Observations on orbitofrontal rhytidectomy.

We describe a combined procedure of mobilization of the orbitofrontal flap, which involves passing through a subgaleal plane in the posterior region, corresponding to a portion of the scalp, and subcutaneously in the anterior frontal and orbital region. The galea, in the shape of an albatross wing, is irrigated via the distal parts of the temporal vessels. The flap lies free of the frontal muscle and the suprazygomatic aponeurotic sheath, thus allowing a broad shifting space for the replacement of each part in a manner that is both anatomically and artistically satisfactory. This technique avoids lesions of the frontal and orbicularis branches as well as alopecia, both the surgical kind and that caused by traction.