title: Complications of browlift techniques: a systematic review.
abstract: BACKGROUND
  There is ongoing debate over which surgical technique is the safest for brow elevation.
  
  
  OBJECTIVE
  The authors outline complication rates for a variety of open and endoscopic browlift techniques based on the results of a literature review.
  
  
  METHODS
  The following databases were searched to capture relevant studies: MEDLINE, EMBASE, CINAHL, LILACS, Web of Science, Cochrane Libraries, controlled-trials.com, and clinicaltrials.gov. Eighty-two studies met the inclusion criteria. Assuming between-study heterogeneity due to the limitations and biases inherent to case series, a random-effects model was used to calculate weighted proportions. Pooled weighted proportions with 95% confidence intervals were determined.
  
  
  RESULTS
  All open and endoscopic procedures are associated with a variety of complications. Unacceptable scarring and paresthesia are the most common complications among all surgical browlifts. For anterior hairline incision with subcutaneous dissection, alopecia occurred in 8.5% of patients, paresthesia in 5.4%, unacceptable scarring in 2.1%, and skin necrosis in 1.8%. For coronal incision with subgaleal dissection, unacceptable scarring occurred in 3.6% of patients, hematoma in 0.5%, and infection in 0.2%. Endoscopic techniques with subperiosteal dissection had the highest complication rates: 6.2% for paresthesia, 3.6% for asymmetry, 3.0% for alopecia, and 2.7% for lagophthalmos.
  
  
  CONCLUSIONS
  Although complication rates vary with respect to incision site and plane of dissection, endoscopic techniques are associated with a larger variety of complications than open approaches. The findings should be interpreted with caution due to the limitations inherent to a case series. A well-designed comparative study is needed to evaluate the "true" rate of complications among the various browlift techniques.
authors: Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors: Stephanie
authors: S
authors: Byun
authors: Ilya
authors: I
authors: Mukovozov
authors: Forough
authors: F
authors: Farrokhyar
authors: Achilles
authors: A
authors: Thoma
mesh_terms: D002921:Cicatrix / Q000453:epidemiology / Q000209:etiology; D004724:Endoscopy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D010292:Paresthesia / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012060:Rejuvenation; D015361:Rhytidoplasty / Q000009:adverse effects* / Q000379:methods