Colorado Springs, Colo. From the Division of Plastic Surgery, Department of Surgery, University of Colorado Health Sciences Center.
Plast Reconstr Surg. 2009 Dec;124(6):2118-2126. doi: 10.1097/PRS.0b013e3181bd0726.
Brow lifting became a component of the facialplasty procedure 45 years ago, and the original brow-lifting technique incorporating a coronal incision approach is still practiced by many surgeons today. Over the past 15 years, however, the endoscope-assisted procedure and the limited incision, nonendoscopic techniques have evolved as alternate procedures for brow lifting. The level of artistry in performing any brow lift technique is raised when the surgeon acquires knowledge of upper facial anatomy and integrates that knowledge into a working concept of the aging process of the upper face.
This article presents one surgeon's concepts of the process that culminate in the typical appearance of the aged upper face. The same understanding of upper facial anatomy that can be called upon to explain the steps in this aging process can also be applied to the technical steps of any foreheadplasty procedure. Those anatomic structures that play a role in this process are examined here.
The typical appearance of the aged upper face is the product of muscle action and gravitational forces acting on the unique anatomy of the human face. Interestingly, the appearance of the typical aged upper face exhibits much the same characteristics as one might observe in the face of an individual experiencing the emotions of sadness or grief. It is an inappropriate facial expression of sadness or grief that most often motivates the patient to schedule a consultation with the plastic surgeon.
Any of the brow lift procedures used in current clinical practice can provide a successful cosmetic result in selected patients if the procedure incorporates technical steps based on sound anatomic principles.
提眉术作为面部整形术的一部分已有 45 年的历史，目前许多外科医生仍在采用最初的冠状切口提眉技术。然而，在过去的 15 年中，内窥镜辅助手术和有限切口、非内窥镜技术已作为提眉的替代方法发展起来。当外科医生掌握了面部上区解剖学知识，并将这些知识融入到对面部上区老化过程的工作概念中时，任何提眉技术的艺术性水平都会提高。
本文介绍了一位外科医生对面部上区老化过程的理解，最终形成了典型的老年上面部外观。对面部上区解剖学的相同理解，也可以应用于任何额部整形手术的技术步骤。这里检查了在此过程中起作用的那些解剖结构。
典型的老年上面部外观是肌肉活动和重力作用于人类面部独特解剖结构的产物。有趣的是，典型的老年上面部的外观与人们在观察一个经历悲伤或悲痛情绪的个体的面部时可能观察到的特征非常相似。正是这种不恰当的悲伤或悲痛的面部表情，促使大多数患者预约与整形外科医生进行咨询。
如果手术过程基于合理的解剖学原则，包含技术步骤，那么当前临床实践中使用的任何提眉术都可以为选定的患者提供成功的美容效果。
