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Head & Neck Surgery 1978Brow modifications are discussed with respect to their role as aids in achieving certain aesthetic effects when rhinoplasty is being performed. If a deep nasofrontal...
Brow modifications are discussed with respect to their role as aids in achieving certain aesthetic effects when rhinoplasty is being performed. If a deep nasofrontal angle should not be brought forward, reduction of the brow may be indicated. If the nasofrontal angle should not be retrodisplaced to deepen a shallow angle, brow augmentation may prove helpful in separating the nose from the forehead or in making the nose appear shorter in the vertical dimension. Augmentation and reduction browplastic techniques are discussed, and selected methods are illustrated. Some involve additional resection of frontal bone or procerus muscle at the time of nasal-hump removal. Others employ grafts of bone and/or cartilage removed from the nose at the time of septorhinoplasty. The versatile aesthetic surgeon should be capable of changing all structures adjacent to the nose. Certain difficult cosmetic problems are best treated by directing appropriate attention to these structures and to the nose rather than by concentrating on the nose alone. That the brow is one of these important abutting landmarks is demonstrated.
Topics: Bone Transplantation; Esthetics; Eyebrows; Face; Female; Forehead; Frontal Bone; Humans; Nose; Osteotomy; Rhinoplasty; Surgery, Plastic; Transplantation, Autologous
PubMed: 385555
DOI: 10.1002/hed.2890010204 -
Plastic and Reconstructive Surgery Jan 2000The coronal incision forehead lift became a component of the face-lift procedure 35 years ago and increased the cosmetic benefit for the facial aesthetic surgery...
The coronal incision forehead lift became a component of the face-lift procedure 35 years ago and increased the cosmetic benefit for the facial aesthetic surgery patient. Later, this enhanced cosmetic effect achieved from eyebrow resuspension was complemented by treatment of the glabellar skin lines by modifying corrugator supercilii and procerus muscle function through the same coronal incision. In recent years, newer procedures for treating the corrugator supercilii and procerus muscles by using endoscopy or limited incision techniques have eliminated the need for the coronal incision. With these newer techniques has come a renewed interest in the surgical anatomy of the muscle complex that acts on glabellar skin. This study was designed to examine the current understanding of the anatomy of these muscles and to resolve misconceptions and controversy concerning them. Fresh cadaver dissections and simulated muscle action studies done on the glabellar musculature of four specimens were correlated with nerve blockade studies performed in 10 subjects on the temporal and zygomatic branches of the facial nerve. The presence of the depressor supercilii muscle as a distinct entity was confirmed. The little-appreciated oblique head of the corrugator supercilii muscle was identified. The conclusions from this study suggest that the transverse head of the corrugator supercilii muscle produces the vertical component of the glabellar skin line and also contributes to the formation of the oblique component of the glabellar skin line. The oblique head of the corrugator supercilii muscle, the depressor supercilii muscle, and the medial head of the orbital portion of the orbicularis oculi muscle all appear to depress the medial head of the eyebrow and contribute to the formation of the oblique glabellar skin line. The nerve block study provided evidence that the zygomatic branch of the facial nerve supplies the three medial eyebrow depressor muscles, which opens the possibility for future nerve ablation techniques to control the action of the medial eyebrow depressor muscle group. This nerve block study also supports the concept of "physiologic" elevation of the medial eyebrow as an effective component of foreheadplasty.
Topics: Adult; Aged; Blepharoplasty; Eyebrows; Facial Muscles; Female; Forehead; Humans; Male; Middle Aged; Motor Neurons; Rhytidoplasty; Skin Aging
PubMed: 10627005
DOI: 10.1097/00006534-200001000-00056 -
The Laryngoscope Jun 1997Management of the aging brow and forehead has recently evolved based on available innovative technologies. Likewise, procedure-specific indications have changed based on...
Management of the aging brow and forehead has recently evolved based on available innovative technologies. Likewise, procedure-specific indications have changed based on collective surgical experiences. No longer is the approach based solely on hair pattern or degree of brow ptosis. Patients require varying combinations of brow elevation (prior to blepharoplasty), correction of brow asymmetries, and hairline-preserving forehead elevation. Some may only require excisional or paralytic procedures of the frontalis muscle (horizontal forehead creases), corrugator supercilii muscles (vertical glabellar furrows), and procerus muscle (horizontal glabellar furrows). We present a 3-year experience using a problem-specific approach. This incorporates endoscopic technology, botulinum toxin type A purified neurotoxin complex (Botox, Allergan, Irvine, CA) intramuscular injection, and traditional procedures such as the coronal, pretrichial, midforehead, and direct browlift. Current indications, patient selection, and results are also discussed.
Topics: Aging; Anti-Dyskinesia Agents; Botulinum Toxins; Endoscopy; Eyebrows; Forehead; Humans; Surgery, Plastic; Treatment Outcome
PubMed: 9185724
DOI: 10.1097/00005537-199706000-00002 -
Diseases (Basel, Switzerland) Sep 2022Facial hemiplegia happens when the seventh cranial nerve is inflamed, causing a dysfunction of the facial nerve in specific regions. This case report brings a complex...
Facial hemiplegia happens when the seventh cranial nerve is inflamed, causing a dysfunction of the facial nerve in specific regions. This case report brings a complex case of facial hemiplegia, a non-temporary lesion caused by a traumatic accident, which had a more conservative approach, treating the patient with botulinum toxin. After explanation of treatment outcomes, the patient favored treatment on a unilateral side with botulinum toxin applied locally to the muscles. It was applied on her left side, in order to change the muscles tonus and improve the esthetic. The patient adhered to immediate and short-term instructions following the procedure, including movement limitation and skin exposure avoidance. At 2 weeks, the patient returned to follow-up, and the result was checked. After around 6-month follow-up, the patient was reassessed, and a new application was done. The patient tried to contract the procerus and corrugator muscles which were treated, and periorbicular region that was corrected. After contracting the frontal muscle, a satisfactory result was also seen in the frontal area. While limited to a single case presentation, botulinum toxin may be an effective short-term tool for treatment of facial hemiplegia to establish an effective esthetic result.
PubMed: 36278566
DOI: 10.3390/diseases10040067 -
Plastic and Reconstructive Surgery Jul 2004As part of forehead rejuvenation and surgical treatment of migraine headaches, the mass of the corrugator supercilii, the procerus, and the depressor supercilii muscles...
As part of forehead rejuvenation and surgical treatment of migraine headaches, the mass of the corrugator supercilii, the procerus, and the depressor supercilii muscles is replaced with fat for optimal aesthetic contouring of this region and to help prevent recurrence of the glabellar lines. The authors propose a new fat graft donor site that is convenient and safe and that adds only minutes to the total operating time. This fat is located between the deep layer of deep temporal fascia and the temporalis muscle as it approaches the zygomatic arch. The temporal musculofascial anatomy as it relates to the available fat donor sites is described. This source has been used on 74 occasions at 128 sites, from July 1, 2002, to December 31, 2002, with no complications attributable to the technique.
Topics: Adipose Tissue; Female; Forehead; Humans; Migraine Disorders; Rejuvenation; Temporal Muscle; Tissue and Organ Harvesting
PubMed: 15220600
DOI: 10.1097/01.prs.0000128825.62390.73 -
Journal of Cosmetic Dermatology Jun 2009Ptosis is an important side effect of frown correction by botulinum toxin type A (BTX-A). The most likely reason of eyelid ptosis is the diffusion of the toxin to...
BACKGROUND
Ptosis is an important side effect of frown correction by botulinum toxin type A (BTX-A). The most likely reason of eyelid ptosis is the diffusion of the toxin to levator palpebrae superioris muscle through orbital septum while the toxin is injected into the corrugator muscle.
OBJECTIVES
In this pilot study, to prevent ptosis, we evaluated the efficacy of BTX-A injection at superior middle aspect of the corrugator muscle instead of the common injection site located above the medial eyebrow head.
METHODS
Fifteen patients were selected from those referred to our clinic with history of eyelid ptosis due to previous BTX-A (dysport; Ipsen) injection. They received three injections of BTX-A; 10 U into the procerus muscle and 20 U into the superior middle aspect of each corrugator muscle, instead of injecting into the belly of the corrugator muscles.
RESULTS
We observed excellent, good and moderate responses in 66.66%, 13.33% and 20% of our patients 2 weeks post-injection respectively. The outcomes were improved to excellent in the latter two groups by injecting 5 U of BTX-A (dysport; Ipsen) into the contractible corrugator in patients with good and 5 U in each corrugator (total of 10 U) in patients with moderate responses.
CONCLUSION
Employing this method a very satisfactory outcome was obtained while no ptosis was observed. Therefore, we recommend this safe technique for treating patients with a history of eyelid ptosis.
Topics: Adult; Blepharoptosis; Botulinum Toxins, Type A; Cosmetic Techniques; Dermatologic Agents; Female; Forehead; Humans; Injections, Intramuscular; Middle Aged; Oculomotor Muscles; Patient Satisfaction; Pilot Projects; Skin Aging; Treatment Outcome
PubMed: 19527332
DOI: 10.1111/j.1473-2165.2009.00433.x -
Archives of Ophthalmology (Chicago,... Feb 1984The refinement of a muscle excision technique for the correction of essential blepharospasm has been a major contribution to treatment. In this procedure, incisions are...
The refinement of a muscle excision technique for the correction of essential blepharospasm has been a major contribution to treatment. In this procedure, incisions are made directly above the eyebrow to excise the brow muscles, often resulting in adherent scars and poor brow position. The bicoronal scalp flap has been used by many other surgical subspecialities for exposure of the frontal bone area, eg, in neurosurgical procedures, sinus surgery, and cosmetic forehead lifts. The use of the coronal flap exposure for excision of the corrugator and procerus muscles has allowed them to be more easily excised and has avoided the problems associated with the direct brow incisions. The Anderson muscle stripping technique, combined with the coronal flap exposure for the brow muscles, provides the best correction for the spasms in patients who have essential blepharospasm. The frequency of complications is low, and patient acceptance is high.
Topics: Blepharospasm; Eyebrows; Eyelid Diseases; Humans; Methods; Muscles; Patient Care Planning; Postoperative Complications; Preoperative Care; Surgical Flaps
PubMed: 6696676
DOI: 10.1001/archopht.1984.01040030219031 -
Plastic and Reconstructive Surgery Feb 2000
Topics: Eyebrows; Facial Muscles; Humans; Rhytidoplasty
PubMed: 10697198
DOI: 10.1097/00006534-200002000-00060 -
Annali Italiani Di Chirurgia 2014The aim of this study is to prove the therapeutic effectiveness of nerve decompression, performed endoscopically for frontal migraine and by open surgery for occipital...
AIM
The aim of this study is to prove the therapeutic effectiveness of nerve decompression, performed endoscopically for frontal migraine and by open surgery for occipital migraine.
MATERIALS AND METHODS
Twenty patients were enrolled and underwent surgery for endoscopic resection of the glabellar muscle group, including the corrugator supercilii, depressor supercilii, and procerus muscles, while the occipital decompression was performed in open surgery through decompression of occipital nerves from occipital, semispinalis capitis, trapezius and sternocleidomastoid muscles. Every patient was diagnosed with: migraine without aura, chronic tensiontype headache and new daily persistent headache, refractory to medical management.
RESULTS
Analyzing the answers given by the patients to validated questionnaires, 9 referred alleviation of migraine symptoms (45%), 8 described elimination of their migraine headaches (40%) while 3 didn't report any improvement.
DISCUSSION
Our data confirmed the results of previous studies, pointing out the effectiveness of trigeminal branches and occipital nerves (trigger points) decompression from the surrounding muscles. Moreover, our technique has the same results but it's less invasive and has less collateral effects.
CONCLUSIONS
Our results highlight migraine surgery as an effective treatment for patients with migraine headaches who do not tolerate or do not wish to continue medical interventions.
KEY WORDS
Endoscopic surgery, Headache migraine.
Topics: Endoscopy; Facial Muscles; Female; Forehead; Humans; Male; Migraine Disorders; Surveys and Questionnaires; Treatment Outcome
PubMed: 25711848
DOI: No ID Found -
Facial Plastic Surgery : FPS Feb 2001On a path analogous to other surgical disciplines, the progression of facial cosmetic surgery has trended toward shorter scars and less invasive techniques. This article...
On a path analogous to other surgical disciplines, the progression of facial cosmetic surgery has trended toward shorter scars and less invasive techniques. This article outlines an approach to facelifting that limits the scar to the temporal scalp, preauricular area, and retroauricular sulcus. It will enable the reader to identify those patients who are candidates for a less invasive procedure compared with the conventional facelift approach. Specifically, the temporal facelift addresses the lateral brow, the middle one third of the face, and the upper neck. In addition, this article examines the various and current methods for treatment of the glabellar area of the forehead. Medical and surgical options are outlined for the correction of those rhytids induced by corrugator and procerus muscle activity.
Topics: Blepharoplasty; Cicatrix; Forehead; Humans; Rhytidoplasty; Temporal Muscle
PubMed: 11518978
DOI: 10.1055/s-2001-16365