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Spinelli, Henry M. M.D.

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Plastic and Reconstructive Surgery: January 2008 - Volume 121 - Issue 1 - p 337
doi: 10.1097/01.prs.0000294950.95669.15
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Sir:

I have reviewed and appreciate the letter concerning my recently published article entitled “Limited Incision Nonendoscopic Brow Lift” (Plast. Reconstr. Surg. 119: 1563, 2007). My coauthor and I thank the many individuals who took the time to write or e-mail us directly to endorse the article and the technique. With regard to Drs. Agaoglu and Erol’s letter, I first would like to thank them both for their positive comments regarding the article. Second, I regret any negative feelings engendered by omitting the article by Erol et al. from our list of references. My coauthor and I wholeheartedly acknowledge a host of other references to nonendoscopic or minimally invasive methods of addressing brow ptosis in the medical literature which we also omitted. However, the intention of the article was to report the feasibility and efficacy of performing a limited incision brow lift without an endoscope. As with the open brow lift technique, both the minimally invasive nonendoscopic brow lift and the endoscopic technique are ones that require “dissection” or soft-tissue undermining and some form of fixation. As such, my coauthor and I chose to include references that were related to “dissection” techniques as opposed to those related to “nondissecting” methods, to which Drs. Agaoglu and Erol allude. By their own admission, nondissecting techniques, including their own, are not a replacement for established techniques of forehead rejuvenation. While I recognize their contribution to “nondissection” or suspension-only brow lifts, I wish to call attention to the even broader issue of the validity and longevity of suspension-only procedures (i.e., thread lifts and so on). Do they last? Or is there inherent soft-tissue cheese wiring through soft tissue that is not scarred into a suspended position?

I thank Drs. Agaoglu and Erol for their contribution to this discussion.

Henry M. Spinelli, M.D.

Department of Surgery

Weill-Cornell Medical College

Cornell University

875 Fifth Avenue

New York, N.Y. 10021

hmspinelli@aol.com

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