Step 2 Skin Incision

The eyebrow is not shaved. The skin is straddled over the orbital rim using two fingers and a 2 cm incision is made. The incision should be parallel to the hair of the eyebrow to avoid cutting hair shafts. Which might retard growth of the eyebrow hair. The incision may be made to the depth of the periosteum in one stroke (Fig. 4-1). The skin is freely movable in this plane.

Access can be improved by extending the incision more anteriorly within the confines of the eyebrow. Extending the incision inferiorly along the orbital rim should be avoided because the incision crosses the lines of resting skin tension, making the scar very conspicuous. If more inferior exposure is required, the incision should extend laterally into a crow's foot wrinkle at least 6 mm above the level of the lateral canthus.

Figure 4 1 Placement of incision within confines of eyebrow hair. The incision is made through skin and subcutaneous tissue to the level of the periosteum in one stroke.

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