One-year sustainability of brow-lifting procedures

Abstract

Unlike blepharoplasty or facelifting procedures, there is little evidence of the sustainability of brow-lifting techniques. This study aimed to investigate the one-year sustainability of three brow-lifting techniques performed at our department. Thirty-six patients received an upper blepharoplasty and simultaneously one of three brow-lifting procedures: the direct (excisional) browpexy, the transpalpebral brow lift, and the EndotineⓇ forehead fixation. analogue and digital measurements of 3 vertical distances, from fixed anatomical points at pupil, lateral canthal, and lateral orbital rim level, were performed preoperatively and 12 months postoperatively. Patients' and surgeons' satisfaction considering functional and aesthetic outcomes were investigated by carrying out paper-pencil surveys. Direct browpexy was performed in 8, transpalpebral eyebrow lift in 10, and the EndotineⓇ fixation in 18 of the cases. In the first year, direct browpexy showed a general descent of 1.2mm at the pupil level, 2.1mm at the lateral canthal, and 0.6mm at the orbital rim level. In the transpalpebral eyebrow lift group, a descent of 0.7mm at the pupil level and 0.3mm at the lateral canthal level was found; the orbital rim level showed a slight but nonsignificant ascent of 0.7mm. In the EndotineⓇ group, a descent of 1.1mm at the pupil level, 1.2mm at the lateral canthal level, and 0.7mm at the orbital rim level was shown. Subjective surgeon opinions and overall patient satisfaction underline an aesthetic improvement despite objective results falsifying the hypothesis of a raised eyebrow position after one year. Patients showed minor eyebrow decrement after 12 months postoperatively; therefore, sustainability is questioned and must be reevaluated. The extent of dissection, the downward pull of upper blepharoplasty resection, and the decrease in frontalis muscle activity are discussed as the possible causes.