The Experts below are selected from a list of 168 Experts worldwide ranked by ideXlab platform
Barry M Jones - One of the best experts on this subject based on the ideXlab platform.
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the impact of Endoscopic Brow Lift on eyeBrow morphology aesthetics and longevity objective and subjective measurements over a 5 year period
Plastic and Reconstructive Surgery, 2013Co-Authors: Barry M JonesAbstract:BACKGROUND The longevity of a Brow Lift, its morphology, and its contribution to overall facial aesthetics have not been addressed in previous studies using both objective measurements and validated subjective aesthetic scoring systems. METHODS Thirty-one patients with a 5.4-year follow-up after subperiosteal Endoscopic Brow Lift were assessed by (1) objective measurements using computer software, (2) validated regional aesthetic scoring systems, and (3) global aesthetic scoring systems. RESULTS In part 1, objective measurements confirm a subtle elevation of the Brows at less than 5 mm (p<0.001) that persisted at 5.4 years after surgery in all areas except the tail of the eyeBrow. In part 2, subjective regional aesthetic scoring indicated that the dimensional change is small but apparent to observers, and is maintained at 5.4 years; that depressor muscle resection with a Brow Lift provides a statistically significant reduction in glabellar lines, which is maintained at 5.4 years; and that a Brow Lift provides temporary improvement in forehead lines but that this improvement relapses to baseline at 5.4 years. In part 3, global aesthetic scores suggest that 64 percent patients are still judged as appearing better 5.4 years after a Brow Lift than before surgery. CONCLUSIONS This is the first study to provide evidence from both objective measurements and validated subjective aesthetic scoring systems regarding the morphology, benefits, and longevity of Endoscopic Brow-Lift surgery. This demonstrates that a Brow Lift produces a subtle elevation, with a natural eyeBrow morphology close to the original, and with minimal long-term relapse except at the tail of the eyeBrow. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
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Endoscopic Brow Lift a personal review of 538 patients and comparison of fixation techniques
Plastic and Reconstructive Surgery, 2004Co-Authors: Barry M Jones, Rajiv GroverAbstract:Since the introduction of Endoscopic Brow Lifting in the mid-1990s, it has become widely accepted as a method for rejuvenation of the upper third of the face. Despite the multitude of Brow fixation techniques, there are few long-term studies providing accurate analysis of outcome. The aims of this investigation were to evaluate the long-term objective results of Endoscopic Brow Lifting and to establish whether the technique of fixation altered the longevity of aesthetic outcome. The outcome of Endoscopic Brow Lifts carried out on 538 consecutive patients over a 6-year period was assessed. For each patient, midpupil-to-Brow distance was measured preoperatively and at intervals postoperatively. Two different fixation methods were compared: fibrin glue (n = 189, group 1; 104 records available) and polydioxanone sutures tied through bone tunnels (n = 349, group 2; 220 records available). In 214 patients, an upper lid blepharoplasty was performed simultaneously (85 in group 1 and 129 in group 2). At 1 month postoperatively, each fixation technique had produced a significant change in mean pupil to Brow height (5.93 mm in group 1 and 6.21 mm in group 2, with no significant difference between the two methods; p = 0.17). However, when measurements were compared more than 3 months postoperatively (mean, 9.4 months), there was a significant difference, with some relapse in the patients treated with fibrin glue (p 0.3 in group 1, p > 0.4 in group 2). Complications were few in both groups. In group 1, there was one infection, two instances of significant alopecia (both temporary), and one reoperation for relapse. In group 2, four patients required minor surgical revision of a lateral port scar and three minor areas of temporal alopecia, which recovered in less than 3 months. One patient had a paresis of the frontal branch that had recovered after 4 months. The Endoscopic Brow Lift is therefore a safe and effective technique for increasing mean pupil to Brow height. Fixation with polydioxanone sutures tied through bone tunnels produces a significantly more stable result than fibrin glue, without greater risk. This lends weight to experimental evidence that periosteal fixation must be maintained for at least 6 weeks to be secure.
Henry M. Spinelli - One of the best experts on this subject based on the ideXlab platform.
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Limited incision nonEndoscopic Brow Lift.
Plastic and reconstructive surgery, 2007Co-Authors: Nassim Tabatabai, Henry M. SpinelliAbstract:BACKGROUND: The authors compared the nonEndoscopic Brow Lift technique to the popular Endoscopic procedure to determine whether it offers a less complex and less expensive but equally effective alternative. METHODS: A retrospective comparison of the senior author's experience with the Endoscopic Brow Lift (100 patients; years 1999 to 2004) and the nonEndoscopic Brow Lift (93 patients; years 2002 to 2005) was conducted. Using a three-incision approach for both procedures (one midline and two temporal), Endoscopic visualization was used to assist in the last 2 cm of subperiosteal dissection over the superior orbital rim only in the Endoscopic technique. In the nonEndoscopic technique, this final dissection was performed without the endoscope, and the expected path of the supraorbital and supratrochlear neurovascular bundles through preoperative marking of their meridians was respected. Effective Brow elevation, operative times, size of incisions, complications, and overall patient satisfaction were compared between groups. RESULTS: The authors found no significant difference in average Brow elevation between the two Brow Lift groups (4 mm). However, the nonEndoscopic Brow Lift was completed, on average, 20 minutes faster than the Endoscopic Brow Lift (30 minutes versus 50 minutes) and required a smaller incision than the Endoscopic Brow Lift (2 cm versus 2.5 cm). No nonEndoscopic patient experienced permanent complications, but one Endoscopic patient developed permanent paresthesias of the forehead secondary to supraorbital/supratrochlear nerve injury. Overall patient satisfaction was equivalent in both groups. CONCLUSIONS: The limited incision nonEndoscopic Brow Lift is a safe and effective alternative to the Endoscopic technique. With thorough anatomical knowledge of this region, it offers equivalent Brow elevation, shorter operative times, smaller incisions, similarly low complications rates, and patient satisfaction and eliminates the need for costly and cumbersome Endoscopic equipment.
Paul E Chasan - One of the best experts on this subject based on the ideXlab platform.
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the k wire fixation technique for Endoscopic Brow Lift a long term follow up
Aesthetic Surgery Journal, 2020Co-Authors: Paul E Chasan, Adam HauchAbstract:BACKGROUND Many techniques have been presented for fixation during Endoscopic Brow Lift, but no singular technique has become dominant. OBJECTIVES The authors described a technique for fixation for Endoscopic Brow Lift that is inexpensive, easy to use, and versatile and has minimal morbidity. METHODS The charts of 284 patients who underwent the K-wire fixation technique between December 1996 and September 2018 were reviewed. This technique employs a transcutaneous K-wire to hold the Brow in position until tissue adhesion creates a lasting elevation of the Brow. RESULTS A total of 284 patients underwent K-wire fixation for Endoscopic Brow Lifting. Two patients had hematomas and 5 patients (1.8%) required a second unilateral Brow Lift procedure. Long-term elevation of the Brow was maintained in all patients. CONCLUSIONS K-wire fixation for Endoscopic Brow Lift is a simple, safe, and effective technique for fixation during Endoscopic Brow Lifting that provides long-term aesthetic results. LEVEL OF EVIDENCE: 4
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how i modified the k wire fixation technique for Endoscopic Brow Lift
Aesthetic Surgery Journal, 1999Co-Authors: Paul E ChasanAbstract:“Second Thoughts” focuses on ways in which aesthetic surgeons have modified or even dramatically changed their techniques over time to achieve optimal results. Contributors are Aesthetic Society members and other recognized experts.
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direct k wire fixation technique during Endoscopic Brow Lift
Aesthetic Plastic Surgery, 1998Co-Authors: Paul E Chasan, David M KupferAbstract:Endoscopic Brow Lift has now become a well-established procedure for restoring a youthful Brow. Multiple techniques have been described for fixation of the scalp; however, these methods do not allow for direct positioning of the Brow. A simple method is described that establishes precise and direct Brow fixation using K-wires. Twelve female patients underwent direct fixation of the Brow with one or more K-wires to the supraorbital rim. No complications occurred as a result of this technique. Direct Brow fixation with K-wires appears to be a simple effective technique for precise restoration of Brow position.
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Endoscopic Brow Lift for visual field correction and aesthetic improvement in the elderly bald male
Aesthetic Surgery Journal, 1996Co-Authors: Paul E Chasan, Renato SaltzAbstract:We have performed Endoscopic Brow Lift in 25 men (63 to 77 years old). Sixteen had male pattern baldness, ranging from class IV to VII of the Norwood classification, and 14 had associated eyelid ptosis. Elderly male patients with male pattern baldness require special consideration in terms of Brow fixation and placement of incisions. The techniques used are described and the results reviewed. The effects of these procedures on visual field deficits are discussed.
Thomas L Roberts - One of the best experts on this subject based on the ideXlab platform.
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in pursuit of optimal periorbital rejuvenation laser resurfacing with or without blepharoplasty and Brow Lift
Aesthetic Surgery Journal, 1998Co-Authors: Thomas L Roberts, Karen M YokooAbstract:Abstract Learning Objectives: The reader is presumed to have a broad understanding of plastic surgical procedures and concepts. After studying this article, the participant should be able to: 1. Recognize the 11 major signs of periorbital aging. 2. Realize the benefits of laser techniques applied to periorbital rejuvenation surgery. Physicians may earn 1 hour of Category 1 CME credit by successfully completing the examination based on material covered in this article. The examination begins on page 333. Although blepharoplasty and coronal foreheadplasty have been the traditional methods for improving the periorbital region, in our opinion these techniques together can address only three of the 11 major signs of periorbital aging. We found no improvement with skin-muscle flap type blepharoplasty and coronal Lift in the wrinkling and pigmentation changes in the infraBrow, crow’s-foot, lower lid, and malar regions, and no improvement in malar bags, “dark circles” under the eyes, or the apparent lengthening of the vertical height of the lower lid and its associated sharp transition between cheek and lid skin. CO2 laser resurfacing can improve these signs of periorbital aging and permits the laser transconjunctival approach if blepharoplasty is necessary, thus eliminating a visible lower lid incision. When Brow ptosis is present, we prefer Endoscopic Brow Lift to minimize dysesthesia and incision size. We evaluated 174 patients and contrasted the results of the traditional approach versus laser resurfacing with or without laser blepharoplasty and Endoscopic Brow Lift. The mean time to evaluation was 9 months, ranging up to 2 ½ years. We found that the laser approach can address almost all of the 11 major signs of periorbital aging at one procedure. It is minimally invasive, technically simple and fast, offers lasting improvements, and yields high patient satisfaction and better results with fewer persistent problems than the traditional surgical approach.
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in pursuit of optimal rejuvenation of the forehead Endoscopic Brow Lift with simultaneous carbon dioxide laser resurfacing
Plastic and Reconstructive Surgery, 1998Co-Authors: Thomas L Roberts, Laura B EllisAbstract:Coronal foreheadplasty has long been the traditional method of improving the aesthetic appearance of the forehead, permitting not only repositioning of ptotic tissues but also direct access for modification of the frown muscles. However, it was only moderately successful in eliminating vertical corrugator lines or deeply etched transverse wrinkles. The recent advent of the Endoscopic Brow Lift has permitted us to minimize the dysesthesias associated with the coronal approach by making the incisions shorter and radially oriented and by being more precise in the muscle resection. Nonetheless, Endoscopic Brow Lift gives no further improvement in persistent deep vertical and transverse wrinkles. Carbon dioxide laser resurfacing can improve the existing wrinkles but does not eliminate the muscular cause of forehead wrinkles. It seemed reasonable that combining these techniques might yield better results than either procedure alone. To evaluate this possibility, 30 patients with simultaneous Endoscopic Brow Lift and carbon dioxide resurfacing were compared with 24 patients having laser resurfacing only and with 26 patients who had traditional coronal foreheadplasty. Both foreheadplasty groups had corrugator resection. All patients were evaluated at least 4 to 6 months postoperatively. Ratings were based on the percent of wrinkles removed, both vertical and transverse. The ratings were performed with predetermined criteria by a surgeon not involved with the operative procedures nor after care. A rating of excellent (≥95 percent reduction in wrinkles) was obtained in 50 percent of coronal foreheadplasties; 41.7 percent of carbon dioxide resurfacing alone and 80 percent of endoBrow Lifts with carbon dioxide laser resurfacing. There was no vascular compromise front this latter combination of procedures, no hypertrophic scars, and no impairment of healing. We conclude that Endoscopic Brow Lift with carbon dioxide laser resurfacing is a safe and perhaps more effective means of aesthetic rejuvenation of the forehead.
Laura B Ellis - One of the best experts on this subject based on the ideXlab platform.
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in pursuit of optimal rejuvenation of the forehead Endoscopic Brow Lift with simultaneous carbon dioxide laser resurfacing
Plastic and Reconstructive Surgery, 1998Co-Authors: Thomas L Roberts, Laura B EllisAbstract:Coronal foreheadplasty has long been the traditional method of improving the aesthetic appearance of the forehead, permitting not only repositioning of ptotic tissues but also direct access for modification of the frown muscles. However, it was only moderately successful in eliminating vertical corrugator lines or deeply etched transverse wrinkles. The recent advent of the Endoscopic Brow Lift has permitted us to minimize the dysesthesias associated with the coronal approach by making the incisions shorter and radially oriented and by being more precise in the muscle resection. Nonetheless, Endoscopic Brow Lift gives no further improvement in persistent deep vertical and transverse wrinkles. Carbon dioxide laser resurfacing can improve the existing wrinkles but does not eliminate the muscular cause of forehead wrinkles. It seemed reasonable that combining these techniques might yield better results than either procedure alone. To evaluate this possibility, 30 patients with simultaneous Endoscopic Brow Lift and carbon dioxide resurfacing were compared with 24 patients having laser resurfacing only and with 26 patients who had traditional coronal foreheadplasty. Both foreheadplasty groups had corrugator resection. All patients were evaluated at least 4 to 6 months postoperatively. Ratings were based on the percent of wrinkles removed, both vertical and transverse. The ratings were performed with predetermined criteria by a surgeon not involved with the operative procedures nor after care. A rating of excellent (≥95 percent reduction in wrinkles) was obtained in 50 percent of coronal foreheadplasties; 41.7 percent of carbon dioxide resurfacing alone and 80 percent of endoBrow Lifts with carbon dioxide laser resurfacing. There was no vascular compromise front this latter combination of procedures, no hypertrophic scars, and no impairment of healing. We conclude that Endoscopic Brow Lift with carbon dioxide laser resurfacing is a safe and perhaps more effective means of aesthetic rejuvenation of the forehead.