[Frontal stage in cervicofacial lift: the "helmet crest" technique associated with rapid expansion]

The frontal level is generally the less and the last concerned in facial ageing and the classical incisions of the cervicofacial facelift provide no changes in the frontal and glabellar wrinkles. To avoid such residual defects, the authors perform for the lost ten years an important push back of a central band of the vertex (the so called "Helmet crest") by means of a bilateral triangular excision subsequently closed by VY. This push back needs a very large undermining in the subgalea plan, from the eyebrow and glabellar region to the crest of the hemet itself. The VY closure is now really facilitated by a rapid expansion obtained by a special T shaped expander which allows not only cutaneous expansion but also aponeurotic expansion of the reputedly inextensible galea. This technique avoids the coronal incision and its serious sequelae and may be carried technique out at the same time as cervicofacial face lift. It allows a personal, equilibrated tension of the facial mask which is the essential condition for a good presentation of natural expression of the face.