Temporal Lift Research Articles

"Temporal MORE (Modified Orbicularis REpositioning): going beyond the limits of temporal lifting".

Periorbital rejuvenation is often challenging and requires comprehensive evaluation of its various components to obtain satisfying results. Considering the crucial role of the orbicularis muscle in the periorbital aging process, the first author recently described his personal technique for temporal lifting through a subcutaneous approach in conjunction with an orbicularis muscle flap. In the current article, the authors present a modified and extended temporal lift approach, which allows for remarkable improvement not only in the temporal and brow region, but in the whole periorbital area up to the malar region, therefore named "Temporal MORE" (Modified Orbicularis REpositioning). 212 consecutive patients underwent Temporal MORE by the same surgeon between May 2021 and September 2022. Each patient filled a FACE-Q© questionnaire preoperatively and 12 months postoperatively. 5 independent surgeons were asked to score the results evaluating patients' preoperative and postoperative pictures. No major complications were recorded. The most satisfying aspect of this technique was dramatic periorbital rejuvenation noticeable in all patients.FACE-Q pre-operative score was 34.29±5.872, while the post-operative was 80.11±6.796 (p<0.05); delta (post-pre) mean value was 45.82±8.925. Surgeons' questionnaire mean value was 41.92±6.010. Statistical analysis showed a strong correlation between surgeons' and patients' satisfaction ("r" value 0.7488). Temporal MORE proved to achieve a comprehensive rejuvenation of the periorbital area in a straightforward and reproducible way, with a fast recovery and a low complication rate. In this cohort, patient satisfaction with the result was remarkable and comparable to the judgment of the surgeons interviewed.

Dual-Plane Midface Lift Through Transoral and Transtemporal Approach.

The surge in the popularity of midface and temporal lifting procedures can be attributed to evolving social media trends and heightened patient expectations, particularly among younger individuals seeking "beautification" rather than traditional rejuvenation. Scarless techniques, such as transtemporal/transoral approaches, are increasingly preferred. This study aimed to combine the advantages of both superficial and deep dissection planes in midface and temporal lifting procedures. This retrospective study included 184 patients who underwent surgery using a dual-plane midface and temporal lift technique. Preoperative and postoperative assessments, including P1/P2 ratio calculations, were performed to evaluate volumetric distribution in the midface. The study cohort exhibited a significant improvement in the P1/P2 ratio postoperatively (p < 0.05), indicating successful volume redistribution. Complications, including hypoesthesia, bruising, and infection, were managed effectively. Minor asymmetries were observed, with revisions offered, but declined by the patient. This technique offers hidden incisions and reduces the risk of scar-related complications, making it suitable for patients seeking facial enhancement. Addressing the tear trough area and the lateral canthus provides comprehensive facial rejuvenation. The dual-plane approach facilitates both skin mobilization and volume shift, yielding favorable aesthetic outcomes. The dual-plane midface and temporal lift technique presented in this study offers a bi-vectoral approach to midfacial lifting, suitable for both beautification and rejuvenation goals. Despite the potential limitations, including infection risk, this method is an effective option for facial enhancement. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Long-Term Improvement of Crow's Feet Wrinkles in Combination With Cervicofacial and Temporal Lifting: Review of the Literature.

The lateral orbital crow's feet area is one for which rejuvenation is most frequently requested by patients. Moreover, lateral canthal wrinkles are a common source of dissatisfaction after rhytidoplasty. Botulinum toxin injection has emerged as a most popular, easy, and effective solution; nevertheless, repeated injections are required periodically for long-term effect. Other nonsurgical options have also been described to have some demonstrable advantages. Orbicularis oculi surgical manipulations have been described as well. A systematic PubMed literature search was conducted to identify clinical cohort studies including more than 10 patients describing surgical approaches for improvement of crows' feet wrinkles in combination with face and/or temporal lifts. The search was complemented by Embase, Medline, and Cochrane searches in addition to screening of reference lists of selected studies and simple term searches about surgical treatment of crow's feet. Fourteen studies satisfied the inclusion criteria and were included in this review describing various muscle excision techniques including vertical strip excision, lateral partial resection, wedge resection, muscle resection in "C" pattern, and enlarged myectomy of about one-third of the whole orbital extension in addition to muscle manipulation modalities, including muscle splaying, muscle division, muscle division and splaying, muscle undermining with partial denervation, and muscle suspension. Interposition of fascia between orbicularis muscle and overlying skin was also reported. View the few studies retrieved and the wide spectrum of reported techniques, it is not possible to determine from this review the most effective modality. Nevertheless, it seems that subcutaneous undermining of the lateral canthal area combined with splaying and traction of the orbicularis oculi muscle and fixation to the temporalis fascia with or without muscle division would yield the best long-term results. This review indicates also that surgical correction of crow's feet during rhytidectomy or temporal lift could be a positive complement to improve aesthetic outcome. Unfortunately, if not underreported, it is definitely neglected. We believe that this review may be an eye-opener for surgeons.

Aerodynamic sound production from flying beetles

Extensions of previous research on the aerodynamic sound production by flying beetles are presented. The topic is of interest in terms of both fundamental acoustics and the applications such as classification and tracking of invasive insect species. High speed video with synchronous acoustics recordings of the Coconut Rhinoceros Beetle (Oryctes rhinoceros) and the Oriental Flower Beetle (Protaetia orientalis) provide experimental data for the analytical and numerical models. Three dimensional, unsteady flow simulations were conducted using compressible flow software (CAESIM, Adaptive Research, Inc.) with a TVD methodology. Flapping wing motion requires mesh deformation with a rotation with a prescribed bending and also coupled rotation and translation of the wing’s hinge position. Contributions of wing beat frequency and vorticity to sound generation are examined with respect assumptions of the spatial dimensions (two or three dimensional), bending and fluid structure interactions. Underlying sound generation mechanisms at the wing tips are examined in higher fidelity. Both hovering and forward flight are investigated and compared in terms of the different flapping motion of the two species. In addition, relationships of the tones to the temporal lift and drag lift coefficients are highlighted.

Practice Patterns: An American Society of Plastic Surgeons (ASPS) Member Survey, 2000 and 2020-How Much Has Brow Lifting Changed?

In 2001, Elkwood and Matarasso published an American Society of Plastic Surgeons (ASPS) member survey detailing brow lift practice patterns. Interval changes in practice patterns have not been studied. The previous survey was revised to elucidate current trends in brow lift surgery. A 34-question descriptive survey was distributed to a random group of 2360 ASPS members. Results were compared to the 2001 survey. A total of 257 responses were collected (11% response rate; ± 6% margin of error at 95% CI). The most frequent technique for the correction of brow ptosis in both surveys was the endoscopic approach. The use of hardware fixation has increased in endoscopic brow lifting, whereas the use of cortical tunnels has decreased. Although coronal brow lifting has decreased in frequency, hairline and isolated temporal lift have increased. Neuromodulators have replaced resurfacing techniques as the most common nonsurgical adjunct. Frequent use of neuromodulators has risen from 11.2% to 88.5%. Nearly 30% of current surgeons feel that neuromodulators have replaced formal brow lifting procedures to a significant degree. In comparing the 2001 and current ASPS member survey there has been a clear transition to less invasive procedures over time. Although the endoscopic approach was the most popular means of forehead correction in both surveys, coronal brow lifting has decreased in frequency and the hairline and temporal approaches have increased. Neurotoxins have replaced laser resurfacing and chemical peeling methods as an adjunct, and in some cases replaced the invasive procedure entirely. Possible explanations for these findings will be discussed.

SUBKÜTAN KAŞ KALDIRMA CERRAHİSİNİN EVRİMİ: SONUÇLARIN VE KOMPLİKASYONLARIN KARŞILAŞTIRMALI ANALİZİ

Aim: This study aims to analyze and compare the results of three different subcutaneous brow lift techniques: Fogli temporal lift, pretrichial brow lift, and gliding brow lift.&#x0D; Material and methods: Thirty-three female patients underwent brow lift surgery between July 2022 and September 2021. Initially, eighteen consecutive patients were operated with either the temporal lift technique or pretrichial brow lift technique based on their forehead length. Then, fifteen consecutive patients underwent the gliding brow lift surgery regardless of their forehead length. Age, type of anesthesia, other accompanying surgical procedures, and postoperative complications including presthesia in the scalp, incisional postoperative healing problems, unfavorable incisional scarring, non-incisional healing problems, hypopigmentation, hyperpigmentation, neuropraxia of the frontal branch, recurrence, and hematoma were analyzed based on the type of the brow lift technique retrospectively.&#x0D; Results: The average follow-up period was 13.6 months (range, 9-21 months). In the gliding brow lift, the most common complications were transient scalp paresthesia (47%), non-incisional healing problems (27%), and small areas of hypopigmentation in the forehead skin (20%). The most common complications of the temporal lift were the unfavorable incisional scarring (85%) and transient (77%) or permanent (31%) paresthesia in the scalp. The rate of postoperative small incisional problems (80%) and scarring (60%) were high in the pretrichial subcutaneous brow lift. None of the patients required a revision surgery or had a permanent frontal branch injury.&#x0D; Conclusion: There has been a trend toward the minimally invasive techniques in periorbital rejuvenation. The ideal technique should have minimal morbidity and provide long-lasting effects. This study demonstrates that the gliding brow lift technique is a promising and minimally invasive technique with pleasing outcomes in brow rejuvenation.

Practice Patterns, Part 2: An American Society of Plastic Surgeons (ASPS) Member Survey, 2000 and 2020. How Much Has Browlifting Changed?

PURPOSE: In 2001, Elkwood and Matarasso conducted an American Society of Plastic Surgeons (ASPS) member survey detailing browlift practice patterns. Despite significant changes in approach in the past twenty years, no survey has been performed since. METHODS: A 34-question descriptive survey was electronically distributed to a random group of 2,360 ASPS members. Results were then compared to the 2001 survey. RESULTS: A total of 257 responses were collected (11% response rate; ±6% margin of error at 95% CI). The most frequent technique for the correction of brow ptosis in both surveys was the endoscopic approach. The use of hardware fixation has increased in endoscopic browlifting while the use of cortical tunnels has decreased. While coronal browlifting has decreased in frequency, hairline and isolated temporal lift have increased. Neuromodulators have replaced resurfacing techniques as the most common non-surgical adjunct. Frequent use of neuromodulators has risen from 11.2% to 88.5%. Nearly 30% of current surgeons feel that neuromodulators have replaced formal browlifting procedures to a significant degree. CONCLUSION: In comparing the 2001 and current ASPS member survey there has been a clear transition to less invasive procedures over time. While the endoscopic approach was the most popular means of forehead correction in both surveys, coronal brow lifting has decreased in frequency while the hairline and temporal approaches have increased. Neurotoxins have replaced laser resurfacing and chemical peeling methods as an adjunct, and in some cases replaced the invasive procedure entirely. Possible explanations for the above will be discussed.

Temporal lift with repositioning of the orbicular muscle and eyebrow tail

A Revista Brasileira de Cirurgia Plástica é o órgão oficial de divulgação da Sociedade Brasileira de Cirurgia Plástica (SBCP), tem como objetivo registrar a produção científica em Cirurgia Plástica, fomentar o estudo, aperfeiçoamento e atualização dos profissionais da especialidade.

On association of lift generation, wake topology and kinematics of oscillating foils

The association of lift generation and evolution of wake topology behind an oscillating foil with combined heaving and pitching motion is investigated numerically at a range of bluereduced frequency (0.16 [Formula: see text] 0.48), phase offset (0[Formula: see text] [Formula: see text] 315[Formula: see text]) and Reynolds number (1000 [Formula: see text] 4000). The pitch-dominated kinematics that coincide with the range of [Formula: see text] 120[Formula: see text] and [Formula: see text] 225[Formula: see text] suggests that leading edge vortices are suppressed while trailing edge vortices dominate the wake with increasing reduced frequency. This corresponds to a transition in wake topology from a [Formula: see text] to a reverse Von Kármán wake mode. Contrarily, heave dominated kinematics (120[Formula: see text] [Formula: see text] 225[Formula: see text]) did not exhibit any wake topology transition with increasing [Formula: see text]. The temporal lift variation associated with heave-dominated regime further revealed a symmetric feature in terms of the time taken to attain peak lift generation within an oscillation cycle. This temporal symmetry was, however, lost as kinematics transitioned from heave- to pitch-dominated regime. Analyzing the wake evolution and lift features at quarter phase of an oscillation cycle revealed the existence of a correspondence between the two processes during the heave- and pitch-dominated kinematics.

A New Perspective to the Periorbital Aesthetics: Bella Eyes.

The term beautiful eyes can be defined as youthful, brilliant, vivid, and attractive eyes. The anthropometric findings about beautiful eyes may differ according to gender or race. In order to form such a beautiful eye, a variety of surgical, nonsurgical, or combination methods for periorbital region rejuvenation have been proposed. The surgical methods include coronal/peritrichial, endoscopic, upper and lower eyelid, or transconjunctival incisional procedures. Neuromodulators, fillers, and laser treatments are some of the nonsurgical approaches. Regardless of the method, while treating this particular area, the aesthetic unit concept should always be taken into consideration. We attempted to combine an endoscopic dynamic canthopexy procedure with endoscopic temporal and brow lift, which we call "bella eyes" to achieve a more attractive look, especially in young people who desire a slanted eyelid. We aim to share our clinical experience from 35 patients and the technical details of the bella eyes procedure. Patient satisfaction was high, and the endoscopic technique eliminated all of the minor deformities and provided excellent harmony through each subunit of the periocular area with minimal discomfort and well-hidden scars. We believe that this procedure is a good way to achieve a beautiful eye in young women. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Lateral Browlift Using Temporal (Pretrichial) Subcutaneous Approach Under Local Anesthesia

Lateral brow ptosis is a common aging phenomenon, contributing to the lateral upper eyelid hooding, in addition to dermatochalasis. Lateral brow lift complements upper blepharoplasty in achieving a youthful periorbital appearance. In this study, the author reports his experience in utilizing a temporal (pretrichial) subcutaneous lateral brow lift technique under local anesthesia. A retrospective analysis of all patients undergoing the proposed technique by one surgeon from 2009 to 2016 was conducted. Additional procedures were recorded. Preoperative and postoperative photographs at the longest follow-up visit were used for analysis. Operation was performed under local anesthesia. The surgical technique included a temporal (pretrichial) incision with subcutaneous dissection toward the lateral brow, with superolateral lift and closure. Total of 45 patients (44 females, 1 male; mean age: 58 years) underwent the temporal (pretrichial) subcutaneous lateral brow lift technique under local anesthesia in office setting. The procedure was unilateral in 4 cases. Additional procedures included upper blepharoplasty (38), ptosis surgery (16), and lower blepharoplasty (24). Average follow-up time was 1 year (range, 6 months to 5 years). All patients were satisfied with the eyebrow contour and scar appearance. One patient required additional brow lift on one side for asymmetry. There were no cases of frontal nerve paralysis. In conclusion, the temporal (pretrichial) subcutaneous approach is an effective, safe technique for lateral brow lift/contouring, which can be performed under local anesthesia. It is ideal for women. Additional advantages include ease of operation, cost, and shortening the hairline (if necessary).

Frontal Cranioplasty: The Endoscopic Approach

Sir: Advantages of the endoscopic approach to brow repositioning have led to a greater acceptability of this procedure among cosmetic patients. It is also being used increasingly in reconstructive procedures, including trauma, tumor resection, and craniotomy. While open coronal approaches remain the accepted standard, a limited number of reports have been published concerning endoscopic forehead recontouring. We present a 40-year-old woman with significant forehead contour irregularities following bifrontal craniotomy for resection of a pituitary macroadenoma. Her primary complaints were a change in her appearance and limited forehead motion. On physical examination she was noted to have a well-healed bicoronal incision with visible and palpable bilateral vertical defects over her forehead osteotomy sites. In addition, there was significant contraction of her frontalis muscle with limited bilateral brow movement (Fig. 1, left).Fig. 1.: Preoperative and postoperative views of the endoscopic cranioplasty procedure. This procedure was combined with an endoscopic brow lift. Note the improvement in the bony contour of the forehead.Using endoscopic techniques, a subperiosteal dissection was accomplished using five small incisions. The temporal incisions were used to create a flap just above the superficial layer of the deep temporal fascia that joined the center subperiosteal flap through the temporal line. The forehead soft tissues were lifted completely from the arcus marginalis. Once the flap was elevated, the vertical frontal bone defects were well visualized. The bilateral defects were filled with 10 cc of Norian bone cement (Synthes Corporation, Paoli, Pa.) using a beaver-tail elevator as a spatula. Standard elevation of the brow was accomplished with bone- anchored sutures, and a temporal lift was performed (Fig. 1right). Cranioplasty is particularly amenable to the endoscopic approach given the ease with which a subperiosteal flap can be elevated. Recently, successful case reports of endoscopic forehead recontouring have been published using different contour techniques, including power rasps and burrs,1 expanded polytetrafluoroethylene,2 hydroxylapatite,3 and calcium phosphate cement.4,5 These reports differ from ours, however, as to the type of defect repaired, the placement, number, and types of incisions, and the type of graft used. Temporal access incisions allow easy exposure to the lateral forehead deformities bilaterally as well as easier insertion of the bone graft. They also allow for possible bone rasping if necessary. With respect to our choice of synthetic bone graft, we used a calcium phosphate cement paste (Norian). The advantages of Norian bone cement include avoidance of donor-site morbidity, a smaller structure than synthetic hydroxylapatites (which results in better remodeling), and an isothermic reaction upon application. We found that forehead recontouring is particularly amenable to the endoscopic approach. There are some unique differences when using this technique for cosmetic versus reconstructive purposes. The reconstructive approach may involve elevating over hardware, elevating over irregular bone surfaces, and dissecting in previously dissected planes. However, these differences had no effect on the final results and were challenges that were easily overcome. With proficiency in endoscopic cosmetic brow lifting, this approach is easily applied in reconstructive cases, providing patients with a less invasive option. Jeremy Warner, M.D. Department of Surgery Division of Plastics Surgery University of Wisconsin Madison, Wis. Tom D. Wang, M.D. Department of Otolaryngology Division of Facial Plastic Surgery Oregon Health Sciences University Portland, Ore. Benjamin C. Marcus, M.D. Department of Surgery Division of Facial Plastic Surgery University of Wisconsin Madison, Wis.

Trans-inferior orbital rim anchorage and fascia roll multi-loop temporal anchorage in midface rejuvenation

A paradigm promoted for midface rejuvenation by Besins in his reverse and repositioning effect (RARE) technique considers 3 vertical sectors of the face. It relies on thread-based suspensions of the malar area and the orbicularis oculi with long cable suture forehead anchoring. The author reports on the use of short cable suture anchorage points as an alternative suspension method that helps to avoid and/or correct asymmetry and ectropion. An oblique malar elevation with short cable suture transorbital anchoring, in conjunction with a Hester-Flowers orbicularis oculi transzygoma anchoring technique, was performed using a new technique for fascia roll, multi-loop temporal anchoring and auricular tightening. A series of 295 patients have undergone the procedure since Spring 2002, with follow-up of up to 31 months. A strong oblique malar elevation, focused on nasolabial fold correction, eyebrow elevation, and better jaw definition, along with a natural appearance of the face were found to be stable over time. Transorbital anchoring allows strong malar elevation and lower lid support for rejuvenation and correction of complications. It should be combined with a Hester-Flowers orbicularis oculi transzygoma anchoring technique and can be performed in conjunction with a fascia roll, multi-loop temporal lift, submental fat and partial submaxillary gland removal, and auricular tightening as part of a full face lift procedure.

Brow Lift via the Direct and Trans-Blepharoplasty Approaches

Brow ptosis occurs as part of the aging process, and as a complication of facial nerve paresis. The article addresses the options available for correction of brow ptosis. The direct brow lift is effective for medial and central brow ptosis, and additional lift laterally may occasionally be needed. This is achieved with either a temporal external lift or an internal lift combined with blepharoplasty. The direct brow lift is suitable for any degree and pattern of brow ptosis, usually in males. It is also suitable for older females as well as male patients with facial paresis or marked involutional brow ptosis. The trans-blepharoplasty brow lift is suitable for relatively small degrees of brow ptosis affecting mainly the lateral two-thirds of the brow in any age group. It is often combined with upper lid blepharoplasty and is performed through the same incision. Complications associated with the direct brow lift include a cosmetically disturbing scar, granuloma formation due to the use of braided absorbable sutures rather than monofilament sutures, and the brow descending again. There may be temporary patches of reduced sensation in the forehead which normally recover in a few months. Complications associated with the trans-blepharoplasty brow lift include less lift than desired, and sutures causing dimpling of the skin. These two techniques are useful additions to the approaches for patients with brow ptosis.

319 蚊の羽ばたき運動における羽根周りの流れの可視化と揚力の時間的変動の測定

319 蚊の羽ばたき運動における羽根周りの流れの可視化と揚力の時間的変動の測定

A Discussion of the Article, “Temporal Lift by Galeapexy,” by Alain L. Fogli, M.D.

Many patients, even those with marked aging signs, ask only for blepharoplasty. When performing blepharoplasty alone, the correction or improvement of the deformities of the lateral aspects of the orbit is usually not sufficient. In his article ‘‘Temporal Lift by Galeapexy,’’ Dr. Fogli describes an excellent idea for treating the ptotic tail of the brow and crow’s feet. The procedure proposed is not complicated and I believe it can enhance the results of blepharoplasty in those patients in whom blepharoplasty alone is recommended. (The result shown in Fig. 8 of his article exemplifies the efficiency of the technique.) The patient in Fig. 10, I believe, presents acceptable preoperative brow tail position. The frontal view is difficult to analyze because hair is covering the brow. I congratulate Dr. Fogli for this paper. I will definitely encourage the utilization of this procedure in my service of plastic surgery at the University of the State of Rio de Janeiro.

Temporal lift by galeapexy: a review of 270 cases.

The purpose of this technique is to correct the ptotic tail of the brow and crow's feet as well as to redrape the premalar skin to allow us to make a greater skin resection in the lower lid. The purpose of this presentation is to expose the advantages, the inconveniences, and the complications of this technique. We reviewed the charts of 270 patients who were operated on between June 1996 and January 2002. The average age of the patients was 45 years old. Temporal lifts were performed during a frontotemporal lift in 92 cases, and during a three-stage lift (frontal, facial, and cervical) in 170 cases. In eight cases, an isolated temporal lift was performed. An upper blepharoplasty was performed in 252 cases and transconjunctival fat pad excision was performed in 188 cases. Finally, a lower lid skin resection was done following a galeapexy in 241 cases. The surgical approach consists of a temporal incision, followed by a subgaleal dissection, and then a subcutaneous dissection that allows the cephalic galea, previously incised, to be anchored to the temporal aponeurosis. This allows good cutaneous redraping that raises the brow tail and a detachment of the orbicularis fibers. The suturing of the scalp is done without tension and without eliminating hair. The results of the technique with a follow-up period of more than five years for the earlier cases and six months for the last cases, were evaluated with three criteria: (1) the distance between the brow and the eyelashes, (2) the reduction of crow's feet, (3) the reduction of wrinkles at the level of the lower lid and the malar region. Overall satisfaction was also rated. Of 270 patients, 225 had ratings of very good to good, 13 had average results, and 13 had unsatisfactory results. As far as complications, five had unilateral hematoma requiring an evacuation, four patients had temporary alopecia, and eight patients had temporary frontal muscle weakness that resolved within one to three months. This technique, performed under local anesthesia, is very efficient, reproducible, and simple. The incidence of complications can be reduced when one is meticulous during dissection.

Numerical simulation of vortex shedding past a circular cylinder under the influence of buoyancy

Flow past an isolated circular cylinder is numerically simulated, under the influence of aiding and opposing buoyancy. A modified velocity correction procedure is incorporated. Galerkin weighted residual formulation is employed for spatial discretization along with a second-order Runge–Kutta (R–K) time integration scheme. The influence of buoyancy on the Nusselt number, wake structures, temporal lift and drag forces have been studied. At low Reynolds numbers (for, e.g., Re=20–40), buoyancy opposing the flow could trigger vortex shedding. The degeneration of the Kàrmàn vortex street into twin vortices is numerically simulated for a heated cylinder. The two zones of vortex shedding and twin vortices are demarcated.

Subperiosteal lateral browlift and its relationship to upper blepharoplasty.

Skin redundancy of the upper eyelid is often associated with a variable degree of ptosis of the lateral third of the eyebrow, which increases the extent of the defect. Correcting this condition implies a combination of a temporal lift with a standard upper blepharoplasty. In the temporal lift it is possible to perform an easy subaponeurotic and subperiosteal dissection of the soft tissues of the temporal area through an incision behind the hairline with pleasing and long-lasting results. The brow ptosis is corrected without noticeable scars and with inconspicuous damage to scalp follicles of the temporal region.

The frontalis nerve in the temporal brow lift.

Brow elevations via the indirect temporal lift approach was carried out on a series of 26 cadaver half heads. The purpose of the dissection was to identify the course and depth of plane of the frontalis branch of the facial nerve. Of particular interest was the area superolateral to the brow. Histologic sections were taken along the course of the nerve to determine its exact depth. It was determined that the nerve lay in the superficial musculoaponeurotic system layer of superficial fascia lying above the level of the temporalis fascia. Utilizing this information, a method of dissection in the temporal lift operation is described that safely avoids the frontalis branch of the facial nerve.