Discontinuous coronal brow lift

Abstract

Lawrence B. Robbins, MD, Miami Beach, FL, is a board-certified plastic surgeon and is president of ASAPS. The upper third of the face contributes significantly to facial appearance and expression. With aging, brow malposition and contour changes can create a tired, sad, or even an angry look.1 Brow ptosis often contributes to redundant upper eyelid skin, leading to a misdiagnosis of dermatochalasia. Raising the eyebrow, particularly laterally, may at times obviate the need to perform upper blepharoplasty or to extend a blepharoplasty incision lateral to the orbital rim. Elevation of the brow and reestablishment of an aesthetic brow contour can give the patient a younger-looking forehead and periorbital appearance. Reduction of the transverse forehead, glabellar, and lateral orbital wrinkles adds to this result. Despite the introduction of endoscopie techniques, the open brow lift is a valuable and time-tested procedure. In my experience, brow ptosis is the earliest sign of aging in the upper third of the face, which led me to modify the standard coronal and temporal techniques when treatment of lateral brow ptosis was the primary objective. Instead of one continuous coronal incision, two separate incisions are made. These discontinuous incisions come to within approximately 4 cm of the midline and allow full mobilization of the forehead flap, as well as complete release and repositioning of the eyebrow areas. This discontinuous coronal approach is indicated primarily for patients with lateral brow ptosis and avoids overelevation of the medial portion of the brow. This approach allows …