Direct Brow Lift: A technique for selected group of patients

Objectives:
Direct brow lift allows for rapid, powerful, and predictable elevation of the brows. Direct brow lift is appropriate for individuals who desire an elevated brow and are not too concerned about the scar.
Introduction:
Facial aesthetic procedures are commonly performed to address the ptotic facial tissues.
None of the brow lift techniques are completely satisfactory because of their limited effectiveness, lack of longevity and potential complications.
Eyebrow ptosis occurs in older persons because of gravity and aging. As the brow moves inferiorly, the frontalis muscle is recruited to elevate the eyebrow, which may result in deep horizontal forehead lines. Frontalis muscle fibers do not extend to the lateral brow, so despite maximum frontalis contraction, lateral brow ptosis often persists.
The goal of the surgery is to achieve the optimal height and contour of the brow with minimal scarring and downtime and maximal predictability.
Location and length of the incision (supra brow cilia vs mid /lower forehead) is chosen depending upon the degree and extend of ptosis and location of the forehead rhytids.
As most brow ptosis is usually in the mid to lateral brow area, incision on the medial 1-2 cm for forehead should be avoided as it can leave a visible scar without achieving major improvement.
Material and methods: The aim of the study was to review all direct brow lift procedures carried out between January 2022 to December 2023. All cases were performed under local anaesthesia.
Results: 35 cases were performed at the ASC as a day case procedure. The mean age was 62 years. The surgery time ranged from 22-30 min. The follow up period ranged from 6-24 months. Most patients were satisfied with the outcome.
Conclusion: Direct browlift is most effective and predictable technique for addressing static brow position and in cases of unilateral brow ptosis.

Aesthetic

PSTM 2024