Proposing A New Objective Grading Scale To Assess Outcomes Of Different Techniques In Brow-lift Surgery: A 15-year Experience Of Over 200 Patients At A Single Institution
Jeremie Oliver, BA, Ali Charafeddine, MD, Uldis Bite, MD, Samir Mardini, MD.
Mayo Clinic, Rochester, MN, USA.
PURPOSE: The purpose of this study was to compare operative outcomes of multiple different brow-lift surgical approaches utilizing novel objective measurements longitudinally before and after surgical intervention.
METHODS: All patients who underwent brow lift surgery (endoscopic or open) between 2002 and 2017 were retrospectively reviewed. Objective measurements of medial brow(ANGLE A), mid-lateral brow (ANGLE B; at the level of the lateral limbus), and lateral brow (ANGLE C) vectors in relation to the middle point of Cupid's bow were recorded for all patients by retrospective review of preoperative and postoperative images at different time points to evaluate longevity of objective outcomes (pre-operatively, 1-week postoperatively, then 4-to-6-months, 1-year, and 2-years postoperatively) for all patients with postoperative images taken at these time points.
RESULTS: The complication rate for patients undergoing open brow-lift procedures was 4.4%, while the endoscopic brow-lift procedurehad a complication rate of 5.2%, which did not demonstrate a statistically significant difference. Open procedures were associated with a significantly greater increase in Angle B (p=0.0031) and Angle C (p=0.001) measurements immediately following brow-lift surgery compared to endoscopic. Statistically significant shifts in Angle C (p<0.0001) and Angle B (p<0.0001) positions were found when comparing preoperative angles to postoperative angles following brow-lift surgery at all time points selected in this study.
CONCLUSION: There may be substantial utility in pre- and post-operative objective analysis particularly of the middle and lateral brow in relation to Cupid's bow as a mechanism for pre-operative planning and longitudinal tracking of post-operative functional and aesthetic outcomes in brow-lift surgery.
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