Retrograde Forehead Lift
3 December 2019 onur
“Retrograde” means in the opposite direction or backwards.
Let’s start by explaining how the anterograde version works.
Forehead lift surgeries are typically performed top-down. The procedure starts with incisions in the scalp at the top and progresses towards the eyebrows as tissue planes are separated from each other. At the lowest level, the connective tissues holding the eyebrows are mobilized, and the eyebrows are modified. Then the tissues are stretched upwards and fixed.
The connective tissue mobilization/muscle modification steps at the bottom are very important to obtain an effective result in forehead lift surgeries and to raise the eyebrow sufficiently. If you don’t mobilize them enough, you won’t be able to raise the eyebrow in the long run, no matter how much you pull. The step in which we mobilize the eyebrow from the surrounding structures is also the riskiest step of surgery in terms of nervous and vascular injuries.
This area just below the eyebrow should be well-visualized during surgery.
In order to do that, it is necessary to choose classical approaches such as the crown technique, where a large incision is done, or forehead lift from the hairline, or to prefer the endoscopic technique, which allows us to see through limited incisions to perform surgery.
What I have described so far is about isolated forehead lift techniques.
When upper eyelid surgery is also involved, the picture changes.
In upper eyelid surgery, we make an incision at a horizontal length of 3-4 cm and only 1 cm away from the eyebrow. Through this incision, we can perform the connective tissue mobilization / muscle modification procedures, which are the most critical steps of forehead lift surgeries, all the while seeing the procedure directly.
In retrograde forehead lift, however, a bottom-up procedure is performed, starting from the upper eyelid incision. First, the muscles are modified, then the ligaments holding the eyebrow are mobilized, and then we rise towards the forehead. At the end of the surgery, the forehead tissue is fixed to the bone skeleton via small incisions in the scalp.
Retrograde forehead lift is a procedure that is very similar to endoscopic forehead lift. Similarly, minimal incisions are made, a similar fixation method is used, and the results are similar. The upper eyelid incision makes the use of an endoscope largely unnecessary.
As a result, if we think a patient has the indication for a short-incision forehead lift/eyebrow lift,
We may prefer a retrograde forehead lift if the upper eyelid is also included in planning, or
We prefer the endoscopic forehead lift if the upper eyelid will remain intact.
The key advantage of retrograde forehead lift surgery is that it is a cheaper and faster procedure since it does not require endoscopic equipment. Another advantage of it is that it provides a more comfortable operation flow than the endoscopic technique, particularly in the patient group with an excessively curved forehead.
Compared to endoscopic forehead lift surgery, the main disadvantage of retrograde forehead lift surgery is that its effect at the center of the forehead is limited. Another disadvantage is that the risk of postoperative edema and bleeding is slightly higher.
In cases where upper eyelid aesthetic surgery and forehead lift are planned for the same session simultaneously, the retrograde forehead lift is a reasonable alternative.
Please feel free to contact us for detailed information on retrograde forehead lift.
Take good care…
… of yourself and your beauty.