From Holcomb Facial Plastic Surgery, Sarasota, Fla (Dr Holcomb), and
the McCollough Plastic Surgery Clinic, Gulf Shores, Ala (Dr McCollough).
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
Holcomb JD, McCollough EG. Trichophytic Incisional Approaches to Upper Facial Rejuvenation. Arch Facial Plast Surg. 2001;3(1):48-53. doi: