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Cosmetic and Quality of Life Outcomes of the Direct Brow Lift
Srinivas Sai A.
Kondapalli ,
Craig N.
Czyz ,
Foster ,
Jill A.
Kenneth V.
Loyola University Medical Center, Maywood, IL;
Ohio University,
Doctor’s Hospital, Columbus, OH; 3Ophthalmology, The Ohio State University, Columbus, OH
The purpose of this study is to evaluate the postoperative
changes in quality of life and cosmesis in patients who
underwent direct brow lifting procedures.
The direct brow lift is a superjacent surgical technique
designed to improve brow ptosis. The purpose of the
procedure is to improve ptosis and expand the patient’s
visual field. The procedure is traditionally reserved for
patients with thick upper eyelid skin and who are elderly.
Advantages of the procedure include overall effectiveness
and minimal bleeding. In addition, the procedure is often of
short duration with minimal recuperation time.
Disadvantages include a visible facial scar and a potentially
unnatural eyebrow contour, that can result in a “surprised”
look. Moreover, patients may experience paresthesia over
the eyebrow and forehead area.
To evaluate patient expectations prior to direct browplasty.
To examine cosmetic benefit of direct brow surgery.
To note functional improvement in overall vision as well as
visual field peripherally after direct brow surgery.
To assess overall satisfaction with the direct brow procedure
and in comparison to alternative brow ptosis repair methods.
To evaluate post operative complications after direct brow
surgery specifically with light sensitivity, paresthesias and
To note changes to quality of life in patients who undergo
direct brow surgeries.
Patients who underwent direct brow surgery from 2005 to
2012 were asked to participate in a fourteen question survey.
Patients who had concurrent eyelid surgeries, such as
blepharoplasty, were excluded.
25 patients participated in the study.
When asked if they were happy with their surgery, patients
Moreover, 21 (84%), patients denied light sensitivity, 25
(100%) denied any new headaches/pain, and 24 (96%)
denied forehead/scalp numbness.
NO 8%
Questions included:
1. Did you have your eyebrow surgery for cosmetic or
functional reasons or both?
2. Do you notice a scar from your brow surgery?
1. If yes, do you notice the scare on one side more
than another?
2. If yes, does it bother you that the scar is visible?
3. If you had a medical brow lift and were now
offered the choice to instead do a cosmetic outof-pocket surgery in order to hide the scar,
would you?
3. Do other people notice your scar?
4. Are you happy with the result of your surgery?
5. Do you feel your appearance has changed since your
eyebrow surgery?
6. Do you find it easier to participate in activities/hobbies
since your surgery?
7. Has the brow surgery improved your self-confidence?
8. Since your surgery, do you feel your vision has improved?
1. If yes, do you specifically notice an
improvement in your peripheral or side vision?
9. Has your ability to read newspaper print improved since
your eyebrow surgery?
10. Since your surgery healed, do you have any new light
11. Since your surgery healed, have you had any increases in
headaches or pain?
12. Has your ability to drive improved since your eyebrow
13. Have you noticed an numbness in your forehead or scalp
since your eyebrow surgery?
Direct brow surgery is a straight forward procedure to
improve brow ptosis.
YES 92%
The surgery provides an improvement in vision and an
overall positive surgical result.
Negative outcomes—including scar formation, postoperative paresthesias and headaches—are minimal.
When asked, since your surgery, do you feel your vision has
improved, patients responded:
Angelos PC, Stallworth CL, Wang TD. “Forehead Lifting: State of the
Art.” Facial Plastic Surgery. 2011 Feb; 27(1):50-7.
Barker L, Naveed H, Adds PJ, Uddin JM. “Supraorbital Notch and
Foramen: Positional Variation and Relevance to Direct Brow Lift.”
Ophthalmic Plastic and Reconstructive Surgery. 2013 Jan;29(1):67-70.
NO 40%
Booth AJ, Murray A, Tyers AG. “The Direct Brow Lift: Efficacy,
Complications and Patient Satisfaction.” British Journal of
Ophthalmology. 2004 May;88(5):688-91.
YES 60%
Har-Shai Y, Gil T, Metanes I, Scheflan M. “Brow Lift for the Correction of
Visual Field Impairment.” Aesthetic Surgery Journal. 2008 SepOct;28(5):512-7.
Pollock H, Pollock TA. “Subcutaneous Brow Lift with Precise Suture
Fixation and Advancement.” Aesthetic Surgery Journal. 2007 JulAug;27(4):388-95.
When asked, do you notice a scar from your brow surgery,
patients responded:
Walrath JD, McCord CD. “The Open Brow Lift.” Clinical Plastic Surgery.
2013 Jan;40(1):117-24.
Bothered 28%
Srinivas Sai A. Kondapalli, M.D., PGY-2
Loyola University Medical Center
2160 South 1st Avenue
Maywood, IL 60154
[email protected]
NO 56%
Primary author acknowledges The Richard A. Perritt Charitable

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