title: Volumization of the Brow at the Time of Blepharoplasty: Treating the Eyebrow Fat Pad as an Independent Unit.
abstract: Loss of volume in the sub-brow fat pad with associated descent of the eyebrow is a common anatomical finding resulting in both functional and aesthetic consequences. A variety of techniques have been described to address brow position at the time of blepharoplasty. To our knowledge, none of these techniques treat the sub-brow fat pad as an isolated unit. Doing so enables the surgeon to stabilize and volumize the brow without resultant tension on the blepharoplasty wound. The authors describe a technique for addressing volume loss in the eyebrow with associated brow descent that treats the sub-brow fat pad as an isolated unit.
  
  
  
  A retrospective review of all patients undergoing brow ptosis repair by a single surgeon (J.W.S.) over an 11-month period was performed.
  
  
  
  Eighteen patients and 33 brows underwent the technique described. Patients were followed for an average of 11 weeks (range: 4 weeks to 20 weeks). All patients preoperatively displayed both visually significant dermatochalasis and brow descent below the orbital rim. Evaluation of pre- and postoperative photos demonstrates successful volumization of the brow with skin redraping without focal dimpling or undue tension on the eyelid wound.
  
  
  
  Performing a dissection that allows the sub-brow fat pad to be elevated in isolation from the overlying orbicularis and underlying periosteum allows for volumization and of the brow without compromising closure. This technique is a safe and effective means of volumizing the brow and treating secondary brow descent.
authors.affiliation: TOC Eye and Face, Austin, Texas, U.S.A.
authors.forename: Ivan
authors.initials: I
authors.lastname: Vrcek
authors.forename: Eva
authors.initials: E
authors.lastname: Chou
authors.forename: Marie
authors.initials: M
authors.lastname: Somogyi
authors.forename: John W
authors.initials: JW
authors.lastname: Shore
mesh_terms: D000273:Adipose Tissue / Q000601:surgery*; D000328:Adult; D000368:Aged; D019882:Blepharoplasty / Q000379:methods; D005138:Eyebrows; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies