Practice Patterns: An American Society of Plastic Surgeons (ASPS) Member Survey, 2000 and 2020 - How Much Has Browlifting Changed?

Abstract

In 2001, Elkwood and Matarasso published an American Society of Plastic Surgeons (ASPS) member survey detailing browlift practice patterns. Interval changes in practice patterns have not been studied. The previous survey was revised to elucidate current trends in browlift surgery. A 34-question descriptive survey was distributed to a random group of 2360 ASPS members. Results were compared to the 2001 survey. A total of 257 responses were collected (11% response rate; ± 6% margin of error at 95% CI). The most frequent technique for the correction of brow ptosis in both surveys was the endoscopic approach. The use of hardware fixation has increased in endoscopic browlifting while the use of cortical tunnels has decreased. While coronal browlifting has decreased in frequency, hairline and isolated temporal lift have increased. Neuromodulators have replaced resurfacing techniques as the most common non-surgical adjunct. Frequent use of neuromodulators has risen from 11.2% to 88.5%. Nearly 30% of current surgeons feel that neuromodulators have replaced formal browlifting procedures to a significant degree. In comparing the 2001 and current ASPS member survey there has been a clear transition to less invasive procedures over time. While the endoscopic approach was the most popular means of forehead correction in both surveys, coronal brow lifting has decreased in frequency while the hairline and temporal approaches have increased. Neurotoxins have replaced laser resurfacing and chemical peeling methods as an adjunct, and in some cases replaced the invasive procedure entirely. Possible explanations for these findings will be discussed.