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BROWPEXY REVISITED
Tancredi D'Amore, MD, David M. Young, M.D., Charlotte Young.
University of California San Francisco, San Francisco, CA, USA.

Purpose
The goal of this study is to quantify the effect of the lateral browpexy in brow position using a standardized method of measurement. The procedure is performed often in conjunction with upper eyelid blepharoplasty to rejuvenate the periorbital area. The goals of the procedure are to correct lateral brow ptosis, stabilize lateral brow to prevent further postoperative descent and to correct lateral hooding.
Methods/Techniques
The technique is performed by supraperiosteal dissection of the lateral suprorbital area and suture fixation of the posterior aspect of the brow to the frontal periosteum, 12 to 14 mm above the supraorbital rim. Preoperative and postoperative photographs were analyzed and standardized measurements were obtained at four points for each brow: the lateral brow, the lateral canthus, the lateral limbus and the medial canthus. The height of the brow was measured as a vertical line perpendicular to the line extending through the medial canthi and was expressed as a percentage of the intercanthal distance. The change in the height of the brow was defined as the difference between the preoperative and postoperative measurements. Fig 1.
Results
From September 2006 to June 2011 88 female patients underwent browpexy, but only 49 had a complete set of photos to be measured from before the operation and three months post-operation. The mean age was 57 (range 42 to 67). The average change in the height of the brow for these 49 patients was +2.4% for the right lateral brow, +1.5% for the right lateral canthus, +1% for the right lateral limbus, +.7% for the right medial limbus, +1.5% for the left medial limbus, +1.7% for the left lateral limbus, +2.2% for the left lateral canthus and +2.6% for the left lateral brow. For each of the four positions, the average change was always positive, meaning an elevation in the brow.
Conclusion
This study concludes that this browpexy procedure elevates the brow more in the lateral portion of the brow compared to the medial portion. As well, this study shows that the results of browpexy can be quantified. Qualitatively, this procedure helps in correcting lateral brow ptosis and lateral hooding. As previously well-described, upper eyelid blepharoplasty alone can result in postoperative descent of the lateral brow and create hooding, a problem this procedure addresses by stabilizing the lateral brow.
Fig 1. Results and location of measurements


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