外科および臨床実践ジャーナル

Scarless brow reduction surgery

Dominik L Feinendegen

So far, there are no reports in the realm of medical literature which particularly describe from a surgical point of view any brow reduction technique. As up to this day, brow reduction has only be analysed and investigated from a non-surgical point of view. The following paper aims to fill into this lack of research and will introduce a new surgical brow reduction technique with less scar formation. By doing this, the paper questions the present treatment of brow forming and contributes to new insights in surgical procedures and contributes to present academic literature. The reluctance to form the brow surgically might be the prevailing medical opinion and experience of noticeable scar formation following reduction of brow fullness and brow symmetrization or direct brow lift procedures. The use of the ‘flat incision technique’ proposed in this article can alleviate these visible sequelae following incisions in the brow area. With this technique the brow can be directly reduced in size and/or simultaneously elevated, especially to feminize or harmonize the brow form. The brow rows are deliberately reduced which leads to nearly invisible scar formation. Compared to the vertical skin incision the herein described flat incision technique increases the dermal wound layers more than a double. By maximization of these dermal layers the scar quality is remarkably improved. Hair growth can be maintained through the incision line by sparing the hair follicles. This technique was prospectively evaluated in a series of 18 patients with surgery performed by one surgeon in one center. All patients showed good to excellent scar formation with exception of 2 heavy smokers. The subjective rating of the results was very good in fourteen patients, good in two patients and poor in two patients.