Evaluation of Pericranial Skull Adherence During Healing in the Rabbit Model

Abstract

Background:The endoscopic brow-lift is a popular technique for rejuvenation of the aging brow and forehead. Long-lasting results depend on readherence of the pericranium to the underlying skull in the newly elevated position. Determination of the time required for pericranial readherence to occur is important when considering optimal brow fixation time postoperatively; however, few studies of pericranial healing exist in the literature.Objective: To quantify the time required for pericranial adherence after pericranial elevation in a rabbit model. Design: Anesthetized New Zealand white rabbits underwent elevation of a pericranial flap on day 0. The flap was then repositioned and the skin sutured. One unoperated-on group served as a control. A tensiometer was used to measure the force required to separate the pericranial flap from the skull of the control animals and of test animals killed on postoperative days 3, 5, 8, 10, 13, 17, 20, 25, and 28. Statistical analysis was performed to determine the effect of healing time on the strength of pericranial readherence.Results: There was a statistically significant decrease in the force required for pericranial separation at 3 and 5 days after surgery compared with the control group. By 8 days postoperatively and throughout the subsequent times examined, no statistically significant differences from the control group were observed. Conclusion:In this rabbit model, pericranial adherence (as measured by tensile strength) is decreased postoperatively and does not return to baseline levels until postoperative day 8.

Comprehensive Periorbital Rejuvenation with Resorbable Endotine Implants for Trans-lid Brow and Midface Elevation

“…Myoplasty is not intrinsic to either of these procedures, so it is reasonable to assume that longevity of elevation is caused by healing of the periosteum to bone at the new, elevated position, counterbalanced by differential ptosis of the more superficial tissues. Sclafani and colleagues [10] previously showed that the bone-periosteum bond is well established by 6 weeks in an animal model, whereas others have described faster time courses [11,12]. In light of this report, late loss of elevation presumably would be caused by resorption of tines that are engaging tissue above the periosteum (eg, retro-orbicularis oculi fat or galeal fat [brow], suborbicularis oculi fat or malar fat [midface]).…”

Subgaleal Endoscopic Browlift with Absorbable Fixation

“…Troilius [9] concluded that subperiosteal lifts achieve more permanent fixation because the inelastic periosteum adheres to bone, compared with the elastic galea/ frontalis, which can descend. Healing time of periosteum to bone has been documented and ranges from 7 days to 6 to 12 weeks [33][34][35][36][37]. However, we feel that the galeal layer adheres to the periosteal layer more rapidly than periosteum heals to bare bone, thus providing an additional advantage to the subgaleal plane of dissection.…”

Experimental model for the study of soft tissue fixation methods on skin-pericranium flaps in rats

“…Kriet et al 18 studied the tensile strength of pericraniumcutaneous flaps using a tensiometer in rabbits that did not receive periosteal fixation, and observed a decrease in tension starting on day 3 postoperatively and a recovery by day 8 postoperatively, which remained until the last measurement on day 28 postoperatively.…”