Adaptation of endoscopic frontoplasty for patients with alopecia

▪ ABSTRACT

Introduction:

Aging of the upper third of the face is characterized primarily by eyebrow ptosis, glabellar wrinkles, and deep transverse wrinkles. Endoscopic frontoplasty is our treatment option of choice, but in cases of alopecia, visible scars are not always acceptable to patients. We developed a videoendoscopic approach with three incisions, two 3-cm temporal incisions, and one 1-cm midline (sagittal) incision. This study aims to describe subperiosteal frontoplasty through three incisions in patients with frontotemporal alopecia, evaluating its applicability and efficacy.

Method:

Twelve patients with alopecia, 10 males and two females, who underwent frontoplasty through three incisions (two temporal incisions and one midline incision), aged between 50 and 66 years, over 5 years, were retrospectively evaluated.

Results:

There were three complications: one case of insufficient correction of the lateral portion of the eyebrow and two cases of recurrence of glabellar wrinkles.

Conclusion:

The endoscopic subperiosteal frontoplasty technique with only three incisions proved to be a good alternative in the treatment of aging of the upper third of the face in patients with alopecia, being effective, providing good aesthetic results and low morbidity.

Keywords:

Alopecia - Endoscopy - Esthetics - Face - Plastic surgery procedures

Institution: Clínica Privada, Curitiba, PR, Brazil.

Publikationsverlauf

Eingereicht: 22. November 2023

Angenommen: 27. Juli 2024

Artikel online veröffentlicht:
22. Mai 2025

• REFERENCES

• 1 Jacono AA. A Novel Volumizing Extended Deep-Plane Facelift: Using Composite Flap Shifts to Volumize the Midface and Jawline. Facial Plast Surg Clin North Am 2020; 28 (03) 331-368
• 2 Warren R, Gartstein V, Kligman AM, Montagna W, Allendorf RA, Ridder GM. Age, sunlight, and facial skin: a histologic and quantitative study. J Am Acad Dermatol 1991; 25 (5 Pt 1): 751-760
• 3 Shaw Jr RB, Kahn DM. Aging of the midface bony elements: a three-dimensional computed tomographic study. Plast Reconstr Surg 2007; 119 (02) 675-681 ; discussion: 682-3
• 4 Coleman SR, Grover R. The anatomy of the aging face: volume loss and changes in 3-dimensional topography. Aesthet Surg J 2006; 26 (1S): S4-9
• 5 Knize DM. Limited-incision forehead lift for eyebrow elevation to enhance upper blepharoplasty. Plast Reconstr Surg 1996; 97 (07) 1334-1342
• 6 Knize DM. Limited incision foreheadplasty. Plast Reconstr Surg 1999; 103 (01) 271-284
• 7 Viterbo F, Auersvald A, O’Daniel TG. Gliding Brow Lift (GBL): A New Concept. Aesthetic Plast Surg 2019; 43 (06) 1536-1546
• 8 Graça L, Araújo LR, Graça ACM. Frontoplastia Endoscópica Subperiostal com Fixação Temporal por Fios de Sutura. Rev Bras Cir Plást 2022; 37 (01) 3-8
• 9 Lem M, Pham JT, Kim JK, Tang CJ. Changing Aesthetic Surgery Interest in Men: An 18-Year Analysis. Aesthetic Plast Surg 2023; 47 (05) 2136-2141
• 10 American Academy of Facial Plastic and Reconstructive Surgery. AAFPRS Announces Annual Survey Results: Demand for Facial Plastic Surgery Skyrockets as Pandemic Drags On. Self-Improvement Surge Spills into Aesthetics in a Big Way with 40 Percent Increase in Facial Plastic Surgery in 2021 [Accessed 2022 Jul 2]. Available from: https://www.aafprs.org/Media/Press_Releases/2021%20Survey%20Results.aspx
• 11 Piraccini BM, Alessandrini A. Androgenetic alopecia. G Ital Dermatol Venereol 2014; 149 (01) 15-24
• 12 Mendelson B, Wong CH. Changes in the facial skeleton with aging: implications and clinical applications in facial rejuvenation. Aesthetic Plast Surg 2012; 36 (04) 753-760