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Today, we're going to show you how to do a temporal browlift. This is part of an endoscopic brow lift, but it is just for the outer corner of the brow. As we age, a lot of people notice that the outer corner of the brow will start to drop and that accentuates the lines and wrinkles in the crow's feet. So, what we're going to do is do a small incision behind the hair line, come down underneath the skin, and just lift up that outer corner of the brow. The incision is up behind the hairline, so it's not visible after the surgery, and it really helps to recreate the natural contour of the brow.
And what're we going to do here is just lift outer corner of the brow with a temporal browlift. This is where our incision will be, and what it'll do is just help pull up this outer corner of the brow. That will do. There is a beveled incision here, coming down to the... Called the deep temporalis fascia. So, we'll just spread, so we see the fascia which is this glistening white covering on the muscle. Then, we know we are in the right plane. If we lift up here, we know that we are in the right plane because nothing is moving. We'll take our elevator, start to dissect up. We're going to go all the way down to the orbital rim. We got the rim. The rim is right there, so we want to make sure we're well-released.
Now, when we do an endoscopic brow, we also do the top part and get the central part of that brow, but we are not doing it here. We're just doing the outer corner. So, we just call this the temporal browlift. And you can just sweep with your finger, make sure it's all free. And this is what you want to lift up, this part here. OK, then what we will do is a couple of myotomies, which means to cut through the muscle little bit, freeze it up a little bit more. It also cuts the nerve that comes over to your corrugator which is what produces the fanning. So, it sometimes helps with your fan lines as well. And we'll just check again, make sure that everything is nice and... Sew it up here, so we can get a lift there. Sometimes, people worry they're going to be way over-corrected, just doesn't happen. And they usually sink down little bit, so usually get maybe about four or five millimeters of lift. You will not get a surprise look when you're done.
And what's nice about it is that the incision is back behind the hair, so that you won't see it once it's healed. Just going to take a suture through the fascia. You want to get a fair like good bite, you don't want to be too superficial or it will show. Take at the level of dimpling. The suture will dissolve eventually, so that the dimpling will go away. We usually put in two of these, and so this is a dissolvable stitch. OK, so put in one more of these sutures through the fascia here. It's dry, so you can see the... That's the fascia. I may get in your way here. Take a bite through the deep tissue again. Pull that out. And then, you can see as we pull on this, see how it pulls up on the brow tissue. So, just tie this. Tie this down.
Now, at this point, you definitely have some extra skin. Some people leave it, some people take it off. I think if we take it off, you get a little bit more of the secure left. And you don't want it too tight, or you will get a bald if you get some hair loss on the scar. So, you just do a beveled incision here. Here as well. Let's tick off with a [inaudible 00:06:54], so it grows nicely. We'll just take a look to stop any bleeding. it'll stay for about a week to 10 days. You see it's behind the hair line because you get a nice lift to the brow. But it's a very natural lift. We're doing this under local sedation today, but you can also do it with just [inaudible 00:07:38] local in the office. And now, we'll do that on the other side as well.
And what're we going to do here is just lift outer corner of the brow with a temporal browlift. This is where our incision will be, and what it'll do is just help pull up this outer corner of the brow. That will do. There is a beveled incision here, coming down to the... Called the deep temporalis fascia. So, we'll just spread, so we see the fascia which is this glistening white covering on the muscle. Then, we know we are in the right plane. If we lift up here, we know that we are in the right plane because nothing is moving. We'll take our elevator, start to dissect up. We're going to go all the way down to the orbital rim. We got the rim. The rim is right there, so we want to make sure we're well-released.
Now, when we do an endoscopic brow, we also do the top part and get the central part of that brow, but we are not doing it here. We're just doing the outer corner. So, we just call this the temporal browlift. And you can just sweep with your finger, make sure it's all free. And this is what you want to lift up, this part here. OK, then what we will do is a couple of myotomies, which means to cut through the muscle little bit, freeze it up a little bit more. It also cuts the nerve that comes over to your corrugator which is what produces the fanning. So, it sometimes helps with your fan lines as well. And we'll just check again, make sure that everything is nice and... Sew it up here, so we can get a lift there. Sometimes, people worry they're going to be way over-corrected, just doesn't happen. And they usually sink down little bit, so usually get maybe about four or five millimeters of lift. You will not get a surprise look when you're done.
And what's nice about it is that the incision is back behind the hair, so that you won't see it once it's healed. Just going to take a suture through the fascia. You want to get a fair like good bite, you don't want to be too superficial or it will show. Take at the level of dimpling. The suture will dissolve eventually, so that the dimpling will go away. We usually put in two of these, and so this is a dissolvable stitch. OK, so put in one more of these sutures through the fascia here. It's dry, so you can see the... That's the fascia. I may get in your way here. Take a bite through the deep tissue again. Pull that out. And then, you can see as we pull on this, see how it pulls up on the brow tissue. So, just tie this. Tie this down.
Now, at this point, you definitely have some extra skin. Some people leave it, some people take it off. I think if we take it off, you get a little bit more of the secure left. And you don't want it too tight, or you will get a bald if you get some hair loss on the scar. So, you just do a beveled incision here. Here as well. Let's tick off with a [inaudible 00:06:54], so it grows nicely. We'll just take a look to stop any bleeding. it'll stay for about a week to 10 days. You see it's behind the hair line because you get a nice lift to the brow. But it's a very natural lift. We're doing this under local sedation today, but you can also do it with just [inaudible 00:07:38] local in the office. And now, we'll do that on the other side as well.
Temporal Brow Lift As Part of an Endoscopic Brow Lift
Dr. John Martin performs a temporal brow lift to raise the outer parts of the brow and help diminish the chances the patient has to develop or worsen pre-existing crow's feet wrinkles.
