Advertisement

Gliding Brow Lift (GBL): A New Concept

  • Fausto ViterboEmail author
  • André Auersvald
  • T. Gerald O’Daniel
Innovative Techniques Facial Surgery
  • 39 Downloads

Abstract

Background

Creating the ideal aesthetic eyebrow shape and position is an important goal in facial rejuvenation. One challenge of an eyebrow lift is to find a predictable procedure that balances the advantages and disadvantages of the available strategies. The gliding brow lifting (GBL) is a technique that provides minimal incisions, an effective and stable eyebrow lift, and offers the advantage of precise reshaping of the eyebrow.

Methods

In a retrospective review, 124 patients, who underwent GBL technique from November 2015 through April 2016, were evaluated. With minimal incisions and tumescent infiltration, the subcutaneous plane of the forehead, eyebrows and temporal face is undermined releasing the skin from the underlying frontalis muscle, orbicularis oculi muscle, corrugator muscle and temporal parietal fascia. Fixation of the repositioned and reshaped eyebrow is achieved with the use of a hemostatic net for temporary cutaneous fixation.

Results

The average follow-up period was 17 months. Adequate brow repositioning and/or reshaping was achieved in 118 patients. Six patients had bilateral or unilateral recurrence of ptosis. Of these patients with recurrence, four patients had the same procedure re-performed within 1 month postoperatively with successful repositioning and/or reshaping of their brow. There was no incidence of hematoma, seroma, infection, permanent sensory changes, motor dysfunction, skin flap necrosis or alopecia.

Conclusion

The “gliding brow lifting” (GBL), which combines subcutaneous frontal undermining with minimal incisions, elevation and reshaping of eyebrow and use of a temporary cutaneous fixation with hemostatic net (Net), allows effective, long-lasting results with low rates of complications and satisfactory results.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Keywords

Frontal rejuvenation Brow lifting Hemostatic net Video endoscopy Skin undermining Hemostatic net 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that Dr. Fausto Viterbo receives royalties from Faga Medical, the company that produces the dissectors used to perform this technique. The other authors, Dr. André Auersvald and Dr. T. Gerald O’Daniel have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of Fausto Viterbo Plastic Surgery Clinic and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

Supplementary material 1 (MP4 86618 kb)

Supplementary material 2 (MP4 90380 kb)

References

  1. 1.
    Friedman O (2005) Changes associated with the aging face. Facial Plast Surg Clin N Am 13:371–380CrossRefGoogle Scholar
  2. 2.
    De La Plaza R, Valiente E, Arroyo JM (1991) Supraperiosteal lifting of the upper two-thirds of the face. Br J Plast Surg 44(5):325–332CrossRefGoogle Scholar
  3. 3.
    Knize DM (1998) Reassessment of the coronal incision and subgaleal dissection for foreheadplasty. Plast Reconstr Surg 102(2):478–489CrossRefGoogle Scholar
  4. 4.
    Tessier P (1989) Subperiosteal face-lift. Ann Chir Plast Esthet 34(3):193–197Google Scholar
  5. 5.
    Psillakis JM, Rumley TO, Camargos A (1988) Subperiosteal approach as an improved concept for correction of the aging face. Plast Reconstr Surg 82(3):383–394CrossRefGoogle Scholar
  6. 6.
    Wojtanowski MH (1993) Subcutaneous forehead lift: a technical alternative for upper facial rejuvenation. Can J Plast Surg 1(3):116–122CrossRefGoogle Scholar
  7. 7.
    Elkwood A, Matarasso A, Rankin M, Elkowitz M, Godek CP (2001) National plastic surgery survey: brow lifting techniques and complications. Plast Reconstr Surg 108(7):2143–2152CrossRefGoogle Scholar
  8. 8.
    Byun S, Mukovozov I, Farrokhyar F, Thoma A (2013) Complications of browlift techniques: a systematic review. Aesthet Surg J 33(2):189–200CrossRefGoogle Scholar
  9. 9.
    Castañares S (1964) Forehead wrinkles, glabellar frown and ptosis of the eyebrows. Plast Reconstr Surg 34:406–413CrossRefGoogle Scholar
  10. 10.
    Vinas JC, Caviglia C, Cortinas JL (1976) Forehead rhytidoplasty and brow lifting. Plast Reconstr Surg 57(4):445–454CrossRefGoogle Scholar
  11. 11.
    Matarasso A, Terino EO (1994) Forehead-brow rhytidoplasty: reassessing the goals. Plast Reconstr Surg. 93(7):1378–1389 (discussion 1390-1) CrossRefGoogle Scholar
  12. 12.
    Vasconez LO, Core GB, Gamboa-Bobadilla M, Guzman G, Askren C, Yamamoto Y (1994) Endoscopic techniques in coronal brow lifting. Plast Reconstr Surg 94(6):788–793CrossRefGoogle Scholar
  13. 13.
    Ramirez OM (1994) Endoscopic full facelift. Aesthet Plast Surg 18(4):363–371CrossRefGoogle Scholar
  14. 14.
    Isse NG (1994) Endoscopic facial rejuvenation: endoforehead, the functional lift. Case reports. Aesthet Plast Surg 18(1):21–29CrossRefGoogle Scholar
  15. 15.
    Chiu ES, Baker DC (2003) Endoscopic brow lift: a retrospective review of 628 consecutive cases over 5 years. Plast Reconstr Surg 112(2):628–633CrossRefGoogle Scholar
  16. 16.
    Graziosi AC, Beer SMC (1998) Browlifting with thread: the technique without undermining using minimum incisions. Aesthet Plast Surg 22(2):120–125CrossRefGoogle Scholar
  17. 17.
    Erol OO, Sozer O, Velidedeoglu HV (2002) Brow suspension: a minimally invasive technique in facial rejuvenation. Plast Reconstr Surg 109:2521CrossRefGoogle Scholar
  18. 18.
    Abraham RF, DeFatta RJ, Williams EF III (2009) Thread-lift for facial rejuvenation: assessment of long-term results. Arch Facial Plast Surg 11(3):178–183CrossRefGoogle Scholar
  19. 19.
    Paul MD (1996) Subperiosteal transblepharoplasty forehead lift. Aesthet Plast Surg 20(2):129–134CrossRefGoogle Scholar
  20. 20.
    Niechajev I (1996) Transpalpebral browpexy. Plast Reconstr Surg 113(7):2172–2180CrossRefGoogle Scholar
  21. 21.
    Cohen BD, Reiffel AJ, Spinelli HM (2011) Browpexy through the upper lid (BUL): a new technique of lifting the brow with a standard blepharoplasty incision. Aesthet Surg J 31(2):163–169CrossRefGoogle Scholar
  22. 22.
    Viterbo F, Auersvald A (2017) Gliding brow lifting (GBL). Plast Reconstr Surg Glob Open 5(9):186–187CrossRefGoogle Scholar
  23. 23.
    Guyuron B, Davies B (1988) Subcutaneous anterior hairline forehead rhytidectomy. Aesthet Plast Surg 12(2):77–83CrossRefGoogle Scholar
  24. 24.
    Powell B, Younes A, Friedman O (2011) Evaluation of the midforehead brow-lift operation. Arch Facial Plast Surg 13(5):337–342CrossRefGoogle Scholar
  25. 25.
    Abramo AC (1995) Forehead rhytidoplasty: endoscopic approach. Aesthet Plast Surg 19(5):463–467CrossRefGoogle Scholar
  26. 26.
    Pontes R (2011) Universo da ritidoplastia. Ed. Revinter, Rio de JaneiroGoogle Scholar
  27. 27.
    Auersvald A, Auersvald LA, Biondo-Simões MLP (2012) Hemostatic net: an alternative for the prevention of hematoma in rhytidoplasty. Rev Bras Cir Plast 27:22–30CrossRefGoogle Scholar
  28. 28.
    Auersvald A, Auersvald LA (2014) Hemostatic net in rhytidoplasty: an efficient and safe method for preventing hematoma in 405 consecutive patients. Aesthet Plast Surg 38(1):1–9CrossRefGoogle Scholar
  29. 29.
    Luz DF, Wolfenson M, Figueiredo J, Didier JC (2005) Full-face undermining using progressive dilators. Aesthet Plast Surg 29(2):95–99CrossRefGoogle Scholar
  30. 30.
    Berkowitz RL, Jacobs DI, Gorman PJ (2005) Brow fixation with the endotine forehead device in endoscopic brow lift. Plast Reconstr Surg 116(6):1761–1767CrossRefGoogle Scholar
  31. 31.
    Graham DW, Heller J, Kurkjian TJ, Schaub TS, Rohrich RJ (2011) Brow lift in facial rejuvenation: a systematic literature review of open versus endoscopic techniques. Plast Reconstr Surg 128(4):335e–341eCrossRefGoogle Scholar
  32. 32.
    Kim JC, Crawford Downs J, Azuola ME, Devon Graham H III (2004) Time scale for periosteal readhesion after brow lift. Laryngoscope 114(1):50–55CrossRefGoogle Scholar
  33. 33.
    Brodner DC, Downs JC, Graham HD III (2002) Periosteal readhesion after brow-lift in New Zealand white rabbits. Arch Facial Plast Surg 4(4):248–251CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2019

Authors and Affiliations

  1. 1.Plastic Surgery DivisionSão Paulo State University Júlio de Mesquita Filho, UNESPBotucatuBrazil
  2. 2.Brazilian Society for Plastic SurgeryCuritibaBrazil
  3. 3.Department of Plastic SurgeryUniversity of LouisvilleLouisvilleUSA

Personalised recommendations