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At least 361 records · Page 20Linked to original sources
PubMed1996

Transblepharoplasty forehead lift and upper face rejuvenation.

A complete upper face rejuvenation via blepharoplasty incisions is feasible. This technique is indicated in: (1) patients with male pattern baldness, (2) patients with a history of hair transplants, (3) patients with excessively high foreheads, (4) patients in which upper blepharoplasty is planned simultaneously with the brow lift, (5) patients with spastic frontalis syndrome, and (6) patients needing periorbital or bicularis muscle repositioning. Standard upper blepharoplasty incisions are made. Dissection is proceeded to the superior orbital rim. All the soft tissues, including the retro-orbicularis oculi fat (ROOF) pad, are elevated. A cuff of periosteum and the overlying subgaleal fascia is left. Superior dissection in the frontal area can proceed subgaleally or sub-periosteally. In the latter case, the periosteum is entered about 1.5 cm above the orbital rim. In the temporal area, dissection is done in the subgaleal plane up to 1 cm above the zygomatic arch. This dissection is accurately and safely done with the aid of the endoscope introduced through the same incision. Resection of the procerus and corrugator muscles is performed via the eyelid incision, identifying and protecting the supratrochlear and supraorbital nerves. Extra-fine-tip cautery is used for hemostasis. Initial fixation consists of suturing the ROOF pad to the periosteum of the orbital rim (two sutures). The tail of the brow is sutured to the temporal fascia (third suture). The frontotemporal flap can be stabilized in an elevated position with an external tied-over dressing, percutaneous screws, or well-supportive contouring tape, depending on the clinical situation. The eyelids are closed in a standard fashion. This operation was performed on 14 patients--12 with the assistance of the endoscope and in 2 without the endoscope. However, the endoscope has made the operation more precise. Analysis of the brow position, frontalis and corrugator activity, and the aesthetics of the upper face reveal that this operation can give results similar to other techniques with comparable morbidity, more expeditiously and with fewer scars.

Adult↗
PubMed2001

Invasive streptococcal infection of the periorbita and forehead.

Recent epidemiological reports suggest an increased frequency of invasive streptococcal infections linked to the appearance of a dominant group A Streptococcus serotype. Necrotizing streptococcal infections involving the skin and soft tissues of the face are uncommon. This case demonstrates the aggressive and invasive nature of these infections. The patient presented with symptoms of angioedema and was treated with corticosteroids. Her condition worsened and plastic surgery was consulted. There was extensive necrosis of the periorbital and forehead soft tissue, requiring extensive debridement to control the invasive process. Multiple reconstructive procedures were performed to close the defects and to preserve function of the facial muscles and eyelids. The literature indicates less than 50 reported cases of necrotizing streptococcal infections limited to the periorbita. This case reflects the importance of rapid diagnosis, and emphasizes the need for prompt and appropriate surgical treatment.

Debridement↗
PubMed1997

Endoscopic approach for benign tumor ablation of the forehead and brow.

Resection of benign tumors of the forehead and brow raises aesthetic concerns. An endoscopic subperiosteal approach to benign bony and soft-tissue tumors in the supraorbital and frontotemporal regions permits extirpation of these masses without producing visible facial scars. Therefore, this technique was used for tumor resection in 4 patients. This procedure demonstrated magnified visualization of the masses, and safe access for excisional biopsy and bony contouring. In addition to more acceptable surgical scars, patients experienced no significant postoperative morbidity and a reduced incidence of swelling, discomfort, and scalp anesthesia. Therefore, we conclude that the endoscopic subperiosteal approach is a favorable alternative for resection of suitable tumors.

Adult↗
PubMed1999

Unilateral coronal synostosis treated by internal forehead distraction.

A 1-year-old infant with left hemicoronal synostosis was treated by distraction osteogenesis of the craniofacial skeleton using an internal distraction device. Surgery was performed through a coronal incision. The frontal bone and upper half of both orbits were first osteotomized en bloc after minimal epidural dissection of the supraorbital area and no epidural dissection around the coronal osteotomy site. The lateral one fourth of the frontal bone, including the right lateral half of the orbit, was left intact. The internal distraction device was fixed in the left temporal area. A 0.5-mm per day rate of distraction was performed up to an elongation of 17 mm after a 5-day latency period. The distraction device was removed after a consolidation period of 2 months. The results obtained were satisfactory, with symmetry of the forehead, orbit, and nose achieved without complications. The merits of this procedure are no extradural dead space after the operation (which prevents infection), shortened operative time, reduced blood loss, filling in the bone gap created by advancement with new bone, acceptable cosmesis by the parents during distraction, and no fixation device left after the second operation.

Craniosynostoses↗
PubMed2006

Gradual distraction fronto-orbital advancement with 'floating forehead' for patients with syndromic craniosynostosis.

Eleven patients with syndromic craniosynostosis were treated with gradual distraction fronto-orbital advancement using "floating forehead." The frontal and supraorbital area was cut and remolded. Bony orbits were widened in three patients. Frontal bone was let floating on the dura and fixed loosely with absorbable threads to remolded supraorbital bone. A pair of distracters with hinge plates (A.V.D. system, Bear Medic Corp, Tokyo, Japan) was fixed between the temporal area and supraorbital bone. Distraction was begun 5 to 7 days after the surgery, and 1.8 to 3.2 cm advancement was obtained. Distracters were taken off after 3 to 7 weeks of consolidation periods. Although no major complication was encountered, some minor complications related to the devices were experienced.

Absorbable Implants↗
PubMed1978

Bitemporal flap reconstruction of forehead.

The bitemporal flap meets the increasing demand for esthetic reconstruction of forehead defects. The surgical technique, applied anatomy, and plastic surgery principles are reviewed. Illustrative case histories review the application of the bitemporal flap reconstruction technique.

Adult↗
PubMed1978

Serial flap advancement in an avulsion defect of the forehead.

Staged revision of a forehead defect consisting of a wide fibrotic skin grafted mass in a young man is reported. Serial temporal flap advancement resulted in considerable cosmetic improvement. Closing of such wounds with some tension on the advancing edges is recommended.

Adult↗
PubMed1983

Fishhooks for forehead harnessing.

Coronal lifting can be simplified and dissection enhanced with a system of hooks attached to elastic bands harnessing the forehead and providing steady and symmetrical retraction.

Forehead↗
PubMed1986

Obliteration of decompressed frontal sinus by means of a deepithelialized island forehead flap.

A new surgical procedure for the treatment of chronic unilateral suppurative frontal sinusitis was described. A vascularized composite tissue--forehead island flap--was used for obliteration of the decompressed left frontal sinus. In the author's opinion (in selected cases) it is more physiologically sound than the use of abdominal fat or bone graft as an alternative for obliteration. It will withstand the test of time, since myocutaneous flaps have been used reliably as vascularized tissues for anatomic regions troubled by infection and radiation.

Aged↗
PubMed1986

Unsatisfactory forehead scar following face lift.

The W-plasty scar revision technique has been found to be effective in the repair of the difficult and cosmetically unsatisfactory hairline scar following the ill-advised face lift technique that excises forehead skin.

Cicatrix↗
PubMed1987

Feminization of the forehead: contour changing to improve female aesthetics.

Anthropologists have identified those characteristics which enable them to differentiate the male from the female skull. Some women have masculine skeletal characteristics which, if changed, would improve their facial appearance. Changing the skeletal configuration through bony contouring of the craniofacial skeleton for aesthetic purposes is a natural spinoff of craniomaxillofacial surgery. Techniques for sculpturing the masculine characteristics present in the foreheads of some females are discussed. The deformity has been divided into three subdivisions. Group 1 patients can be treated through bony contouring alone; group 2 patients require bony contouring in conjunction with a methyl methacrylate cranioplasty; and group 3 are those patients with a more severe deformity requiring osteotomies. The technique, results, complications, and patient acceptance are discussed.

Esthetics↗
PubMed1989

The subcutaneous forehead lift.

A limited experience (27 patients, all female) is presented utilizing the subcutaneous approach to forehead lifting. This approach has been little utilized and has been condemned in the literature for being dangerous. However, no difficulties in wound healing or alopecia have been encountered, and the procedure has the advantages of more effectively removing the vertical and transverse wrinkles in the glabellar region, raising the brows, and preserving sensation to the scalp posterior to the incision.

Aged↗
PubMed1996

Endoscopic forehead lift: an operative technique.

On the basis of over 100 endoscopic forehead lifts, we present an in-depth view of the current operative technique. The critical components are the following: (1) a subgaleal resection of muscle insertions rather than a subperiosteal approach to muscle origins, (2) a complete periosteal release along the lateral orbital rim, (3) a vertical suspension utilizing screws and staples that are removed at 1 week, and (4) a lateral temporal expansion using absorbable sutures. With this technique, a more controlled eyebrow position and eyebrow shape can be achieved.

Adult↗
PubMed1997

Fibrin glue fixation in forehead endoscopy: evaluation of our experience with 206 cases.

The endoscopic approach has totally replaced the bicoronal approach for the treatment of forehead aging in our practice since November of 1993. The fixation in proper position is obtained with fibrin glue. Results of a series of 206 procedures performed in 196 patients are presented. Eyebrow positioning and muscle weakening were rated on a scale of 1 to 4. The evaluation has been made at a minimal follow-up time of 6 months. The comparison of the results between the first series of 28 patients during the first 6 months of our experience and the second series of 69 patients during the following period showed a significant increase in the number of excellent results (from 47 to 78 percent). Altogether, the satisfactory results (rated excellent or good) increased from 71 to 86 percent. Fibrin glue provides a stable fixation with the possibility of displacement in several directions, including transversal expansion. Complications have been minimal. Secondary procedures and association with other facial operations have been analyzed.

Aged↗
PubMed2000

A simple method for forehead unit reconstruction.

The supratrochlear and supraorbital vessel-based island flap was used to avoid excessive scarring during reconstruction of the unilateral forehead defects after surgical excision of a malignant tumor. This method had a number of advantages: operation time was short, it was a one-stage procedure, the technique was relatively simple, a good match of the texture and color could be achieved, and scars were inconspicuous.

Aged↗
PubMed1982

Eight year persistence of individual differences in the bacterial flora of the forehead.

Eight subjects having a rich (greater than or equal to 100,000 per cm2) population of Propionibacterium acnes on the forehead and 7 with a sparse population (great than or equal to 15,000 per cm2) in earlier tests were reexamined after median interval of 8 yr. All of those with an initial rich population had greater than or equal to 100,000 per cm2 on retest. Of the 7 with an initial sparse population, 4 again had fewer than 15,000, one had more than 100,000 per cm2 and 2 were intermediate. Three subjects harbored Peptococcus saccharolyticus in the initial test (26,000 to 75,000 per cm2) and all 3 carried this organism on the later test (5,000 to 49,000 per cm2). Of the 12 without P. saccharolyticus initially, 11 were again negative and one had a small number (200 per cm 2). We conclude that the presence or absence of P. saccharolyticus and the relative population density of P. acnes were individual characteristics that persisted in most subjects for at least 8 yr.

Adult↗
PubMed2006

Repair of a glabellar and inferior forehead defect.

This 44-year-old healthy white male was referred to our office for the treatment of a recurrent basal cell carcinoma clinically involving the left inferior forehead extending down to the left glabellar region of the face. The preoperative size of the tumor was 1.5 x 1.5 cm (Figure 1). The lesion had been present since 1998 and had undergone previous liquid nitrogen treatment and, subsequently, excisional surgery. The patient had no significant medical history, and the only medication he had been taking was ibuprofen as needed. The patient did not smoke, nor did he have a history of diabetes. After discussing the various treatment options with the patient, he opted to undergo Mohs micrographic surgery. After two stages, the tumor was fully removed, and the defect measured 2.0 3 2.3 cm (Figure 2). The postoperative defect extended through the frontalis muscle superiorly and the procerus muscle inferomedially, down to the periosteum. The left corrugator supercilli muscle was spared from removal. How would you manage this wound?

Adult↗