The dissection begins in the temple, lifting and separating the skin edges with double-prong hooks, dissection is carried through the temporoparietal fascia to the temporalis fascia. Branches of the superficial temporal artery or vein may be encountered here. These vessels should be controlled; it is helpful to try to identify them before cutting. Blunt dissection is used to elevate over the temporalis fascia, working as far forward as the temporal crest and inferiorly to just above the zygomatic arch. Both superiorly and posteriorly, the dissection is also carried out so that a flap is mobilized which can later be elevated and secured to the temporalis fascia. The fibrous attachments of the temporal crest are broken to allow better mobilization of the temple flap. This permits better elevation of the lateral brow area. After completion of the lower dissection, this flap will be firmly advanced, and the temporoparietal fascia will be secure to the deep temporal fascia.
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