Akademik Veri Yönetim Sistemi
ESPRAS 2022, Porto, Portekiz, 4 - 07 Ekim 2022
CHANGE OF THE EYEBROW
POSITION AFTER UPPER BLEFAROPLASTY WITH OR WITHOUT INTERNAL BROWPEXY
Introduction: While upper blepharoplasty is one
of the most common aesthetic procedures to treat dermatochalasis, it can be combined with browpexy for better results
in cases where there are drooping eyebrows or where the brow arch will be
displaced downwards after skin excision. Browpexy can be performed with direct
skin excision above the eyebrows, with endoscopic or non-endoscopic temporal-coronal
approaches, with suture suspension techniques, or internally via upper blepharoplasty
incision. In this study, change of the eyebrow position after upper
blefaroplasty with or without internal browpexy will be evaluated with pre- and
post-operative photographs.
Methods: Patients who underwent upper
blepharoplasty at Dokuz Eylul University Hospital between 2018 and 2022 were
evaluated retrospectively. Female patients who had pre- and post-operative
photographs suitable for digital evaluation and did not have any additional
cosmetic procedures resulting in the postoperative eyebrow position and shape to
change were identified. As a result, a total of 20 patients were chosen, of
which 10 had upper blepharoplasty only and 10 had upper blepharoplasty combined
with internal browpexy. The pre- and post-operative photographs were evaluated
using the ImageJ program. At the midpupillary and lateral canthus levels, distances
of the upper border of the eyebrow to interpupillary reference horizontal plane
were proportionally compared for both eyelids. Through evaluation of both
eyelids, 20 data could be obtained for each criteria. According to the data
obtained, the proportional change of eyebrow height in cases of upper
blepharoplasty with or without internal browpexy was revealed
Results: The first group, which only underwent
upper blepharoplasty operation, consisted of 10 patients, all female, with a
mean age of 49.1 (40-59). The second group, which underwent upper
blepharoplasty and internal browpexy, consisted of 10 patients, all female,
with a mean age of 54.5 (42-75). The change at the midpupillary level of the
distance between the upper eyebrow border and the horizontal plane drawn
between the pupils was determined as an 8.35% decrease in the 1st group and a
4.38% increase in the 2nd group. At the lateral canthus level, this change was a
8.93% decrease in the 1st group and a 5.98% increase in the 2nd group.
Discussion:
In cases of
dermatochalasis accompanied by droopy eyebrows, only blepharoplasty procedure may
cause a shortening of the distance between the eyebrow and the upper eyelid
groove and an unaesthetic appearance. In addition, eyebrow stabilization may be
required in some cases, even if there is no significant drooping of the eyebrow
due to the downward displacement of the eyebrow arch with the blepharoplasty. Internal
browpexy is actually an easy-to-apply technique that provides stabilization of
the eyebrow after skin excision and a small amount of elevation in the lateral
eyebrow, rather than a complete eyebrow lift. Although the dimple effect is not
expected because it is performed in the deep plane, it can be observed
temporarily in patients with thin tissue. Frontal nerve damage or entrapment,
another rare but important complication, is also expected to be temporary. The
negative aspects of the technique can be considered as the reduction of
dynamism due to fixation of the lateral eyebrow to the periosteum and the less
than expected eyebrow elevation effect.
Dokuz Eylul University Hospital, Izmir/Turkey
Plastic, Reconstructive and Aesthetic Surgery
Departmant