Lateral Brow Lift: A Multi-Point Suture Fixation Technique

Abstract

BackgroundDescent of the lateral aspect of the brow is one of the earliest signs of aging. The purpose of this study was to describe an open surgical technique for lateral brow lifts, with the goal of achieving reliable, predictable, and long-lasting results.MethodsAn incision was made behind and parallel to the temporal hairline, and then extended deeper through the temporoparietal fascia to the level of the deep temporal fascia. Dissection was continued anteriorly on the surface of the deep temporal fascia and subperiosteally beyond the temporal crest, to the level of the superolateral orbital rim. Fixation of the lateral brow and tightening of the orbicularis oculi muscle was achieved with the placement of sutures that secured the tissue directly to the galea aponeurotica on the lateral aspect of the incision. An additional fixation was made between the temporoparietal fascia and the deep temporal fascia, as well as between the temporoparietal fascia and the galea aponeurotica. The excess skin in the temporal area was excised and the incision was closed.ResultsA total of 519 patients were included in the study. Satisfactory lateral brow elevation was obtained in most of the patients (94.41%). The following complications were observed: total relapse (n=8), partial relapse (n=21), neurapraxia of the frontal branch of the facial nerve (n=5), and limited alopecia in the temporal incision (n=9).ConclusionsWe consider this approach to be a safe and effective procedure, with long-lasting results.

Fox Eye Effect Using a Transcutaneous Mini-Eyebrow Tail Lift

“…These complications ended up motivating the development of less invasive techniques, whether endoscopic or with smaller incisions. 19,20…”

“…Sensitivity alterations can also occur, and the cost of the equipment used is high, making the procedure more expensive, which has also led surgeons to seek other alternatives. 19-21…”

Subcutaneous lateral brow lift (“Z-lift”)

“…The main advantage of our method lies in the easy planning and in the versatility of the applied vector lines in comparison to the traditional temporal sub-fascial brow lift. The incidence of publications about anchor systems shows a necessity for a reliable technique, if possible, just using re-absorbable simple sutures [ 29 ], [ 30 ], [ 31 ], [ 32 ], [ 33 ], [ 34 ], [ 35 ], [ 36 ], [ 37 ], [ 38 ], [ 39 ], [ 40 ], [ 41 ]. In the subcutaneous layers, we expect a far better long time adhesion compared to the sub-fascial plane.…”

Evaluation of Endoscopic and Trans-Blepharoplasty Approaches for Brow Lifting

“…1 The definition of an ideal eyebrow may seem impossible, yet criteria for eyebrow position to look younger and attractive includes that the eyebrow should start medially at a line extending upwards from nasal ala passing through medial canthus, then curve upwards and laterally and peaks at a line extending above the lateral limbus, at that point the lateral third starts. 2 These criteria must be adjusted to suite the difference in face shape, gender, age, ethnicity, and many other facial features. Nevertheless, there is a general agreement on the relationship between the eyebrow and the bony orbit, as for females the eyebrow lies and arch just above the supraorbital rim, while in males the eyebrow lies directly over the supraorbital rim.…”