Direct brow lifting: Specific indications for a simplified approach to eyebrow ptosis.
BACKGROUND
Brow lifting is an essential element in the rejuvenation of the ageing face. Various surgical techniques have been described. Among these, the direct brow lifting is an easy and effective technique that is often neglected because the scar can remain visible. Thus, this approach is usually reserved for elderly patients and males, with thick bushy brows.


OBJECTIVE
The authors present their result from a series of fifty consecutive patients treated over 2 years with direct brow lift. The aim is to demonstrate when the hairline is high or temporal alopecia is present and whether this technique is the best in bald patients, when some surgical steps are carefully adhered to. In these cases, the scar is less visible, hidden in the brow and is a good solution in women too.


METHODS
Between January 2011 and January 2013, fifty patients underwent direct brow lift surgery. All were men. In all the cases, brow lifting was undertaken together with an upper blepharoplasty. The amount of brow elevation produced was assessed by comparing the vertical distances between the superior eyebrow hairline and the inter-pupillary line, pre- and post-operatively. The result and the scar quality were assessed both by the patient and the surgeon.


METHODS
The paired t-test.


RESULTS
The authors obtained statistically significant results in brow elevation in 98% of the patients after a 12-month follow-up. The main complication associated with this procedure was visibility of the scar in two patients.


CONCLUSIONS
The direct brow lift technique in bald men and with a high anterior hairline provides excellent and long-lasting results.
Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, Rome, Italy.
Michele
M
Pascali
Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, Rome, Italy.
Ilaria
I
Bocchini
Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy.
Anna
A
Avantaggiato
Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy.
Francesco
F
Carinci
Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, Rome, Italy.
Valerio
V
Cervelli
Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, Rome, Italy.
Fabrizio
F
Orlandi
Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, Rome, Italy.
Davide
D
Quarato
Brow asymmetry; brow lift; brow ptosis; men; periorbital rejuvenation