This is a retrospective case series evaluating the efficacy of and comparing the surgical results between internal (IB) and external browpexy (EB) surgery in lifting central and lateral brow. Patients who underwent blepharoplasty without brow lift were used as a control group. A ptosis procedure was added where necessary in all groups. Preoperative and postoperative photographs were analysed using the Massachussett’s eye and ear infirmary FACE-gram program to quantify surgical outcome. The software measures the height of central brow from mid-pupil and lateral brow from lateral canthus. Ninety-eight patients were included in the study. The average change in lateral brow position was an elevation of 2.97mm in EB group, 2.29 mm in the IB group and a descent of 1.10mm in the control group. The average change in the central brow position was 1.90mm elevation in the EB group, 1.47mm in EB and a descent of 0.38mm in the control groups. There was a statistically significant difference between the control and both browpexy groups, but not between EB and IB. Revision rates of 8% for IB and 4% for IB were not statistically significant. The authors conclude that either form of browpexy should be added to blepharoplasty to avoid worsening brow ptosis. They indicate a preference for EB other than in patients with very fine brow cilia. The study is limited by short-term follow-up of four to five months, lack of randomisation and confounded by the addition of a ptosis repair which can alter brow position. A prospective study with randomisation will be needed to evaluate the outcomes of these procedures.

Quantitative efficacy of external and internal browpexy performed in conjunction with blepharoplasty.
Mokhtarzadeh A, Massry GG, Bitrian E, et al.
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Jaya Myneni

Royal Liverpool University Hospitals, UK.

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