title: Objective Brow Height Measurements Following Pretrichial Brow Lift and Upper Lid Blepharoplasty.
abstract: BACKGROUND
  As the ptotic brow drops below the supraorbital rim, it can exacerbate dermatochalasis by pushing the adjacent skin of the upper lid further down.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the outcomes associated with a combined pretrichial brow lift and upper lid blepharoplasty in patients with dermatochalasis and mild to moderate brow ptosis.
  
  
  METHODS
  A retrospective case series of 46 patients with dermatochalasis and mild to moderate brow ptosis treated with a combined, bilateral pretrichial brow lift and upper lid blepharoplasty from January 2008 to December 2011. Main outcome measures included measurements of brow lift at 3 months post-operatively, complications encountered, patient satisfaction and surgeon satisfaction.
  
  
  RESULTS
  Outcomes from 46 patients were evaluated. The mean brow lift was 1.85 mm at the lateral canthus, 1.54 mm at the lateral limbus, 1.31 mm at the mid-pupil, and 1.07 mm at the medial limbus. Brow lift at the lateral canthus was significantly more elevated than at the medial limbus (P < 0.001). Minor complications were encountered in seven of 46 patients (15.2%). Mean patient satisfaction score was 3.20 and surgeon satisfaction 3.24 (max = 4, very satisfied).
  
  
  CONCLUSIONS
  The modified pretrichial brow lift offered effective lateral lift that complements an upper lid blepharoplasty. This technique was met with a high degree of patient and surgeon satisfaction, and had a minimal complication profile.
authors.affiliation: Grand Rapids Medical Education Partners, Michigan State University Plastic Surgery Residency, Department of Plastic Surgery, Charlottesville, VA, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Martin
authors.affiliation: University of Virginia Ophthalmology Residency, Department of Ophthalmology, Charlottesville, VA, USA.
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Shah
authors.affiliation: University of Michigan Anesthesiology Residency, Department of Anesthesiology, Ann Arbor, MI.
authors.forename: Payal
authors.initials: P
authors.lastname: Attawala
authors.affiliation: Grand Rapids Medical Education Partners, Michigan State University Plastic Surgery Residency, Department of Plastic Surgery, Charlottesville, VA, USA.
authors.forename: Keith
authors.initials: K
authors.lastname: Neaman
authors.affiliation: Department of Eye Plastic and Facial Cosmetic Surgery, Grand Rapids, Michigan; Department of Surgery, Spectrum Health Hospital, Grand Rapids, Michigan.
authors.forename: Melissa
authors.initials: M
authors.lastname: Meldrum
authors.affiliation: Department of Eye Plastic and Facial Cosmetic Surgery, Grand Rapids, Michigan; Department of Surgery, Spectrum Health Hospital, Grand Rapids, Michigan.
authors.forename: Adam S
authors.initials: AS
authors.lastname: Hassan
keywords: Brow ptosis; pretrichial brow lift; temporal brow lift