Lateral subcutaneous brow lift and interbrow muscle resection: Clinical experience and anatomic studies

The authors report consistent improvement in 65 patients with lateral brow ptosis by using a lateral subcutaneous brow lift at the temporal hairline. In 48 of these patients, vertical glabellar wrinkles were improved by the d irect excision of procerus, corrugator, and orbicularis muscles through 3-m m medial brow incisions. Anatomic dissections in 10 cadavers and examinatio ns of 50 skulls were used to study the location of the supraorbital and sup ratrochlear nerves. Dissections revealed that the supratrochlear nerve was never closer than 1.6 cm to the midline at the level of the supraorbital ri dge. In no dissection was a supratrochlear foremen noted. Lateral subcutane ous brow lift was consistently successful in elevating the lateral brow. In no patient was nerve damage to the supraorbital nerve noted. In most patie nts, the temporal hairline was improved by excising a triangle of balding s calp. Through 3-mm medial brow incisions, the interbrow musculature can be excised by using a small rongeur in an area 3.2 cm nide without risk of ner ve damage, improving vertical glabellar wrinkles.