Trichophytic incisional approaches to upper facial rejuvenation.

[OBJECTIVE] To analyze the efficacy of frontal and peritemporal trichophytic incisions in upper facial rejuvenation.

[METHODS] Retrospective study evaluating data from 99 consecutive patients who underwent upper facial rejuvenation.

[RESULTS] Central forehead-lift was performed in 65% (57/88) of the women but in only 1 man (9%), with coronal and frontal trichophytic hairline approaches used in 28% (16/58) and 72% (42/58) of patients, respectively. Lateral brow-lift and lateral periorbital rejuvenation were performed in all the patients, with the peritemporal trichophytic approach used in 43% (38/88) of female patients. Frontal trichophytic and peritemporal trichophytic incisions were commonly used in both revision and primary procedures; nearly all patients with elevation of the frontal hairline or temporal tuft underwent trichophytic incisional approaches. Depending on the anatomical deformities present preoperatively, patients were categorized into 1 of 6 treatment groups; trichophytic incisional approaches were used successfully in 4 of the 6 groups.

[CONCLUSIONS] Frontal and/or peritemporal trichophytic incisions are upper facial rejuvenation surgery and should be offered as an option. Since they avoid anterior hairline elevation and maintain preoperative temporal tuft position, trichophytic incisions are especially valuable in revision procedures in which the hairline has previously been elevated to or beyond an acceptable anatomical position.