MICROSURGICAL FOREHEAD RECONSTRUCTION - AN AESTHETIC APPROACH
coverage; defects; flap; restoration; scalp; Surgery
Satisfactory forehead reconstruction can be accomplished by microsurgical free tissue transfer. Basic principles of forehead resurfacing include: (1) replacement with similar quality soft tissue as a well-defined complete aesthetic unit, (2) establishment of the hairline 5-6 cm above the eyebrows, and (3) use of adjunctive procedures to enhance the aesthetic result. We have found the radial forearm flap and the groin flap to be excellent flaps for achieving this goal.
Weinzweig N; Davies B; Polley J W
Plastic and Reconstructive Surgery
1995
1995-04
Journal Article
<a href="http://doi.org/10.1097/00006534-199504000-00005" target="_blank" rel="noreferrer noopener">10.1097/00006534-199504000-00005</a>
Cessation Of Hairline Recession Following Open Forehead Rejuvenation
androgenetic alopecia; complications; pattern; restoration; Surgery
Background: The senior author (B.G.) observed that patients who underwent forehead rejuvenation using a pretrichial incision did not experience hairline recession. The aim of this study was to objectively measure the effects of forehead rejuvenation on hairline recession. Methods: A 15-year retrospective review was performed in 31 forehead rejuvenation patients [17 endoscopic and 14 open (pretrichial incision) with adequate early (within 1 year) and late (8 years) postoperative photographs] and 11 age- and follow-up-matched cosmetic surgery patients who did not have forehead rejuvenation. Hair recession was measured using the Mirror program for Windows by averaging two successive perpendicular distances from bilateral medial canthi to the hairline and dividing by the intercanthal distance. In pretrichial incision patients, the distance from the incision to the anterior hairline was recorded. Results: The difference in short-term postoperative hairline measurements among groups was not significant (p = 0.445). Only the pretrichial group demonstrated significant stability between short-term and long-term hairline positions (p = 0.005). The pretrichial group demonstrated a stable or improved hairline position compared with either the endoscopic (p = 0.017) or control group (p = 0.006), whereas these patients demonstrated significant recession over time. Hairline measurements between early and late postoperative photographs in the endoscopic and control groups were not significant (p = 0.621). Conclusions: The pretrichial incision results in a stable hairline position over time compared with the endoscopic technique or matched controls. Pretrichial incision patients did not demonstrate separation between the scar and hairline, indicating no hair loss in this site. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
Guyuron B; Gatherwright J; Totonchi A; Ahmadian R; Farajipour N
Plastic and Reconstructive Surgery
2014
2014-01
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1097/01.prs.0000436815.88590.4e" target="_blank" rel="noreferrer noopener">10.1097/01.prs.0000436815.88590.4e</a>