TY - JOUR
T1 - Evolving fixation methods in endoscopically assisted forehead rejuvenation
T2 - Controversies and rationale
AU - Rohrich, Rod J.
AU - Beran, Samuel J.
PY - 1997/11
Y1 - 1997/11
N2 - The goals of surgical rejuvenation of the forehead include component brow manipulation, attenuation of transverse forehead rhytids, and reduction of glabellar frown lines. The endoscopic approach has proved successful in achieving these goals in selective patients while minimizing incisions and improving scalp sensation. Efficacy of endoscopic brow manipulation is dependent on (1) complete release of the brow at the supraorbital rim, (2) brow depressor muscle resection/release, and (3) tension-free fixation of the brow position until wound healing has occurred. Fixation of the brow using an endoscopic technique, unlike the open technique, is dependent on skin retraction and tension-free scalp fixation during the process of wound healing to maintain the desired brow position. Techniques for endoscopic fixation are arbitrarily divided into endogenous and exogenous. Endogenous methods include extensive galea-frontalis-occipitalis release, lateral spanning suspension sutures, external bolster fixation, anterior port skin excision, galea-frontalis advancement, cortical tunnels, and tissue adhesives. Exogenous techniques include internal screw or plate fixation, Mitek anchor fixation, external screw fixation, and absorbable K-wires. This article provides a goal-oriented review of these evolving techniques and a rationale for the use of fixation methods in endoscopically assisted forehead rejuvenation.
AB - The goals of surgical rejuvenation of the forehead include component brow manipulation, attenuation of transverse forehead rhytids, and reduction of glabellar frown lines. The endoscopic approach has proved successful in achieving these goals in selective patients while minimizing incisions and improving scalp sensation. Efficacy of endoscopic brow manipulation is dependent on (1) complete release of the brow at the supraorbital rim, (2) brow depressor muscle resection/release, and (3) tension-free fixation of the brow position until wound healing has occurred. Fixation of the brow using an endoscopic technique, unlike the open technique, is dependent on skin retraction and tension-free scalp fixation during the process of wound healing to maintain the desired brow position. Techniques for endoscopic fixation are arbitrarily divided into endogenous and exogenous. Endogenous methods include extensive galea-frontalis-occipitalis release, lateral spanning suspension sutures, external bolster fixation, anterior port skin excision, galea-frontalis advancement, cortical tunnels, and tissue adhesives. Exogenous techniques include internal screw or plate fixation, Mitek anchor fixation, external screw fixation, and absorbable K-wires. This article provides a goal-oriented review of these evolving techniques and a rationale for the use of fixation methods in endoscopically assisted forehead rejuvenation.
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U2 - 10.1097/00006534-199711000-00032
DO - 10.1097/00006534-199711000-00032
M3 - Article
C2 - 9385975
AN - SCOPUS:0030702083
SN - 0032-1052
VL - 100
SP - 1575
EP - 1584
JO - Plastic and reconstructive surgery
JF - Plastic and reconstructive surgery
IS - 6
ER -