Solving the Endoscopic Forehead Conundrum: Go Deep to the Deep Temporal Fascia
Year: 2025
Type: conference-abstract
Study design: Observational Study
Abstract: BACKGROUND: The standard approach to release of the orbital ligament via endoscopic technique is in the areolar plane between the temporoparietal fascia and the deep temporal fascia lateral to the temporal line of fusion. This plane of dissection is anatomically complex and contains the sentinel veins, branches of the frontal nerve and the inferior temporal septum, all of which obstruct access to the orbital ligament. METHODS: A retrospective review was performed of the senior author’s approach to endoscopic forehead lifting. Comparisons of pre- and postoperative photographs were made at 6-8 weeks and >6 months postoperatively to quantitate the effectiveness of this alternative technique. Measurements of the brow height at five standardized points relative to the mid inter-pupillary line were taken. Patient demographics and outcomes were tabulated. RESULTS: Eighteen patients met inclusion criteria with 100% follow-up. The average age was 59 years (43-70). Spacing between the eye and eyebrow demonstrated proportional expansion, with universal measurable increases at both time intervals. There were no instances of frontal nerve weakness or hematoma. Average overall increase in brow height was 2.22 mm at 6-8 weeks postop and 2.64 mm at >6 months postop. All patients were satisfied with their result. CONCLUSION: The plane deep to the deep temporal fascia is a viable alternative to the classic sub-temporoparietal fascial plane. This approach avoids critical anatomic structures, allows unfettered access to the orbital ligament, and provides satisfactory objective and subjective clinical results.
Institution: Tulane University
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,195
OpenAlex ID: W4411064396