Lateral Subcutaneous Brow Lift: Updated Technique.

Abstract

Age-related changes affecting the periorbital area and resulting in eyebrow ptosis have a greater impact on the lateral eyebrow; correction of this deformity is a common request from patients seeking periorbital rejuvenation.1 Various techniques have been utilized to address eyebrow ptosis, including the coronal brow lift, endoscopic technique, anterior hairline approach, transpalpebral lift, midforehead lift, and direct brow lift. Furthermore, arguments for dissection in each of the different tissue planes—subcutaneous, subgaleal, or subperiosteal—have all been discussed. Each of these approaches has specific indications, risks, and benefits, and should be selected after comprehensive evaluation of the patient.2-4 In our experience, a full coronal incision often results in an obvious midline scar in the central forehead, increases the risk of elongating the vertical height of the forehead, and can result in paresthesias posterior to the hairline, a symptom that is very bothersome to patients. Endoscopic brow lifts require additional equipment with increased operative time, and the deeper dissection involved in this technique results in suboptimal brow elevation compared to the subcutaneous approach. Furthermore, not all patients are appropriate candidates for endoscopic brow lifts, including those with significant convex frontal bones, high or receding hairlines, deep transverse rhytides, or significant brow ptosis. In patients presenting with lateral brow descent, the temporal or lateral subcutaneous brow lift has produced consistent and effective results. This technique has been well described in the literature, and has several advantages, including shorter operative time, feasibility under local anesthesia, decreased …