The direct brow lift: efficacy, complications, and patient satisfaction

Abstract

Background/aims: The direct brow lift operation can be used to treat brow ptosis arising from either involutional changes or facial nerve palsy. The authors reviewed their experience with this operation to establish its efficacy and complication rate in the light of concerns over poor scar cosmesis and forehead paraesthesiae in the postoperative period. Methods: A retrospective review of patients undergoing direct brow lifting from 1989 to 2002 was conducted, and information gained on patient satisfaction by questionnaire. Results: The direct brow lift operation was found to give a predictable outcome, with high levels of patient satisfaction. With careful wound closure, postoperative scars are rarely cosmetically unacceptable to the patient. Paraesthesiae are a common but well tolerated sequelae. Conclusions: The direct brow lift was found to be a reliable method for treating brow ptosis arising through involutional change or facial nerve palsy in both men and women. The postoperative scars may be more evident in younger patients so the authors reserve this technique for ''rehabilitative'' rather than cosmetic brow lifts in patients of middle age and beyond.

Aesthetic analysis of the ideal eyebrow shape and position

“…Endoscopic methods of brow lifting have comparable success rates to open coronal lifting, but a significantly lower incidence of complications and a faster rehabilitation time [26]. Withey et al [27] reported the complications of endoscopic techniques as postoperative numbness, itching, hair loss, tissue swelling and asymmetry.…”

“…This technique is not appropriate for those patients with a high hairline or those with thinning hair. There are numerous potential complications following this procedure including sensory and motor nerve dysfunction, skin necrosis, permanent overcorrection, alopecia, abnormal soft tissue contour, and eyebrow and eyelid asymmetry [26].…”

“…For a soft, aesthetically pleasing result, it is important to avoid overcorrection of the brow position and excessive elevation of the medial brow. Numerous browlift techniques have been defined, including the coronal lift, the endoscopic brow lift, the pretrichial lift, the midforehead lift, the direct browlift and the internal browlift [26].…”

Free Dermal Fat Graft Reconstruction of the Head and Neck: A Cosmetically Appealing Reconstructive Option

“…Patients were asked to rate the success of their operations across four dimensions using a novel grading scale similar to others used in the literature to assess postoperative facial cosmesis 4 .…”

Lacrimal drainage obstruction and dacryocystorhinostomy in children

“…Previous reports have also found surgical skin scars at other sites to be less prominent in elderly patients, when compared with younger patients. 37,38 There are some limitations for the present study. The need for revision was highest in patients not undergoing silicone stent placement.…”