Facial Plast Surg 2018; 34(01): 036-042
DOI: 10.1055/s-0037-1617422
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Management of the Heavy Brows: Long-Term Surgical Options

Olga Plowes Hernandez
1   Department of Facial Plastic Surgery, Cirugia Plastica Facial, Mexico, Ciudad de Mexico, Mexico
,
Jose Juan Montes Bracchini
1   Department of Facial Plastic Surgery, Cirugia Plastica Facial, Mexico, Ciudad de Mexico, Mexico
› Author Affiliations
Further Information

Publication History

Publication Date:
06 February 2018 (online)

Abstract

One of the first signs of aging belongs to the upper third of the face. With the aging process, mestizo facial features become more prominent. The thicker skin-soft tissue envelope (S-STE) has a tendency to sag more, hooding of the eyelids tends to be more pronounced, and there is a tendency for eyebrows to droop, specifically the tail of the brows, because of the loss of support. A “tired” or “sad” look implies that the complex eyebrow-upper eyelid is showing one or more of these signs. Different surgical as well as non-surgical techniques have been described to treat this area, every one of them aiming at making the patient look rested and natural. The objective of this study is to describe a technique for endoscopic brow lifting, consisting on minimal incisions, a biplanar dissection, and a different fixation technique designed for helping reshape the brow. This particular surgical technique has shown the advantage of being minimally invasive and effective. Careful analysis of the patient should be made to decide both the technique and the changes desired by the patient and the surgeon. The authors believe the technique described is another option for approaching and fixating the heavy eyebrows in mestizo patients.

 
  • References

  • 1 Sugiyama-Nakagiri Y, Sugata K, Hachiya A, Osanai O, Ohuchi A, Kitahara T. Ethnic differences in the structural properties of facial skin. J Dermatol Sci 2009; 53 (02) 135-139
  • 2 Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol 1988; 124 (06) 869-871
  • 3 Miller PJ, Wang TD, Cook TA. Rejuvenation of the aging forehead and brow. Facial Plast Surg 1996; 12 (02) 147-155
  • 4 Montagna W, Carlisle K. Structural changes in ageing skin. Br J Dermatol 1990; 122 (Suppl. 35) 61-70
  • 5 Bolognia JL. Dermatologic and cosmetic concerns of the older woman. Clin Geriatr Med 1993; 9 (01) 209-229
  • 6 Adamson PA, Johnson Jr CM, Anderson JR, Dupin CL. The forehead lift. A review. Arch Otolaryngol 1985; 111 (05) 325-329
  • 7 Keller GS. Endoscopic facial plastic surgery. In: Keller GS, Hucherson R. , eds. Endoscopic Forehead and Brow Lift. St. Louis: Mosby'; 1997: 49-81
  • 8 Cobo R, García CA. Aesthetic surgery for the Mestizo/Hispanic patient: special considerations. Facial Plast Surg 2010; 26 (02) 164-173
  • 9 Adamson PA, Cormier R, McGraw BL. The coronal forehead lift--modifications and results. J Otolaryngol 1992; 21 (01) 25-29
  • 10 Cook TA, Brownrigg PJ, Wang TD, Quatela VC. The versatile midforehead browlift. Arch Otolaryngol Head Neck Surg 1989; 115 (02) 163-168
  • 11 Oh SH, Lee Y, Seo YJ. , et al. The potential effect of botulinum toxin type A on human dermal fibroblasts: an in vitro study. Dermatol Surg 2012; 38 (10) 1689-1694
  • 12 Bonaparte JP, Ellis D. Alterations in the elasticity, pliability, and viscoelastic properties of facial skin after injection of onabotulinum toxin A. JAMA Facial Plast Surg 2015; 17 (04) 256-263
  • 13 Core GB, Vasconez LO, Graham III HD. Endoscopic browlift. Clin Plast Surg 1995; 22 (04) 619-631
  • 14 Ramirez OM. Endoscopic techniques in facial rejuvenation: an overview. Part I. Aesthetic Plast Surg 1994; 18 (02) 141-147
  • 15 Foustanos A, Drimouras G, Panagiotopoulos K. Lateral brow lift: a multi-point suture fixation technique. Arch Plast Surg 2015; 42 (05) 580-587
  • 16 Graham III HD, Khoury EP. Preoperative analysis, diagnosis, and evaluation of the forehead and brow. Facial Plast Surg Clin North Am 2003; 11 (03) 319-326
  • 17 Parisis J. Eyebrow lift techniques. In: Cobo R. , ed. Ethnic Considerations in Facial Plastic Surgery. New York, NY: Thieme Medical Publishers; 2016: 96-102
  • 18 Plowes Hernandez O, Montes-Bracchini JJ, Ulloa FL, LaFerriere K. Endoscopic Brow Elevation and Reshaping. Facial Plast Surg 2016; 32 (06) 607-614
  • 19 Elkwood A, Matarasso A, Rankin M, Elkowitz M, Godek CP. National plastic surgery survey: brow lifting techniques and complications. Plast Reconstr Surg 2001; 108 (07) 2143-2150 , discussion 2151–2152
  • 20 Puig CM, LaFerriere KA. A retrospective comparison of open and endoscopic brow-lifts. Arch Facial Plast Surg 2002; 4 (04) 221-225
  • 21 Cobo R. Trends in facial plastic surgery in Latin America. Facial Plast Surg 2013; 29 (03) 149-153
  • 22 Biller JA, Kim DW. A contemporary assessment of facial aesthetic preferences. Arch Facial Plast Surg 2009; 11 (02) 91-97