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Facial Plastic Surgery : FPS May 2006Age-related changes to the upper third of the face manifest, typically, as brow ptosis and the development of deep skin furrows. Depression of the brow evolves as... (Review)
Review
Age-related changes to the upper third of the face manifest, typically, as brow ptosis and the development of deep skin furrows. Depression of the brow evolves as gravity and the action of the corrugator supercilli, procerus, and orbicularis draw on the progressively inelastic forehead skin. Facial mimetic muscle action reveals itself over time via the development of deep forehead rhytids. Facial plastic surgeons have at their disposal several effective surgical, and recently, medical interventions to address these changes. Each technique has merits and suitable applications. This review examines the history of rejuvenation of the upper face, details the pertinent treatment modalities, and evaluates the context in which each is applicable.
Topics: Botulinum Toxins, Type A; Eyebrows; Face; Facial Muscles; Forehead; Humans; Neuromuscular Agents; Rejuvenation; Rhytidoplasty; Skin Aging
PubMed: 16847799
DOI: 10.1055/s-2006-947714 -
Arquivos de Neuro-psiquiatria Aug 2012
Topics: Blepharospasm; Diagnosis, Differential; Dystonic Disorders; Facial Muscles; Humans; Male; Middle Aged; Tic Disorders
PubMed: 22899039
DOI: 10.1590/s0004-282x2012000800016 -
Archives of Otolaryngology (Chicago,... Jan 1978Indications and advantages of the frontal lift are seen in comparison to the limitations of the conventional browplasty. The anatomy is reviewed, including the planes of...
Indications and advantages of the frontal lift are seen in comparison to the limitations of the conventional browplasty. The anatomy is reviewed, including the planes of dissection, nerves, vessels, muscles, and bony landmarks. Temporal and frontal ptosis, as well as glabellar and frontal creases are treated through this approach. The surgical procedure includes site of incision, extent and plane of dissection, and treatment of frontalis, procerus, and corrugator muscles. Some variations of technique have been performed. These include the V-Y shaped closure technique in the temple area and retaining separate anatomic compartments when combined with meloplasty.
Topics: Dermatologic Surgical Procedures; Face; Forehead; Humans; Surgery, Plastic
PubMed: 619882
DOI: 10.1001/archotol.1978.00790010030007 -
The Journal of Dermatologic Surgery and... Oct 1993A postoperative nasal root and glabellar forehead deformity comprised both vertical and horizontal elements, with scar contracture and fixation across the left medial...
Two-stage correction of depressed glabella and nasal root scar contracture utilizing subcutaneous tissue advancement flaps and a layered soft tissue/procerus muscle transposition flap.
BACKGROUND
A postoperative nasal root and glabellar forehead deformity comprised both vertical and horizontal elements, with scar contracture and fixation across the left medial nose base, extending into the adjacent superior canthal region.
METHODS
A two-stage reconstruction was performed, initially correcting the vertical centrally placed forehead depression by dual subcutaneous flaps advanced centrally and joined. The horizontal nasal root contracture was repaired at a second stage utilizing a procerus muscle transposition flap elevated on the ipsilateral deep contracture side, imbricated in serpentine fashion on itself and sutured into the depression over the scar base.
RESULT
Significant improvement followed.
CONCLUSION
The careful and precise placement of subcutaneous tissue and muscle can serve to assist in filling certain deep defects and in elevating scar lines.
Topics: Aged; Carcinoma, Basal Cell; Cicatrix; Female; Humans; Nose; Nose Neoplasms; Postoperative Complications; Reoperation; Surgical Flaps; Treatment Outcome
PubMed: 8408917
DOI: 10.1111/j.1524-4725.1993.tb00986.x -
Clinics in Dermatology 2004Facial wrinkles involving the forehead, glabellar, and/or periorbital regions are a common esthetic problem and are directly related to overactivity of the underlying... (Review)
Review
Facial wrinkles involving the forehead, glabellar, and/or periorbital regions are a common esthetic problem and are directly related to overactivity of the underlying facial musculature. For instance, the development of glabellar wrinkles is related, at least in part, to the dynamics of the underlying procerus, corrugator supercilii, and orbicularis oculi muscles. Facial lines are considered problematic because they produce the appearance of aging. In some cases, they can also be misinterpreted as manifestations of negative emotions (eg, anger, anxiety, sadness), fatigue, or stress. In recent years, botulinum toxin injections have become one of the most popular therapies for the treatment of hyperfunctional facial lines. After injection, the toxin acts to paralyze or weaken facial mimetic muscles. This reduces or eliminates the appearance of wrinkles and is extremely safe.
Topics: Botulinum Toxins; Botulinum Toxins, Type A; Face; Humans; Injections, Intramuscular; Neuromuscular Agents; Skin Aging
PubMed: 15158542
DOI: 10.1016/j.clindermatol.2003.12.033 -
HNO Mar 2007Endoscopic forehead lifting is a widely accepted treatment for brow ptosis. The procedure safely and effectively corrects horizontal forehead rhytids, brow ptosis, upper... (Review)
Review
Endoscopic forehead lifting is a widely accepted treatment for brow ptosis. The procedure safely and effectively corrects horizontal forehead rhytids, brow ptosis, upper eyelid dermatochalasis and periorbital crow's feet. The result is a refreshed and more open facial expression. A thorough understanding of basic facial anatomy is the key to successful cosmetic surgery. The procedure is based on a subperiostal and preperiosteal mobilisation of the temporal and frontal soft tissues and a detachment of the periosteum of the orbital rim. An upper eyelid blepharoplasty and selective incomplete or complete myotomies of the corrugator and procerus muscles may be incorporated in the operation. Most surgeons prefer to fixate the elevated soft tissue planes to the calvarium by sutures, titanium or resorbabale polyglactid anchors. While initial enthusiasm for this procedure seems to be declining in several countries, few ENT-surgeons are familiar with this technique in Europe. This article reviews the surgical anatomy of the forehead and temporoparietal region by means of cadaver dissection and describes the surgical procedure for German speaking readers.
Topics: Blepharoplasty; Blepharoptosis; Endoscopy; Forehead; Humans; Practice Guidelines as Topic; Practice Patterns, Physicians'; Plastic Surgery Procedures
PubMed: 17294146
DOI: 10.1007/s00106-006-1524-2 -
Journal of Cosmetic Dermatology Sep 2020The globally devastating effects of COVID-19 breach not only the realm of public health, but of psychosocial interaction and communication as well, particularly with the... (Review)
Review
BACKGROUND
The globally devastating effects of COVID-19 breach not only the realm of public health, but of psychosocial interaction and communication as well, particularly with the advent of mask-wearing.
METHODS
A review of the literature and understanding of facial anatomy and expressions as well as the effect of botulinum toxin on emotions and nonverbal communication.
RESULTS
Today, the mask has become a semi-permanent accessory to the face, blocking our ability to express and perceive each other's facial expressions by dividing it into a visible top half and invisible bottom half. This significantly restricts our ability to accurately interpret emotions based on facial expressions and strengthens our perceptions of negative emotions produced by frowning. The addition of botulinum toxin (BTX)-induced facial muscle paralysis to target the muscles of the top (visible) half of the face, especially the corrugator and procerus muscles, may act as a therapeutic solution by its suppression of glabellar lines and our ability to frown. The treatment of the glabella complex not only has been shown to inhibit the negative emotions of the treated individual but also can reduce the negative emotions in those who come in contact with the treated individual.
CONCLUSIONS
Mask-wearing in the wake of COVID-19 brings new challenges to our ability to communicate and perceive emotion through full facial expression, our most effective and universally shared form of communication, and BTX may offer a positive solution to decrease negative emotions and promote well-being for both the mask-wearer and all who come in contact with that individual.
Topics: Botulinum Toxins; COVID-19; Emotions; Facial Expression; Facial Muscles; Forehead; Humans; Masks; Nonverbal Communication; SARS-CoV-2
PubMed: 32592268
DOI: 10.1111/jocd.13569 -
Mayo Clinic Proceedings Oct 1985Essential blepharospasm is a progressive, bilateral, involuntary facial spasm. In this study, we conducted a prospective analysis of myectomy for the treatment of this...
Essential blepharospasm is a progressive, bilateral, involuntary facial spasm. In this study, we conducted a prospective analysis of myectomy for the treatment of this condition in 21 patients. The procedure consisted of extirpation of the muscles that close the eyelids (protractors), which include the pretarsal, preseptal, and orbital components of the orbicularis oculi, as well as the procerus and corrugator supercilii muscles of the brow. In addition, the muscles that open the eyelids (retractors) were strengthened (by resection of the frontalis muscle and repair of disinsertion of the levator aponeuroses). The most common symptoms that necessitated myectomy were difficulty with driving (20 patients), watching television (17 patients), reading (15 patients), and eating (5 patients). Overall, the 21 patients had a 70% mean decrease in symptoms postoperatively. Five patients required an additional operation for management of residual blepharospasm.
Topics: Aged; Blepharospasm; Eyebrows; Eyelid Diseases; Facial Muscles; Female; Follow-Up Studies; Humans; Male; Methods; Middle Aged; Oculomotor Muscles; Postoperative Complications; Prospective Studies; Reoperation
PubMed: 4033230
DOI: 10.1016/s0025-6196(12)60741-1 -
Eliminating frown lines with an endoscopic forehead lift procedure (corrugator muscle disinsertion).Aesthetic Plastic Surgery Aug 2011In certain cases of endoscopic forehead lift without muscle resection, patients were incidentally noted to develop weakness or loss of their ability to frown during the...
BACKGROUND
In certain cases of endoscopic forehead lift without muscle resection, patients were incidentally noted to develop weakness or loss of their ability to frown during the postoperative period despite intact musculature. This finding suggested the possibility of decreasing frown strength using the disinsertion of the relevant muscles. This finding persuaded the authors to try to eliminate or decrease the sensory problems resulting from open or endoscopic frowning muscle resection by disinserting these muscles. We therefore sought to determine the efficacy of a brow/forehead lift that involved disinsertion rather than muscle resection.
METHODS
From September 2004 through December 2006, 22 endoscopic forehead lifts (20 females and 2 males) were performed using the conventional corrugator muscle resection technique (group 1). From January 2007 through October 2009, 43 patients (38 females and 5 males) underwent endoscopic forehead lift with a muscle-preserving technique (group 2). In both groups, small scalp incisions were made, and an endoscope was used to elevate the brows and forehead to perform glabellar and forehead muscle resection in group 1 and disinsertion of the frowning muscles in group 2. The skin of the forehead was then reanchored to a more superior location using sutures attached to deep temporal fascia as well as outer table screws and skin staples.
RESULTS
Aesthetically pleasing eyebrow and forehead with reduced power in the frowning muscles were achieved in the majority of patients in both groups. A significant decrease in the depth of vertical and horizontal glabellar creases was obtained in these patients. In group 1, 19 of 22 patients completely lost the ability to frown and 3 patients (13.6%) suffered permanent sensory loss. In group 2, 33 of 43 patients lost their ability to frown but only 2 cases (4.5%) developed minimal unilateral forehead partial sensory deficit after a 12-month follow-up period.
CONCLUSION
Disinsertion of the corrugator supercilli, procerus, or orbicularis oculi muscles can decrease contractility with less chance of damaging nearby or intermingled sensory nerves than offered by resection.
Topics: Adult; Endoscopy; Female; Forehead; Humans; Male; Middle Aged; Muscle, Skeletal; Rhytidoplasty; Skin Aging
PubMed: 21298513
DOI: 10.1007/s00266-010-9649-9 -
Journal of the American Academy of... Jun 2008The facial feedback hypothesis suggests that muscular manipulations which result in more positive facial expressions may lead to more positive emotional states in... (Review)
Review
The facial feedback hypothesis suggests that muscular manipulations which result in more positive facial expressions may lead to more positive emotional states in affected individuals. In this essay, we hypothesize that the injection of botulinum toxin for upper face dynamic creases might induce positive emotional states by reducing the ability to frown and create other negative facial expressions. The use of botulinum toxin to pharmacologically alter upper face muscular expressiveness may curtail the appearance of negative emotions, most notably anger, but also fear and sadness. This occurs via the relaxation of the corrugator supercilii and the procerus, which are responsible for brow furrowing, and to a lesser extent, because of the relaxation of the frontalis. Concurrently, botulinum toxin may dampen some positive expressions like the true smile, which requires activity of the orbicularis oculi, a muscle also relaxed after toxin injections. On balance, the evidence suggests that botulinum toxin injections for upper face dynamic creases may reduce negative facial expressions more than they reduce positive facial expressions. Based on the facial feedback hypothesis, this net change in facial expression may potentially have the secondary effect of reducing the internal experience of negative emotions, thus making patients feel less angry, sad, and fearful.
Topics: Biofeedback, Psychology; Botulinum Toxins; Emotions; Facial Expression; Facial Muscles; Happiness; Humans
PubMed: 18485989
DOI: 10.1016/j.jaad.2007.10.649