Eyebrow revascularization

A 41-year-old man suffered from an incompletely avulsed right eyebrow and forehead after a windshield injury in a traffic accident. Microsurgical techniques were used to revascularize the avulsed tissue of the right eyebrow and forehead with anastomosis of one branch of the frontal branch of the right superficial temporal artery. The revascularized eyebrow and forehead remained viable and provided a good cosmetic result. An aggressive microsurgical approach, either by direct arterial anastomosis or bypass with vein graft, should be encouraged in all incompletely avulsed tissue with inadequate blood supply in the face, hand, and foot.     

Eyebrow Transplantation

BACKGROUND: Reconstruction of the eyebrow has historically been accomplished with temporal scalp pedicle flap formation or free composite scalp grafts. These two techniques may be associated with substantial morbidity and a false, overly dense eyebrow appearance. Hair transplantation of the eyebrows has been described with excellent results, but is relatively underreported in the literature. OBJECTIVE: To determine whether modern techniques of micrograft hair transplantation can suitably re-create an aesthetic eyebrow in a case of iatrogenic eyebrow alopecia. METHODS: A 33-year-old woman with iatrogenic eyebrow alopecia underwent four sessions of eyebrow micrograft hair transplantation to re-create both eyebrows. RESULTS: Suitable aesthetic eyebrows were re-created in a symmetric fashion with proper hair orientation. The process was time consuming and tedious, but highly effective. CONCLUSION: Eyebrow transplantation is a suitable alternative to pedicle flap formation and composite scalp grafting. It is a straightforward procedure that can be performed in the office under local anesthesia with minimal attendant morbidity. The result may be superior to that seen with more involved eyebrow replacement procedures.     

Eyebrow reconstruction following burn injury

Facial burns represent between one-fourth and one-third of all burns. Absence of the eyebrows or distortions in their position alter the character of the face. Thus, eyebrow repair or reconstruction can be an important "finishing touch" in the overall reconstruction of a burned face. Generally, there are three ways to reconstruct the eyebrow: use of superficial temporal artery island flap; composite graft from scalp; and mini or micrografts from scalp. This report presents 20 patients reconstructed with the above techniques. Eleven patients (eight male and three female) with superficial temporal artery island flaps; seven patients (two male and five female) with composite grafts from scalp; and two patients (female) with minigrafts. The results suggest that superficial temporal artery island flaps were more suitable for males and composite graft for females who generally require thinner and less dense eyebrows. Our experience with minigrafts for burn alopecia has not been adequate. Here in this article, different methods of eyebrow reconstruction are presented with the greater emphasis on superficial temporal artery flap.     

Hair Transplant for Eyebrow Restoration

Eyebrow restoration can be best done with individual single hair follicles grafts harvested by FUE. Understanding the male and female eyebrow allows us to plan an aesthetic reconstruction, requiring 70 to 120 grafts. Selection of donor hair, angle of placement, alignment and direction within the rows influences the results, as does scarring and perfusion of the skin. Details of planning, technique, anesthesia and postoperative care, as well as drawbacks of older methods, are discussed in the article.     

眉美容整形的美学设计

目的：探讨眉部美学设计方法在眉美容整形术中的应用。方法：采用“5点”法行眉形设计为98例受术者实施眉美容整形。结果：术后眉形良好,达到了切除坏眉、使眼周年轻化的效果。结论：按照眉部美学以“5点”设计法进行眉形矫治,可获得令人满意的眉形。     

Eyebrow Asymmetry: Ways of Correction

Ocassionally a patient asks for correction of his asymmetric eyelids. In many instances, however, a careful analysis reveals that the actual cause is an asymmetry of the eyebrows. Generally, asymmetric eyebrows are due to excessive muscle dynamics (i.e., a hyperkinesia of the frontalis or the depressor supercilii muscles). Therefore, the asymmetry will not be corrected by an asymmetric blepharoplasty, which will instead disclose the preexisting asymmetry, much to the concern of the patient. Management of the asymmetric brow is demanding and requires a preoperative problem-oriented and detailed analysis of the individual patient to achieve satisfactory results. We present 10-years' experience using a problem-specific approach. This included intramuscular botulinum toxin A injection, superselective neurotomy, endoscopic browlift and traditional procedures such as the coronal and direct browlift. Indication, patient selection, results, and complications are discussed.     

可调控眉毛密度的眉再造术同期治疗瘢痕性秃发的临床护理

目的:探索专项护理在眉再造同期治疗瘢痕性秃发术中的应用效果。方法:根据手术过程分两期进行专项临床护理。扩张器一期置入术后进行扩张器相关专项护理,严密监测扩张注水情况,密切观察扩张部位,防止扩张皮瓣坏死或感染;眉再造和瘢痕性秃发修复二期术后密切观察再造眉毛头皮条的颜色,避免静脉回流不畅发生。结果:本组12例患者进行了眉再造的全方位密切护理,岛状头皮瓣全部存活,头皮瘢痕全部修复,无一例皮瓣坏死。随访6~24个月,再造眉毛毛发密度与健侧非常接近,眉形自然逼真,手术效果满意。结论:在可调控眉毛密度的眉再造同期治疗瘢痕性秃发术中进行全方位护理是手术成功的重要保障。     

A Transpalpebral Approach to Treatment of Eyebrow Ptosis

The aging process in the human face most often is first visible in the temporal–orbital region, where the ptosis of the eyebrow edge and pseudoexcess of upper eyelid skin are caused by orbicularis oculi muscle downfall. Through the upper blepharoplasty standard incision, the orbicularis oculi muscle is mobilized widely and suspended into a higher position with a stitch put on the deep temporal fascia. In this way the eyebrow is elevated and stabilized, thus reducing so-called ``crow's feet.' In some cases, when the skin distance between the temporal hairline and the eyebrow edge is too short or when it is necessary to lift the eyebrow edge more than 3 mm, a supplementary temporal incision is recommended to tighten better, in the same direction as the tension vector, the superficial temporal fascia and the overlying skin, firmly bonded to it.     

Eyebrow Reconstruction With the Subcutaneous Island Pedicle Flap

BACKGROUND: Surgical defects of the eyebrow region routinely present a cosmetic challenge to the reconstructive surgeon. OBJECTIVE: To present the use of a commonly employed reconstructive technique for an uncommon location. METHODS: Defects and repairs are demonstrated to illustrate techniques and document outcomes. The biomechanical influences on flap choice are explored. RESULTS: The subcutaneous island pedicle flap yielded excellent functional and cosmetic results when medium or larger defects were confronted in the eyebrow region. A centrally based pedicle enhanced cosmetic outcome, while rendering an uncompromised vascular supply. CONCLUSION: The subcutaneous island pedicle flap provides a competitive repair alternative when reconstructing substantial defects of the eyebrow region.     

Eyebrow, face, and neck lifts for males

Alternate locations to skin excisions adjacent to the eyebrows for correction of eyebrow ptosis have been presented. Excisions in the upper forehead or in the scalp permit flexibility in width and length of skin or scalp to be excised and may be extended laterally to produce a temporal lift which not only improves the lateral canthal area of sagging skin but also may improve the lower eyelid surgical correction results (Figs. 1 and 3). By use of adequate lipectomy and full-width platysma muscle flaps to support the new neck contour, better and longer lasting results have been accomplished. The currently used techniques for eyebrow, face, and neck lifts for males produce better and longer lasting results than could have been accomplished with previously used techniques. The continued search for improvement in techniques by many surgeons in different areas of the world has enabled these longer lasting and better results to be accomplished.     

毛发移植在修复眉缺损中的临床效果

目的 探讨实施自体毛发移植术对眉缺损的修复效果。方法 选取我院2021年1月-2022年12月收 治接受修复手术的150例眉缺损患者为研究对象。150例患者均接纳自体毛发移植术治疗,记录毛囊数量、 手术时间并发症发生率、成活率、毛发脱落率以及再植次数以及患者满意度。结果 150例患者中,所钻取 毛囊数量50~600个毛囊;35~180 min完成修复术;二次眉毛接种者有14人;受区眉毛成活率70%~90%;全 部病例的供区组织恢复效果良好,术区无并发症发生;满意度为99.33%。结论 对眉缺损患者实施自体毛 发移植术的整体修复效果良好,且具有较强的安全性,成活率较高,值得临床应用。     

A Percutaneous Approach to Eyebrow Lift: The Salvadorean Option

BACKGROUND: Surgical eyebrow lift can result in a number of complications. A nonsurgical simple method of lifting the brow is presented. OBJECTIVE: To raise the eyebrows using a simple, quick, and noninvasive approach. METHODS: Twenty-nine patients, 27 women and 2 men, whose ages varied from 24 to 56 years (mean of 32 years) were included in the study. Preoperative and postoperative photographs were taken. In two patients, brow suspension was performed at the time of blepharoplasty. Informed consent was signed by all of the patients. For measuring the degree of satisfaction of the patients, we gave to them a sheet grading it from one to three (with one being the least satisfactory). Local anesthesia (1% lidocaine, 1:400,000 epinephrine), a conveniently sized Keith needle, and prolene 3/0 sutures were used. RESULTS: Satisfying results were obtained in all cases. The only problem encountered in two patients was temporary edema, and it settled in a few days. CONCLUSION: This is a very simple, quick, and noncomplicated method of raising the eyebrows. It can be repeated, revised easily, or combined with other modalities, such as peels, topical tretinoin, oral isotretinoin, fat injection, Goretex, and Botox as part of a facial rejuvenation program.     

Eyebrow island flap for reconstruction of a partial eyebrow defect

A diverse variety of methods for reconstructing eyebrow defects has been described previously, and each procedure has inherent advantages and disadvantages. The authors present a case of reconstruction of a partial eyebrow defect using two eyebrow island flaps, which are modifications of the subcutaneous pedicle flap.