An Alternative Approach to Brow Lift Fixation: Temporoparietalis Fascia, Galeal, and Periosteal Imbrication

Abstract

Brow elevation is one of the goals of surgical rejuvenation procedures. In this article, the authors evaluate the results of a frontotemporal suspension-fixation technique by means of temporoparietalis fascia/galeal/periosteal flap imbrication through an open or endoscopically assisted approach. A total of 32 female patients aged between 44 and 72 years were operated on under local anesthesia and sedation. In 23 cases, the frontotemporal lift was associated with a cervicofacial lift through separate incisions and in 19 with an upper/lower blepharoplasty performed at the same time or subsequently. The open approach was used in 26 cases and a combined approach with endoscopic assistance and reduced temporal incisions was used in six cases. Preoperative and postoperative measurements were taken between the lower hairline of the eyebrow and the medial and lateral canthal angles. Lateral brow elevation ranged from 3 to 7 mm, with an average of 5 mm. A lasting result was observed during the follow-up period, with partial relapse in five cases. Complications consisted of two transient frontal paresthesias, remarkable periorbital bruising in four cases, and a transient decrease in temporal hair density in six cases (6 to 8 months). No permanent alopecia was observed. Brow elevation is an essential feature for a pleasing aesthetic result in the periorbital region. The best results are those achieved in association with blepharoplasty. This technique produces stable results, and the incidence of sequelae and complications is acceptable.