What Neurotoxins Have Taught Us About the Brow: The Reintroduction and Review of the Transpalpebral Browpexy

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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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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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Correspondence to Julius Warren Few Jr..

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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).

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  • Transpalpebral browpexy
  • Browpexy
  • Brow lift
  • Coronal brow lift
  • Pretrichial brow lift
  • Open brow lift
  • Endoscopic brow lift
  • Neurotoxin
  • Neuromodulator