Severe medial brow ptosis. Direct approach to the corrugator and procerus muscles
Author: patricia akaishi
Base Hospital / Institution: Hospital das Clinicas de Ribeirão Preto – University of Sao Paulo
Video presentation
Abstract ID: 24-485
Purpose
Medial brow ptosis is associated with hyperfunctional corrugator and procerus muscles, and deep glabellar furrows. We describe a direct technique for muscular division in severe medial eyebrow ptosis.
Methods
Surgical steps.
1. Medial suprabrow design is fashioned for skin resection.
2. Local infiltrative anesthesia with a mixture of Lidocaine 1% 1:160.000 and intravenous sedation
3. Beveled skin incision and removal of excess skin
4. Subcutaneous dissection to expose the anterior surface of the procerus, frontalis, and orbicularis muscles
5. Submuscular dissection of the procerus
6. Medial corrugator dissection
7. Procerus and corrugator division
8. Deep sutures between medial frontalis and orbicularis muscle with absorbable monofilament 5-0 interrupted sutures
9. Subcutaneous absorbable monofilament 5-0 interrupted sutures
10. Skin suture with 6-0 nylon
Results
The expected postoperative changes in medial brow are elevation, recontour, and widening of interbrow distance.
Conclusion
The treatment of severe sagging brows due to overactive corrugator and procerus muscles can be difficult. The direct brow lift offers an effective way to address these muscles in the forehead. However, after the procedure, there will be a visible scar near the middle of the forehead for the first few months. Patients need to be prepared for this and committed to allowing enough time for proper recovery.
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