Mehmet Mutaf1. 1. Department of Plastic and Reconstructive Surgery, Gaziantep University School of Medicine, Gaziantep, Turkey. mmutaf@superonline.com
Abstract
BACKGROUND: Prevention of recurrent eyebrow ptosis is the greatest challenge in brow lift surgery today. In this article, the author describes a new surgical procedure to provide long-lasting results in brow lift surgery. METHODS: Over 7 years, this new technique was used in 37 patients. Except for four, all patients were women aged 22 to 57 years. In this procedure, a polypropylene mesh strap is used as a suspender to maintain the elevated position of the eyebrow. The mesh suspender is placed in a subgaleal tunnel that is created between a limited temporal scalp incision and a classic upper blepharoplasty incision. The distal end of the mesh is sutured to the undersurface of the upper orbital part of the orbicularis oculi muscle, and the proximal end is fixed to the periosteum at the temporal region after a desired eyebrow position is obtained by traction of the mesh suspender superolaterally. RESULTS: The polypropylene mesh was tolerated well in all patients. No complication related to foreign body reaction was encountered. During 6 months to 4 years of follow-up, none of the patients experienced recurrent eyebrow ptosis. The long-term results revealed a long-lasting, almost permanent eyebrow elevation in all patients. CONCLUSIONS: This new technique seems to be useful in prevention of recurrent eyebrow ptosis following brow lift surgery. The author suggests that, after its integration with reoperative tissue, the mesh suspender becomes an artificial suspensory aponeurosis that provides stable fixation to maintain the elevated position of the eyebrow. This is considered to be the main reason for the excellent long-lasting results obtained in the current clinical study.
BACKGROUND: Prevention of recurrent eyebrow ptosis is the greatest challenge in brow lift surgery today. In this article, the author describes a new surgical procedure to provide long-lasting results in brow lift surgery. METHODS: Over 7 years, this new technique was used in 37 patients. Except for four, all patients were women aged 22 to 57 years. In this procedure, a polypropylene mesh strap is used as a suspender to maintain the elevated position of the eyebrow. The mesh suspender is placed in a subgaleal tunnel that is created between a limited temporal scalp incision and a classic upper blepharoplasty incision. The distal end of the mesh is sutured to the undersurface of the upper orbital part of the orbicularis oculi muscle, and the proximal end is fixed to the periosteum at the temporal region after a desired eyebrow position is obtained by traction of the mesh suspender superolaterally. RESULTS: The polypropylene mesh was tolerated well in all patients. No complication related to foreign body reaction was encountered. During 6 months to 4 years of follow-up, none of the patients experienced recurrent eyebrow ptosis. The long-term results revealed a long-lasting, almost permanent eyebrow elevation in all patients. CONCLUSIONS: This new technique seems to be useful in prevention of recurrent eyebrow ptosis following brow lift surgery. The author suggests that, after its integration with reoperative tissue, the mesh suspender becomes an artificial suspensory aponeurosis that provides stable fixation to maintain the elevated position of the eyebrow. This is considered to be the main reason for the excellent long-lasting results obtained in the current clinical study.