Connell B F, Lambros V S, Neurohr G H
Aesthetic Plast Surg. 1989 Fall;13(4):217-37. doi: 10.1007/BF01570355.
This discussion of forehead lifting, based on modifications of Vinas, Caviglia, and Cortinas, shares the authors' methods of patient evaluation, diagnostic details, architectural planning, and surgical concepts for forehead rhytidectomy along with correction of malpositioned and ptosis of the eyebrows and also glabellar frown problems. In addition, the nasal deformities associated with the sagging of the skin and subcutaneous tissue onto the upper fourth of the nose may make the nose look too short for a pleasing balance of the face and the upper fourth may appear disagreeably wide. A contribution to this excessive width is made by a sometimes thick and wide procerus muscle along with bilateral thick depressor supercilii muscles. When this nasal deformity is corrected, glabellar frown problems are also corrected. Attention to the details of the above-mentioned factors results in very long-lasting, sometimes permanent, and almost complication-free results that please the surgeon and the patient. Complications such as adherence of the dermis to the underlying pericranium, lack of motion in a portion of or the entire forehead, hyperactivity around areas of immobility, muscle irregularities, and also surgically produced depressions which require grafting, skin sloughing, permanent nerve injury, persistent sensory nerve loss, and short-term improvement have been avoided by paying attention to diagnosis, surgical planning, and technique, and postoperative care. Most patients can return to work in four or five days with minimal discoloration and swelling if they have not had aspirin or vitamin E one month before surgery, and there is hemostasis and the use of drains when indicated. Minimizing detection of the surgical incisions is accomplished by detailed preoperative planning of their location, architectural design development and drawing at the time of surgery, special surgical techniques, and excision of the skin or scalp. For patients with male pattern baldness use of specially designed V-Y advancement flaps with the browlift procedure improve the appearance of the hair's thickness and distribution.
本关于额部提升术的讨论基于维纳斯、卡维利亚和科尔蒂纳斯的术式改良，分享了作者在患者评估、诊断细节、结构规划以及额部除皱术的手术理念等方面的方法，同时还涉及眉位不正和上睑下垂的矫正以及眉间皱纹问题。此外，皮肤和皮下组织下垂至鼻上四分之一处相关的鼻畸形，可能会使鼻子看起来过短，无法与面部形成令人满意的比例平衡，且鼻上四分之一处可能显得过宽。有时增厚且宽阔的降眉间肌以及双侧增厚的皱眉肌也会导致这种宽度增加。矫正这种鼻畸形时，眉间皱纹问题也会得到改善。关注上述因素的细节会带来非常持久、有时甚至是永久性的且几乎无并发症的效果，这让外科医生和患者都很满意。通过关注诊断、手术规划、技术以及术后护理，避免了诸如真皮与下方颅骨膜粘连、部分或整个额部活动受限、活动受限区域周围活动过度、肌肉不规则，以及手术造成的需要植皮的凹陷、皮肤脱落、永久性神经损伤、持续性感觉神经丧失和短期改善等并发症。如果患者在手术前一个月未服用阿司匹林或维生素E，且术中实现了止血并在必要时使用了引流管，大多数患者可以在四五天后恢复工作，且仅有轻微的变色和肿胀。通过对手术切口位置进行详细的术前规划、手术时的结构设计开发和绘图、特殊的手术技术以及皮肤或头皮切除，可将手术切口的可见度降至最低。对于男性型秃发患者，在眉提升术中使用专门设计的V - Y推进皮瓣可改善头发的厚度和分布外观。
