Abstract
There are a number of adjunctive procedures to upper lid blepharoplasty that can be performed via the upper eyelid blepharoplasty incision at the same setting to improve eyelid appearance, brow position and contour, and reduce glabellar rhytids. These include internal brow sculpting and elevation, glabellar myectomy, and lacrimal gland repositioning. Eyebrow ptosis is an important and frequent finding in facial plastic surgery patients, commonly coexisting with dermatochalasis and blepharoptosis. Blepharoplasty and eyelid ptosis repair performed alone, in the presence of significant brow ptosis, can result in further lowering of brow position with negative functional and cosmetic consequences. Internal brow sculpting and elevation, while not as effective as other forms of formal eyebrow lifting, is a convenient way to elevate/stabilize a ptotic brow without the need for additional incisions. Glabellar myectomy is another adjuvant procedure that can be performed through the same upper eyelid incision. The procedure removes the medial brow depressors, allowing the frontalis muscle to more effectively elevate the medial and central brow. In addition, the procedure effectively reduces dynamic vertical glabellar rhytids and dramatically improves the migraine and the tension type headaches that originate in this area. Finally, repositioning a prolapsed lacrimal gland by resecuring it to the lacrimal gland fossa is also a useful procedure that can be performed at the time of blepharoplasty via the same incision. It effectively reduces the temporal fullness present in patients with a dislocated lacrimal gland.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Rafaty FM, Goode RL, Abramson NR. The brow-lift operation in a man. Arch Otolaryngol. 1978;104(2):69–71.
Standring S. Gray’s anatomy: the anatomical basis of clinical practice. 39th ed. Philadelphia: Churchill Livingstone; 2004. ISBN ISBN-10: 0443071683.
Georgescu D, Anderson RL, McCann JD. Brow ptosis correction: a comparison of five techniques. Facial Plast Surg. 2010;26(3):186–92.
Johnson Jr CM, Anderson JR, Katz RB. The brow-lift 1978. Arch Otolaryngol. 1979;105(3):124–6.
Goldstein SM, Katowitz JA. The male eyebrow: a topographic anatomic analysis. Ophthal Plast Reconstr Surg. 2005;21(4):285–91.
McCord CD, Doxanas MT. Browplasty and browpexy: an adjunct to blepharoplasty. Plast Reconstr Surg. 1990;86(2):248–54.
Lemke BN, Stasior OG. The anatomy of eyebrow ptosis. Arch Ophthalmol. 1982;100(6):981–6.
Knize DM. An anatomically based study of the mechanism of eyebrow ptosis. Plast Reconstr Surg. 1996;97(7):1321–33.
Presti P, Yalamanchili H, Honrado CP. Rejuvenation of the aging upper third of the face. Facial Plast Surg. 2006;22(2):91–6. Review.
Burroughs JR, Bearden WH, Anderson RL, McCann JD. Internal brow elevation at blepharoplasty. Arch Facial Plast Surg. 2006;8(1):36–41.
Michelow BJ, Guyuron B. Rejuvenation of the upper face. A logical gamut of surgical options. Clin Plast Surg. 1997;24(2): 199–212.
Levine MR. Manual of oculoplastic surgery. 3rd ed. Philadelphia: Butterworth Heinemann; 2003.
Tyers AG. Brow lift via the direct and trans-blepharoplasty approaches. Orbit. 2006;25(4):261–5. Review.
Walden JL, Orseck MJ, Aston SJ. Current methods for brow fixation: are they safe? Aesthet Plast Surg. 2006;30(5):541–8.
McKinney P, Mossie RD, Zukowski ML. Criteria for the forehead lift. Aesthet Plast Surg. 1991 Spring;15(2):141–7.
Pedroza F, dos Anjos GC, Bedoya M, Rivera M. Update on brow and forehead lifting. Curr Opin Otolaryngol Head Neck Surg. 2006;14(4):283–8. Review.
May Jr JW, Fearon J, Zingarelli P. Retro-orbicularis oculus fat (ROOF) resection in aesthetic blepharoplasty: a 6-year study in 63 patients. Plast Reconstr Surg. 1990;86(4):682–9.
Morley AM, Malhotra R. Subconjunctival prolapse of the palpebral lobe of the lacrimal gland occurring in association with occult orbital fat herniation. Orbit. 2009;28(6):430–2.
Jordan DR, Germer BA, Anderson RL, Morales L. Lacrimal gland prolapse in craniosynostosis syndromes and poor function congenital ptosis. Ophthal Surg. 1990;21:97–101.
Beer GM, Kompatscher P. A new technique for the treatment of lacrimal gland prolapse in blepharoplasty. Aesthet Plast Surg. 1994 Winter;18(1):65–9.
Cook Jr BE, Lucarelli MJ, Lemke BN. Depressor supercilii muscle: anatomy, histology, and cosmetic implications. Ophthal Plast Reconstr Surg. 2001;17(6):404.
Bearden WH, Anderson RL. Corrugator superciliaris muscle excision for tension and migraine headaches. Ophthal Plast Reconstr Surg. 2005;21(6):418–22.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Georgescu, D., Belsare, G., McCann, J.D., Anderson, R.L. (2011). Adjunctive Procedures in Upper Eyelid Blepharoplasty: Internal Brow Fat Sculpting and Elevation, Glabellar Myectomy, and Lacrimal Gland Repositioning. In: Massry, G., Murphy, M., Azizzadeh, B. (eds) Master Techniques in Blepharoplasty and Periorbital Rejuvenation. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0067-7_10
Download citation
DOI: https://doi.org/10.1007/978-1-4614-0067-7_10
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-0066-0
Online ISBN: 978-1-4614-0067-7
eBook Packages: MedicineMedicine (R0)