METHOD OF SUBPERIOSTEAL FOREHEAD LIFT THROUGH UPPER BLEPHAROPLASTIC APPROACH Russian patent published in 2024 - IPC A61B17/00 A61F9/07 

FIELD: medicine.

SUBSTANCE: invention relates to reconstructive plastic surgery. Under general anesthesia or local anesthesia with potentiation, local infiltration anesthesia of upper eyelid and brow region is performed with 1% lidocaine with adrenaline, 0.5% lidocaine is infiltrated under the aponeurosis in the forehead. Upper eyelid crescent skin strips are excised at 8.0 mm from a ciliary edge and not reaching an eyebrow growth line of 12.0 mm. Orbital fat is accessed, and excess nasal and middle portions of fatty bodies are resected, and hemostasis is performed. Soft tissues are detached under a circular muscle of an eye, under an eyebrow and under a frontal abdomen of a musculo-aponeurotic helmet under a periosteum to a middle line of a forehead. Dissection of a preseptal portion of a circular muscle of an eye and soft tissues between a muscle and a brow fat packet upwards to an upper edge of a tail of an eyebrow and through this incision at distance of 2.0 cm from the edge of the orbit longitudinally and inside the aponeurosis of the frontal helmet is dissected along the upper edge of the orbit of the eye to the head of the eyebrow, bypassing the supraorbital and supra-block nerves. Procerus muscles are destroyed by overstretching with a bone raspatory. Subperiosteal forehead detachment is performed with a bone raspatory from the upper edges of the orbits to the midline of the face from below upwards and from the upper edges of the orbits to the middle of the parietal region. Subperiosteal temporal line is peeled off and the temporal line of a forehead is transected in the area of attachment to the tail of an eyebrow with visual haemostasis. Thereafter, the eyebrow is displaced upwards and fixed to the periosteum. Then an active drainage is placed under a detached frontal helmet with diameter of 3.0 mm, at the level of the pupil and at distance of 2.0 cm from the hairline and two skin pricks are made along it, as shown in Fig. 24, at distance of 4.5 cm from each other and a Serdev needle in the subcutaneous layer above the aponeurosis of the helmet, “Викрил 1-0” or “ПДС 1-0” suture is inserted, which is brought out into both pricks, retreating 4.5 cm downwards, and two more pricks are made in parallel, through which the threads from the first two pricks are captured under the aponeurosis of the helmet with a Serdev needle and brought out in two lower pricks. After that, a suture for tying a knot is brought out into the lower external prick with a Serdev needle above the aponeurosis, forming a U-shaped horizontal suture, which, after tightening, forms a cushion of parietal skin. Middle of each U-shaped horizontal suture is oriented along the center of the pupil, after which both U-shaped sutures are tightened across the parietal region, forming a transverse skin fold, the upper eyelid wound is sutured with Prolene 6-0.

EFFECT: method eliminates postoperative scars and alopecia in the scalp, allows avoiding intraosseous screws, endotines and performing osteoperforations in the parietal bone.

1 cl, 37 dwg, 1 ex