Carbon dioxide laser resurfacing combined with endoscopic forehead lift, laser blepharoplasty, and transblepharoplasty corrugator muscle resection

BACKGROUND. Endoscopic forehead lifting has become an increasingly popular method for rejuvenating the upper face, due to its less invasive nature and minimal scars. However, adequate ablation of frown muscles (ie, corrugator and depressor supercili) is difficult with this approach. The frown muscles are in close proximity to the upper eyelid, and it is possible to oblate them via the blepharoplasty approach using the carbon dioxide laser. OBJECTIVE. The purpose of this paper is to describe the combined approach of endoscopic forehead lifting and carbon dioxide laser resurfacing to rejuvenate the upper face. The former technique addresses the issue of brow elevation and improvement of dynamic glabellar frown lines. The latter technique deals with static wrinkles caused by sun damage. METHODS AND RESULTS. Thirty-seven patients underwent endoscopic forehead lift, transblepheroplasty corrugator ablation, with simultaneous carbon dioxide laser resurfacing of forehead skin. Twenty-eight of 37 patients (76%) achieved excellent results, while nine of 37 (14%) experienced good results. Complications were minimal, being mostly due to inadequate corrugator muscle resection with recurrent frowning. There were no instances of scarring, skin necrosis, or permanent hair loss. CONCLUSION. The combination of endoscopic forehead lifting, transblepharoplasty corrugator muscle resection, and carbon dioxide laser resurfacing is an effective and safe technique for rejuvenating the upper face, producing a natural result with minimal complications. (C) 1998 by the American Society for Dermatologic Surgery, Inc.