AESTHETIC ANATOMY OF THE FOREHEAD AND BROW

Dr.Nikhil Panse,

Assistant Professor

Department of Plastic Surgery,

B.J Medical College and Sassoon Hospital,

Pune.

The upper third of the face is most expressive and revealing….

The fascial and muscular planes in forehead

Pitanguys and Ramos line – Frontal branch of facial nerve

Superficial and Deep temporal fascia

The insertion lines of fascia planes on skull

ELLENBOGEN’S CRITERIA FOR IDEAL BROW POSITION

ELLENBOGEN’S CRITERIA CONT….

The surprised look – excessive elevation of medial edge of brow

The sad look – inferior location of lateral edge of brow

The Brow elevator - Frontalis

Frontalis – Brow elevation & formation of transverse rhytids

The Medial Brow depressor - Procerus

Procerus – Inferior & Medial displacement of medial eyebrowand transverse rhytids at nasal radix

The Medial Brow depressors – Corrugators & Orbicularis

The Corrugators - Vertical and Oblique rhytids

Lateral brow depressor – Orbicularis oculi

Lateral Orbicularis oculi – lateral canthus rhytids and lateral brow ptosis

Sensory nerves of the forehead and the brow

Reflected superficial temporal fascia

Relationship to the sentinel vein – endoscopic view

The blood supply of the forehead and the brow

Changes in eyebrow with age

Eyebrow changes with age

Pearls…

• The Frontalis is a primary brow elevator and should not be weakened during a procedure aimed at brow elevation.

• The Procerus and Corrugators are primary brow depressors and should be weakened to achieve medial brow elevation.

Pearls…

• Vertical glabellar rhytids are best corrected by surgical alteration of transverse head of Corrugator.

• Horizontal glabellar rhytids are best corrected by alteration of the Procerus.

• Oblique rhytids require a combined alteration of Depressor superciliaris and oblique head of Corrugator.

THANKS ……