Gull Wing Browplasty
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This is Richard Allen at the University of Iowa. This video demonstrates a seldom used procedure call a "gull-wing" browplasty. This procedure is reserved for patients with significant medial and lateral brow ptosis who wear glasses and have no other advantageous area to place an incision. A bilateral upper lid blepharoplasty is performed. The 15 blade is then used to make an incision along the markings. These markings extend along the entire length of the brow and across the bridge of the nose. The incision then connects to an upper incision which has been premeasured to achieve the preferred amount of lift. Again the advantage of this lift is that it allows elevation of the medial brow. The monopolar cautery is used to excise the skin and subcutaneous fat. Hemostasis is attained with the monopolar cautery. Patients with this lift need to wear glasses to cover the medial extent of the incision. The incision is then closed with deep interrupted 4-0 vicryl suture placed in a buried interrupted fashion. A 5-0 prolene suture is then used to close the skin. This can be placed in a running fashion. In general, these incisions heal relatively well, but this is definitely not considered a cosmetic lift. At the conclusion of the case, antibiotic ointment is placed over the incisions three times a day. The patient returns in approximately one week for removal of the sutures.