Coronal Browlift 

Introduction

As oculofacial surgeons, we encounter patients seeking facial rejuvenation, particularly in the brow and forehead area. The coronal browlift, also known as an “open brow lift,” remains a valuable technique for addressing brow sagging and achieving a refreshed appearance. In this essay, we delve into the intricacies of coronal browlift surgery, covering its mechanisms, comparison to other techniques, ideal candidates, procedural details, recovery, and visual outcomes.

Overview

The coronal browlift involves a single incision made from ear to ear across the forehead. By lifting the brow area, this technique corrects sagging, reduces frown lines, and rejuvenates the upper face. Let’s explore the key aspects of this time-tested procedure.

Mechanisms

1. Incision Placement: The coronal incision extends from one ear to the other, allowing direct access to the forehead and brow region.
2. Forehead Elevation: The surgeon lifts the forehead skin, adjusting the underlying muscles and tissues. This elevation raises the eyebrows, resulting in a more youthful appearance.
3. Hairline Considerations: Coronal lifts are ideal for individuals with smaller foreheads who also desire a subtle lift of their hairline. However, it’s essential to discuss potential permanent numbness behind the incision to the vertex of the scalp with patients.

Comparison to Other Browlift Techniques

• Coronal vs. Endoscopic Browlift:
  • Incisions: Coronal lifts involve a longer incision, while endoscopic browlifts use smaller, minimally invasive incisions.
  • Tissue Dissection: Endoscopic lifts utilize a camera and small instruments to dissect tissues, minimizing trauma and promoting faster recovery.
  • Numbness: Coronal lifts may cause numbness, whereas endoscopic lifts typically avoid this issue.

Ideal Candidates

1. Hairline Concerns: Patients with smaller foreheads who desire both brow elevation and subtle hairline adjustments.
2. Frown Lines and Brow Sagging: Individuals experiencing vertical creases between the eyebrows (glabellar lines) and brow ptosis.
3. Patient Expectations: Those willing to accept a longer incision in exchange for comprehensive brow rejuvenation.

Procedure Details

1. Preparation:
   • Consultation: Assess patient goals, forehead anatomy, and hairline position.
   • Incision Planning: Determine the precise placement of the ear-to-ear incision.
2. Surgical Steps:
   • Incision: Make the coronal incision within the hair-bearing skin.
   • Forehead Elevation: Lift the forehead skin, adjust muscles, and reposition the brow.
   • Hairline Management: Discuss potential hairline changes with the patient.
3. Post-Operative Care:
   • Recovery: Expect swelling, bruising, and discomfort for several days.
   • Scar Management: Advise patients on scar care and concealment.
   • Follow-Up: Regular visits to monitor healing and address any concerns.

In conclusion, the coronal browlift remains a valuable tool in our armamentarium for achieving natural and lasting results in brow and forehead rejuvenation. As oculofacial surgeons, let us continue to refine our techniques and enhance patient satisfaction.