Seattle Plastic Surgeon gives a little anatomy lesson during a brow lift.
I did an open brow lift yesterday on a lady who had just excellent anatomy.
An open brow lift is done with an incision that is made ear to ear across the scalp about and inch in back of the hair line. The forehead is then separated from the frontal bone of the skull down to the top of the eye sockets. (It’s not nearly as gruesome as it sounds.) There are several important structures in harm’s way so great care must be taken with the dissection. The rule of surgery is identify it before you cut it (or in this case, don’t cut it) which I think is pretty good advice for everyday living, don’t you?
This lady’s anatomy was right out of a text book. Her supraorbital nerves that give sensation to the forehead and anterior scalp exited two little holes through the frontal bone just about the rim of her eye socket. And the little muscles that allow us to scowl (the corregators) were exactly where they should have been. I made sure that everyone in the operating room got a good look at this anatomy not just because I find it fascinating no matter how many times I see it, but because it is clinically important.
For example, the entire forehead can be anesthetized with local anesthetic injections into the supraorbital nerves. This is commonly done for excision of skin cancers on the forehead. And another example is the corregator muscles. These are the muscles that are injected with Botox to relax the area and eliminate the scowl. They are very deep which is why the Botox injection in this area needs to go almost to the frontal bone.
Anyway, it’s a great day in the operating room when the anatomy is so clear. And, yes, I am easily amused but believe me, the ability to be easily amused is a gift.
Thanks for reading! Dr. Lisa Lynn Sowder