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Facial Plast Surg 2022 Jun 23. Epub 2022 Jun 23.

Otolaryngology - Head and Neck Surgery, University of Kansas Medical Center, Kansas City, United States.

Brow ptosis is an abnormal descent of the eyebrow resulting in a displeased appearance and/or functional deficit. While most cases of brow ptosis do not result in a functional impairment, functional brow surgery is generally reserved for individuals with severe brow asymmetry or visual field deficit related to excess soft tissue pushing downwards on the eyelid. A combination of both intrinsic and extrinsic anatomic factors contributes to an unfavorable brow shape, contour, and position. Read More

Clin Plast Surg 2022 Jul;49(3):415-420

Case Western Reserve School of Medicine.

As the approach to the upper face has evolved in recent years, so has the focus of aesthetic brow procedures. Brow position was the primary focus early in the late twentieth century, with the coronal brow lift the primary means of surgical correction. In more recent years, improving or maintaining brow shape has taken on greater importance and has increasingly been addressed by contemporary techniques. Read More

Clin Plast Surg 2022 Jul;49(3):409-414

Cleveland Clinic Foundation, Cole Eye Institute, 9500 Euclid Avenue, Cleveland, OH 44195, USA.

Direct browlifting comprises various techniques to lift the brows using incisions on or around the brows. The classic direct browlift involves removing an ellipse of skin and subcutaneous tissue within or just above the brow cilia. However, the technique can be modified to address only lateral brow ptosis, to place the incision in the midforehead or the eyelid crease, and to place the incisions in different areas during bilateral surgery to attempt to improve symmetry. Read More

J Plast Surg Hand Surg 2021 Aug 24:1-7. Epub 2021 Aug 24.

Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

The aim of this study was to produce a Finnish version of the FACE-Q scales Satisfaction with Forehead and Eyebrows, Adverse effects: Forehead, Eyebrows and Scalp, and Adverse effects: Cheeks, Lower face and Neck, and assess the performance of these scales and the Satisfaction with Facial Appearance, Satisfaction with Outcome and Appearance-related Psychosocial Distress in patients who had undergone surgery for functional problems or malignancy affecting the forehead or cheeks. The general health-related outcomes instrument 15 D was used as a reference. Patients who had undergone a frontal lift, a direct brow lift, a facelift or an excision of a facial tumor in Helsinki University Hospital plastic surgery department in 2009-2019 were identified. Read More

Plast Reconstr Surg 2020 11;146(5):565e-568e

From the Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine.

Background: Achieving excellent results in upper lid rejuvenation requires a balanced approach to address skin, muscle, fat, upper lid margin position, and brow aging changes. In the appropriately selected patient, brow lifting plays an essential complement to upper blepharoplasty to restore more youthful upper lid fold-to-pretarsal ratios. The goal of this study is to describe a safe and reproducible method to perform brow lifting and upper blepharoplasty. Read More

Ophthalmic Plast Reconstr Surg 2021 Mar-Apr 01;37(2):179-182

Corneoplastic Unit, Queen Victoria Hospital, East Grinstead, RH19 3DZ, United Kingdom.

Purpose: The direct brow lift is a simple and popular technique, particularly in patients with brow ptosis secondary to facial palsy. It provides a high degree of control in determining the degree of brow elevation and shape achieved. However, it is arguably the least debated in terms of addressing some of its sequelae, namely the risks of a visible or indrawn scar and forehead paraesthesia. Read More

Ophthalmic Plast Reconstr Surg 2021 May-Jun 01;37(3S):S130-S131

Corneoplastic Unit.

The authors present a case series of 4 patients with facial nerve palsy who underwent a direct brow lift to correct brow ptosis, using the excised brow skin as a full-thickness skin graft to correct lower eyelid skin contracture, ectropion, and retraction. Functional outcomes were measured using the validated cornea, static asymmetry, dynamic function, synkinesis (CADS) grading system and by photographic assessment of lower eyelid height via margin reflex distance. Aesthetic outcomes were measured using a published grading scale specific to eyelid skin grafts. Read More

J Ophthalmic Vis Res 2020 Apr-Jun;15(2):218-235. Epub 2020 Apr 6.

Eye and Skull Base Research Centers, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran.

None of brow lift techniques are completely satisfactory because of their limited effectiveness, lack of longevity, and potential complications. The aim of this study was to provide a comprehensive review of the literature on the pros and cons of the most popular techniques in brow and forehead lift. Relevant original articles in the PubMed database (English language) were sought using the search terms "eyebrow lift", "forehead lift", "periorbital rejuvenation", "eyebrow ptosis", "blepharoplasty and eyebrow change", "surgical eyebrow lift", and "non-surgical eyebrow lift", No date limitation was considered. Read More

Plast Reconstr Surg Glob Open 2019 Jun 12;7(6):e2098. Epub 2019 Jun 12.

Northwestern University Feinberg School of Medicine, Division of Plastic and Reconstructive Surgery, Chicago, Ill.

Background: A limited incision lateral brow lift has been described as an alternative to the endoscopic or the bicoronal approaches. The senior author has developed a safe and effective lateral brow lift technique that can be performed in an office setting under local anesthesia.

Methods: We retrospectively reviewed 150 consecutive patients who underwent a brow lift by the senior author (TAM). Read More

J Craniofac Surg 2019 Nov-Dec;30(8):2425-2428

Department of Ophthalmology, Meir Medical Center, Kfar Sava, Israel.

Purpose: Transcutaneous internal browpexy can provide patients with mild-to-moderate lateral brow ptosis, stabilization and modest lift of the lateral brow. Questions regarding effectiveness of this procedure and appropriate indications remain.

Methods: The authors measured consecutive patients who underwent upper eyelid blepharoplasty with transblepharoplasty internal browpexy (TIB) September 2014 to December 2017. Read More

Plast Reconstr Surg Glob Open 2018 Oct 15;6(10):e1943. Epub 2018 Oct 15.

Dallas Plastic Surgery Institute, Dallas, Tex.

Background: Brow lift has been a part of plastic surgeons' armamentarium for over a century. Although there are multiple different techniques available, there has been a dearth of literature comparing which technique is better and has lesser complications. In this study, we performed a systemic literature review of all brow lift techniques to determine and compare complication rates of each technique. Read More

Aesthet Surg J 2019 04;39(5):472-480

The purpose of this article is to describe the necessary steps to correct both primary and postblepharoplasty lateral canthal and lower eyelid malpositions at the time of endoscopic face lifting. Endoscopic surgery is traditionally considered only for brow and forehead lifting. However, in our practice we have successfully expanded the indications of the minimal incision vertical endoscopic lifting technique from being primarily indicated for forehead/brow elevation to also treating both primary and secondary lower eyelid and lateral canthal malpositions. Read More

Can J Ophthalmol 2018 02;53(1):29-33

Maisonneuve-Rosemont Hospital, Montreal, Que.

Objective: To evaluate the effectiveness of a topical silicone gel on scars in patients who had undergone bilateral direct brow lift surgery.

Design: A randomized double-blind clinical trial with a placebo applied to one scar and topical silicone gel (Dermatix Ultra; Valeant Pharmaceuticals, Laval, Que.) used on the other scar for 2 months. Read More

Arch Craniofac Surg 2017 Dec 23;18(4):230-237. Epub 2017 Dec 23.

Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Korea.

Background: The traditional approach for reduction of frontal sinus fractures is coronal incision. Inherent complications of the coronal approach include long scar, hair loss, and long operation time. We describe a simple approach for the reduction of frontal sinus anterior wall fractures using a suprabrow incision that is commonly used for brow lift. Read More

Eplasty 2017 19;17:ic15. Epub 2017 Jun 19.

Division of Plastic Surgery, Department of Surgery, University of South Florida Morsani College of Medicine, Tampa.

Aesthet Surg J 2017 Sep;37(8):863-875

University of Padua, Italy. Private practice in Rome, Italy.

Background: The height of the eyebrow is less crucial aesthetically than is the relationship between the lateral and medial portions of the brow. Although various surgical procedures are effective in raising the brow, the authors maintain that transcutaneous brow shaping (TBS) is the only technique that enables precise shaping of the brow and correction of minor asymmetries.

Objectives: The authors described their experiences with direct TBS alone or in conjunction with blepharoplasty and facelift. Read More

Lasers Surg Med 2016 10 9;48(8):742-747. Epub 2016 Aug 9.

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida 33136.

Purpose: To investigate 1,064 nm long-pulse Nd:YAG laser for postoperative treatment of direct browplasty scars.

Methods: Nine patients who underwent direct browplasty were enrolled in this prospective study. Subjects were randomized to unilateral laser treatment at 2-week intervals for six total treatments, with the contralateral scar used as a control. Read More

J Craniomaxillofac Surg 2016 Aug 24;44(8):958-63. Epub 2016 May 24.

Department of Cranio-Maxillofacial Plastic Surgery, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; Adult Aesthetic and Reconstructive Surgery of the Face at Aneasthesia Center Hamburg at UKE, Hamburg, Germany; Pediatric Facial Plastic Surgery and Craniofacial Anomalies at the Catholic Children's Hospital Wilhelmstift, Hamburg, Germany. Electronic address:

Background: A huge number of procedures for forehead and brow rejuvenation have been described. Nevertheless, the surgical approach of brow aesthetics in terms of correction of brow fullness and symmetry has not been systematically evaluated in the literature. We recently proposed a 20-degree beveled brow incision technique for direct brow lifting. Read More

Indian J Plast Surg 2016 Jan-Apr;49(1):66-71

Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, Rome, Italy.

Context: Brow lifting is an essential element in the rejuvenation of the ageing face. Various surgical techniques have been described. Among these, the direct brow lifting is an easy and effective technique that is often neglected because the scar can remain visible. Read More

Aesthetic Plast Surg 2016 Jun 22;40(3):343-8. Epub 2016 Mar 22.

Institute of Plastic Surgery, Xijing Hospital, FMMU, Changle West Road 127#, Xi'an, 710032, Shaanxi, China.

Background: Direct brow lift surgery remains popular among Asian women despite its disadvantages. The traditional direct brow lift by a supra-brow incision is not suitable for Asian women because of their unique facial features, such as higher eyebrows, wider upper eyelids, and more orbital fat. Therefore, we designed a novel brow lift technique via a supra-brow combined with an infra-brow approach for Asian women. Read More

J Craniofac Surg 2016 Mar;27(2):365-9

*Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, Rome†Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy.

Objectives: The current article is aimed to test the effectiveness of direct and indirect brow lifting to correct brows asymmetry.

Methods: Fifty patients treated with direct brow lift between January of 2011 and January of 2013 were investigated. All patients were men and treated under local anesthesia. Read More

J Dtsch Dermatol Ges 2015 Dec;13(12):1298-301

Department of Dermatology, Venereology, and Allergology, University Medical Center Leipzig, Leipzig, Germany.

Ned Tijdschr Tandheelkd 2014 Oct;121(10):507-15

A prominent characteristic of the aging face is the descent of skin and subcutaneous tissues. In order to reduce this and create a more youthful appearance, several lifting procedures can be employed. In the forehead and eyebrow region the transblepharoplastic brow lift, the direct brow lift, the temporal brow lift, the coronal brow lift and the endoscopic brow lift can be distinguished. Read More

Ann Otol Rhinol Laryngol 2015 Apr 4;124(4):273-9. Epub 2014 Dec 4.

Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA

Objectives: Paralytic lagophthalmos can lead to devastating exposure keratitis. The main surgical intervention consists of upper eyelid loading. However, adjunctive lower eyelid and brow procedures are also available as necessary. Read More

Ophthalmic Plast Reconstr Surg 2015 May-Jun;31(3):182-6

*Department of Ophthalmology, Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan; †Division of Ophthalmology, Section Oculofacial Plastic and Reconstructive Surgery, Ohio University/Doctor's Hospital, Columbus, Ohio; ‡Department of Ophthalmology, Oral and Maxillofacial Surgery, Grant Medical Center, Columbus, Ohio; and §Department of Ophthalmology, Loyola University Health System, Maywood, Illinois, U.S.A.

Purpose: To assess intraoperative blood splatter to the ocular surface and adnexa during oculofacial surgery.

Methods: Four surgeons and multiple assistants at three separate locations wore a total of 331 protective eye shields during 131 surgeries. Postoperatively, a luminol blood detection system was used to identify blood splatter on the shields. Read More

Can J Plast Surg 2013 ;21(3):173-7

Division of Plastic Surgery, Department of Surgery, London Health Sciences Centre, Schulich School of Medicine and Dentistry, Western University, London, Ontario.

Background: Ideal eyebrow aesthetics give a framework for brow rejuvenation and surgical procedures do not always provide satisfying results. Previous studies have shown elevation of the medial brow with aging; however, they failed to characterize overall shape changes.

Objective: To characterize changes in eyebrow slope with increasing age to better direct brow rejuvenation. Read More

Arch Plast Surg 2013 Sep 13;40(5):603-9. Epub 2013 Sep 13.

Department of Plastic and Reconstructive Surgery, Kyungpook National University School of Medicine, Daegu, Korea.

Background: Although the conventional direct brow lift operation provides a simple means of managing lateral brow ptosis, the scars produced have been unacceptable. However, using the modifications proposed here, scarring showed remarkable improvement. This article reviews our experiences with the presented technique, mainly with respect to postoperative scarring. Read More