The use of neuromodulators has grown substantially in our society, particularly in the temporary treatment of brow ptosis. This study revisits the use of the transpalpebral browpexy for upper face and brow rejuvenation in the context of what has been learned from neuromodulators.
A retrospective review of 97 subjects was conducted who had transpalpebral browpexy performed for lateral brow ptosis. Qualitative degree of brow elevation after the procedure was determined by examining before and after photographs for each patient.
Out of 97 patients, 95 (98%) experienced aesthetically optimal brow elevation for their respective gender. Two patients required surgical revision, both of which experienced extenuating circumstances. Two patients experienced edema and one patient experienced periodic eruptions of chalazia along the upper eyelid.
Transpalpebral browpexy is a reliable, minimally invasive surgical procedure that effectively emulates the results of neuromodulator injections for a much longer period of time. While it cannot replace traditional brow-lifting techniques, transpalpebral browpexy does have solid indications with proven long-lasting results, which can be effective in a significant portion of patients with brow ptosis.
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Tower RN, Dailey RA (2004) Endoscopic pretrichial brow lift: surgical indications, technique and outcomes. Ophthal Plast Reconstr Surg 20(4):268–273
Yaremchuk MJ, O’Sullivan N, Benslimane F (2007) Reversing brow lifts. Aesthet Surg J 27(4):367–375
Van Den Bosch W, Leenders I, Mukler P (1999) Topographic anatomy of the eyelids and the effects of sex and age. Br J Ophthamol 83:348–352
Matrox E, Garcia JA, Yaremchuk MJ (2009) Changes in eyebrow shape and position with aging. Plast Reconstr Surg 124(4):1296–1301
Lambros V (2007) Observations on periorbital and midface aging. Plast Reconstr Surg 120:1367–1376
Ahn MS, Catten M, Maas CS (2000) Temporal brow lift using botulinum toxin A. Plast Reconstr Surg 105(3):1129–1135
Sundaram H, Kiripolsky M (2013) Nonsurgical rejuvenation of the upper eyelid and brow. Clin Plast Surg 40(1):55–76
Huilgol SC, Carruthers A, Carruthers JD (1999) Raising eyebrows with botulinum toxin. Dermatol Surg 25(5):373–375 (discussion 376)
Westmore MG (1975) Facial cosmetics in conjunction with surgery. In: Course presented at the Aesthetic Plastic Surgery Society Meeting, Vancouver, British Columbia. May 1975
Ellenbogen R (1983) Transcoronal eyebrow lift with concomitant upper blepharoplasty. Plast Reconstr Surg 71(4):490–499
Gunter JP, Antrobus SD (1997) Aesthetic analysis of the eyebrows. Plast Reconstr Surg 99(7):1808–1816
Matarasso A, Terino EO (1994) Forehead-brow rhytidoplasty: reassessing the goals. Plast Reconstr Surg 93(7):1378–1389
Yalcinkaya E et al (2016) Aesthetic analysis of the ideal eyebrow shape and position. Eur Arch Otorhinolaryngol 273(2):305–310
Freund RM, Nolan WB (1996) Correlation between brow lift outcomes and aesthetic ideals for eyebrow height and shape in females. Plast Reconstr Surg 97(7):1343–1348
McCord CD, Doxanas MT (1990) Browplasty and browpexy: an adjunct to blepharoplasty. Plast Reconstr Surg 86(2):248–254
Niechajev I (2004) Transpalpebral browpexy. Plast Reconstr Surg 113(7):2172–2180 (discussion 2181)
La Passot R (1919) chururgie esthetique dew rides du visage. Presse Med 27:258
Hunt HL (1926) Plastic surgery of the head, face, and neck. Lea & Febiger, Philadelphia
Gonzalez-Ulloa M (1962) Facial wrinkles: integral elimination. Plast Reconstr Surg 29:658
Paul MD (1989) The surgical management of upper eyelid hooding. Aesthetic Plast Surg 13:183
Isse NG (1992) Endoscopic forehead lift. In: Presented at the annual metting of the Los Angeles County Society of Plastic Surgeons, Los Angeles, September 12, 1992
Vasconez LO (1992) The use of the endoscope in brow lifiting. In: A video presentation at the annual meeting of the American Society of Plastic and Reconstructive Surgeons, Washington, DC, 1992
Ramirez OM (2001) Anchor subperiosteal forehead lift: from open to endoscopic. Plast Reconstr Surg 107(3):868–871
Friedland JA, Jacobsen WM, TerKonda S (1996) Safety and efficacy of combined upper blepharoplasties and open coronal browlift: a consecutive series of 600 patients. Aesthetic Plast Surg 20(6):453–462
Chiu ES, Baker DC (2003) Endoscopic brow lift: a retrospective review of 628 consecutive cases over 5 years. Plast Reconstr Surg 112:628
Butz DR, Gill KK, Randle J, Kampf N, Few JW (2016) Facial aesthetic surgery: the safe use of oral sedation in an office-based facility. Aesthet Surg J 36(2):127–131
Few J Jr, Marco E (2012) Blepharoplasty. Plast Surg, 3rd ed., vol. 2. Edinburgh: Saunders, pp 108–137
Odunze M, Rosenberg DS, Few JW (2008) Periorbital aging and ethnic considerations: a focus on the lateral canthal complex. Plast Reconstr Surg 121(3):1002–1008
The authors declare that they have no conflicts of interest to disclose. We would like to thank our summer intern, Shikhar Singh Tomur, for maintaining the research database and helping with data collection for this project.
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Ogilvie, M.P., Few, J.W., Semersky, A.J. et al. What Neurotoxins Have Taught Us About the Brow: The Reintroduction and Review of the Transpalpebral Browpexy. Aesth Plast Surg 42, 126–136 (2018). https://doi.org/10.1007/s00266-017-0988-7
- Transpalpebral browpexy
- Brow lift
- Coronal brow lift
- Pretrichial brow lift
- Open brow lift
- Endoscopic brow lift