Published in:
29-07-2023 | Ptosis | Original Paper
Modification of temporal brow lift procedure with transillumination
Published in: European Journal of Plastic Surgery | Issue 6/2023
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Background
Ptosis causes an extra folding of tissues lateral to the eyebrows. Different techniques aimed to correct this with varying outcomes and limitations. We analyzed the long-term results of an office-based technique for deep-plane subgaleal lift under local anesthesia and assessed patient satisfaction.
Methods
We retrospectively analyzed the long-term outcome of a modified temporal brow lift technique in patients with lateral eyebrow ptosis. The incision lines were marked 3–5 mm behind the temporal lines, and then at the deep temporal fascia layer was dissected. The three key steps in the procedure included (1) detecting the sentinel vein by transillumination; (2) cutting the lateral orbital ligament; and (3) releasing the superior temporal septum by blunt and sharp dissections. Finally, the tissues were fixed to the deep temporal fascia. After 1 and 12–15 months, the distance between the lateral brow and lateral canthus was measured.
Results
We operated on 44 Iranian women (ranging from 28 to 51 years) between 2019 and 2021. The mean post-surgical brow elevation was 11.5 mm (95% CI 10.8–12.2; 133.4% improvement) after 1 month and 7.2 mm (6.4–8.1; 88.2% improvement) after 12–15 months. Minor complication (i.e., the stitch abscess) was observed in 6.8% of patients (three patients). Major complications included a complete relapse (two patients; 4.5%) and alopecia (one patient; 2.3%). Overall, 88.6% of patients (39 patients) were satisfied with the outcome.
Conclusions
Lateral brow ptosis could be corrected with a modified temporal lift technique using transillumination for the detection of the sentinel vein and preservation of the temporal branch of the facial nerve. The durability of this procedure could be enhanced with a complete release of septal adhesions and proper fixations.
Level of evidence: level IV, therapeutic study.