The use of adrenaline in reduction mammaplasty

Conventional rhytidoplasty is somewhat limited in its effectiveness by the need to conceal the incisions that allow access to the affected area. The coronal incision, commonly used in such procedures, results in an inevitable posterior and superior migration of the hairline, which stigmatizes operated patients. This paper presents a new approach to rhytidoplasty by modifying the incisions in both temporal and frontal areas. The modification consists of performing the incisions anterior to the hairline in that area, going around the sideburns and following upward to the level of the supraorbital rim, carried out either superior or inferior to the brow. If lifting of the brow is desired the incision is placed superior to it, if not it is placed below the brow and may coincide with the upper blepharoplasty incisions. Additionally the incisions from both sides may be united in the midline, if excision of glabellar wrinkles is needed. The use of this approach allowed traction to be placed as needed without the restrictions imposed by the position of the temporal hairline or sideburns. Moreover greater control over the position of the brow was achieved. Therefore, greater effectiveness was attained without jeopardizing the naturalness of the result.