Supraorbital Eyebrow Approach SURGICAL ANATOMY A previously poplar incision used 1 gala access wo the supeolteral etl rm I the ‘eyebrow incision. No imparant neurovascular sutures ae involved in ths approach, tnd it gives simple and apd access tote frontorygomatic sea Ifthe incision made most eney within the confines of the eyebeow, the Scar is usually imperepubl ‘Occasional. however, ome hairloss occur, making the scar perceptible. Unfortunately, im individuals who have no eyebrows extending ately an inferiorly along the obit rain this approach is undesinble. Incsone made slong te le orbital im ouside ofthe eyebrow are very conspicuous in such inividvals, and anche ype of incision may ‘be inicted. The mai disadvantage ofthe approach extremely ited access. ‘TRCHNTOLE, ‘Step 1. Vasoconstriction ‘Alocal anesthetic with a vascconstctrisinjeted into the subcutaneous sues over the lateral orbital im to aid in emesis Step 2, Skin Incision ‘The eyebrow i not shaved. The skin i stad ovr the orbit im using two finger and acm incsion is made. The incision sould be parallel tothe hai ofthe eyebrow 0 ‘vung air shafts, which might retard growth af the eyebrows. The incision may be made to the depth ofthe pviostum in one suoke (Fig. 1). The skins fely moy- sein this pine Access can beimproved by extending the incision more aneriay within the confines ofthe eyebrow. Extending the incision inferioy along the obi im should Be woided because te incision crosses the lines of esting skin tension, making the sar Yery com> Spicuous. If more inferior exposures equed, the incision should exten aera into 3 tows fot wrinkle at est mm shove the level ofthe Inter ants.2 [SECTION I+ Periorbital Approaches etn + Feet of con nthin cones ee ha. The io ae ag i andIncision [After undermining in the supraperostal plane, the skin is reacted uni it is over the ‘ecu of intrest. Another inion through the periosteum completes the sharp section ig. 42) ret «2, ‘eso choigh erie lg aera rs i a pee dissection in aril a se oh ce hed te sl nn ee, he eel eteSECTION H+ Periorbtal Approaches ‘Step 4. Subpertosteal Dissection of Lateral Orbital Rim and Lateral Orbit “Two sharp periosteal elevates are edo expo the rao in on he aera ial intraoral), and, if necessary poser (temporal sutaes (Fig 42), Wide under ‘ining ofthe skin and periosteum allows the tssbes tobe revatd nero, proving beter acess fo the lower pation ofthe Intra orbital rim. If one stays inthe sub Peviosel spce, theres virtually no chance of damaging vital sractres, Step 5. Closure ‘The incisions closed in wo layers, the periosteum and he skin,