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Aesthetic Plastic Surgery

, Volume 38, Issue 1, pp 27–31 | Cite as

Subbrow Blepharoplasty Using Supraorbital Rim Periosteal Fixation

  • Yeon Soo KimEmail author
Original Article Aesthetic

Abstract

Background

Subbrow blepharoplasty (SBB) addresses lateral hooding of the upper eyelid skin, a shortcoming of classical upper blepharoplasty. Therefore, SBB is widely used by plastic surgeons in Korea and Japan. The aim of this study is to improve postoperative results and to minimize a relapse of existing SBB by the use of a supraorbital rim periosteal suture fixation technique.

Methods

An upper incision is made along the inferior margin of the eyebrow. A lower incision, which is determined according to necessary amount of skin excision, is made vertically, deep to the posterior fascia of the obicularis oculi muscle (OOM). Then, skin, OOM, and posterior fascia of the OOM are excised en bloc. An upper skin flap dissection is extended to the width of 1 cm. The posterior fascia of the OOM in the inferior flap is pulled up and three transverse 5–0 nylon sutures are placed to fix it to the periosteum and the sub-brow fat of the supraorbital rim temporally to the supraorbital nerve. A margin of upper flap level is usually a suitable position for fixation. Thirty-six patients underwent SBB using the supraorbital rim periosteal suture fixation technique from July 2007 to June 2012.

Results

Thirty-six patients underwent SBB and were followed up for an average of 27 months. The follow-up period ranged from 8 months to 6 years. Their mean age at the time of surgery was 55 years. Thirty-four patients (94.4 %) were satisfied with the surgical results, however, two patients (5.6 %) complained about dimpling at the periosteal suture fixation point. Administration of two focal injections of triamcinolone acetonide resulted in relief and disappearance of the dimpling.

Conclusion

We report our experience with a subbrow blepharoplasty using suture fixation of the OOM in the inferior flap to the supraorbital rim periosteum at the margin of the upper flap after an elliptical excision of subbrow skin. Our method of SBB has the advantage of ensuring the continuance of surgical results and minimizing the risk of relapse by placement of suraorbital rim periosteal fixation sutures.

Level of evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266.

Keywords

Blepharoplasty Suture technique Eyebrow 

Notes

Acknowledgments

The author wishes to thank Professor Kun Hwang, Department of Plastic Surgery, Inha University School of Medicine, for his kindness in reviewing this manuscript and Ji Young Lee, RN, Department of Plastic Surgery, Inha University Hospital for her illustrations.

Conflicts of interest

The author declares that there is no conflicts of interest to disclose.

References

  1. 1.
    Lee D (2009) Subbrow blepharoplasty for upper eyelid rejuvenation in Asians. Aesthet Surg J 29(4):284Google Scholar
  2. 2.
    Kunjur J, Sabesan T, Ilankovan V (2006) Anthropometric analysis of eyebrows and eyelids: an inter-racial study. Br J Oral Maxillofac Surg 44:89–93PubMedCrossRefGoogle Scholar
  3. 3.
    Kim JH, Lee IJ, Park MC, Lim H, Lee SH (2012) Aesthetic blepharoptosis correction with release of fibrous web bands between the levator aponeurosis and orbital fat. JCraniofac Surg, doi:  10.1097/SCS.0b013e3182418d1a
  4. 4.
    Yuzuriha S, Matsuo K, Kushima H (2000) An anatomical structure which results in puffiness of the upper eyelid and a narrow palpebral fissure in the Mongoloid eye. Br J Plast Surg 53(6):466–472PubMedCrossRefGoogle Scholar
  5. 5.
    Parkes ML, Kamer FM, Merrin ML (1976) Infrabrow lift. laryngoscope 86(12):1869–1872PubMedGoogle Scholar
  6. 6.
    Kim YS, Roh TS, Yoo WM, Tark KC, Kim J (2008) Infrabrow excision blepharoplasty: applications and outcomes in upper blepharoplasty in Asian woman. Plast Reconstr Surg 122(4):1199–1205PubMedCrossRefGoogle Scholar
  7. 7.
    Ichinose A, Sugimoto T, Sugimoto I, Ishinagi H, Kuwazuru K, Nagai K, Tahara S (2011) Extended infrabrow excision blepharoplasty for dermatochalasis in asians. Arch Facial Plast Surg 13(5):327–331PubMedCrossRefGoogle Scholar
  8. 8.
    Lee SH (2009) Upper lid lift with browpexy. In: Cosmetic and reconstructive oculoplastic surgery, 3rd edn. Gunja, Seoul, pp 269–278Google Scholar
  9. 9.
    Flowers RS (1987) The art of eyelid and orbital aesthetics: multiracial surgical consideration. Clin Plast Surg 14:703–721PubMedGoogle Scholar
  10. 10.
    Hin LC (1981) Oriental blepharoplasty—a critical review of technique and potential hazards. Ann Plast Surg 7:362–374PubMedCrossRefGoogle Scholar
  11. 11.
    Carraway J, Dean JA (1992) The brow slide: a technique for the aesthetic treatment of eyebrow tumors. Plast Reconstr Surg 89(3):554–557PubMedCrossRefGoogle Scholar
  12. 12.
    Hwang K, Kim YJ, Chung IH (2004) Innervation of the corrugator supercilii muscle. Ann Plast Surg 52(2):140–143PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2013

Authors and Affiliations

  1. 1.Department of Plastic SurgeryInha University School of MedicineIncheonKorea

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