify facial expression more as compared to any other plastic surgery procedure. Properly aligned brows transmit a youthful and rested countenance. An ideal shape of eyebrows is an arch with peak along temporal iris limbus. Ancillary objectives of a brow surgery include correction of upper nasal lines, transverse forehead, glabella lines and fullness of upper eyelids not properly addressed by blepharoplasty.
History & Controversies:
The conventional approach to brow-lift has been an open coronal approach, which developed over the last century and reached its present form in the 1970s. The open brow lift procedure was and still today is the most safe, easily reproducible, effective and long-lasting surgery in facial aesthetics. However, with the swift advances in endoscopic technology in 1990s, many cosmetic surgeons abandoned the conventional approach for more 'minimally invasive' procedure.
In spite of such announcements, the distinct superiority of endoscopic method over the open method has not materialized in the scientific arena, and neither has it been reflected by a widespread shift in medical practice. Moreover, published data and large number of anecdotal reports by plastic surgeons would indicate a gigantic return to the open method as the preferred approach to eyebrow surgery.
A survey by the ASPS membership published in December 2001 brought into limelight the national trends in brow lift. Of approximately, 7,000 procedures reported, more than half were done using open technique, which proved to be the most preferred approach by most surgeons. The survey also mentioned that the members feel that open approach is more efficacious than the endoscopic technique for the treatment of brow ptosis and treatment of forehead lines.
Coronal or Open Brow Lift Surgery The Approach
Patients are placed under the effect of local anesthesia and then coronal incision is placed 7-cm posterior to the front hairline at the mid-line along with dissection plane traveling from subgaleal to sub periosteal at the level of front hairline. Incisions are carried to the helix's roots bilaterally. The neurovascular bundles at the orbital rim are prudently preserved. In addition, arcus marginialis is cautiously mobilized enough to adequately lift up the eyebrows above the orbital rim.
Once the flap is completely elevated, procerus muscle and subtotal resection of corrugators is done under direct visualization. The frontalis skin is disrupted in a check-board manner along the central 5cm of the forehead utilizing electro cautery. The flap is lifted to optimal brow level and excess skin is excised. Incisions are closed with sutures and staples.
Results:
The average operative duration for open brow lift surgery is 45 minutes. This surgery invariably allows for a brilliant lift of the eyebrows while maintaining direct control over the symmetry and arch shape of the eyebrows. Moreover, till date there are no reports of any complaints of considerable sensory loss.
by: jenniferlevine
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Trans Coronal Open Eyebrow Surgery Is Still Regarded As The Gold Standard In The Browplasty