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Bahmani Kashkouli M, Karimi N, Sianati H, Khademi B. Techniques of Eyebrow Lifting: A Narrative Review. JOVR [Internet]. 2020Apr.6 [cited 2024Apr.19];15(2):218–236. Available from: https://knepublishing.com/index.php/JOVR/article/view/6740
https://doi.org/10.18502/jovr.v15i2.6740
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authors
-
Mohsen Bahmani Kashkouli
Mohsen Bahmani Kashkouli
Eye Research Center, The Five Senses Institute, Iran University of Medical Science, Tehran, Iran
-
Nasser Karimi
Nasser Karimi
Eye Research Center, The Five Senses Institute, Iran University of Medical Science, Tehran, Iran
-
Hamed Sianati
Hamed Sianati
Eye Research Center, The Five Senses Institute, Iran University of Medical Science, Tehran, Iran
-
Behzad Khademi
Behzad Khademi
Eye Research Center, The Five Senses Institute, Iran University of Medical Science, Tehran, Iran
Published Date
- Apr 6, 2020
Techniques of Eyebrow Lifting: A Narrative Review
Abstract
None of brow lift techniques are completely satisfactory because of their limited effectiveness, lack of longevity, and potential complications. The aim of this study was to provide a comprehensive review of the literature on the pros and cons of the most popular techniques in brow and forehead lift. Relevant original articles in the PubMed database (English language) were sought using the search terms “eyebrow lift”, “forehead lift”, ”periorbital rejuvenation”, ”eyebrow ptosis”, ”blepharoplasty and eyebrow change”, ”surgical eyebrow lift”, and ”non-surgical eyebrow lift”, No date limitation was considered. Titles and abstracts were scanned to include the most pertinent articles. Subsequently, full texts of included articles (111 articles) were skimmed and finally 56 references were selected for the review. A narrative synthesis of data was finally undertaken with particular attention to the indications, techniques, and common complications of the eyebrow lift procedures. Ten popular techniques including two nonsurgical methods (Botulinum toxin A and soft tissue fillers) were reviewed in this article. In general, non-surgical methods of forehead/brow lift are temporary, need less experience and correction would be easier should any complication occur. Surgical methods are divided into three categories: trans-blepharoplasty eyebrow lift, direct eyebrow lift, and trans-forehead eyebrow/forehead lift. Currently, the most popular method is the endoscopic forehead lift approach even though its longevity is limited. Direct brow-lift is particularly useful in patients with facial palsy and those who are more likely to be accepting of the scar (male gender, high forehead hair line).
Keywords:
Blepharoplasty, Endoscopy, Esthetics, Eyebrow, Forehead, Lifting, Rejuvenation
References
1. Kashkouli MB, Abolfathzadeh N, Abdolalizadeh P, Sianati H, Karimi N. Upper blepharoplasty and eyebrow position. Expert Rev Ophthalmol 2017;12:251–259.
2. Kashkouli MB, Abdolalizadeh P, Abolfathzadeh N, Sianati H, Sharepour M, Hadi Y. Periorbital facial rejuvenation: applied anatomy and pre-operative assessment. J Curr Ophthalmol 2017;29:154–168.
3. Kashkouli MB, Jamshidian-Tehrani M, Sharzad S, Sanjari MS. Upper blepharoplasty and lateral wound dehiscence. Middle East Afr J Ophthalmol 2015;22:452–456.
4. Kashkouli MB, Pakdel F, Kiavash V, Ghiasian L, Heirati A, Jamshidian-Tehrani M. Transconjunctival lower blepharoplasty: a 2-sided assessment of results and subjects’ satisfaction. Ophthalmic Plast Reconstr Surg 2013;29:249–255.
5. Kashkouli MB, Amani A, Jamshidian-Tehrani M, Yousefi S, Jazayeri AA. Eighteen-point abobotulinum toxin a upper face rejuvenation: an eye plastic perspective on 845 subjects. Ophthalmic Plast Reconstr Surg 2014;30:219– 224.
6. Ahn MS, Catten M, Maas CS. Temporal brow lift using botulinum toxin A. Plast Reconstr Surg 2000;105:1129–1135; discussion 1136–1129.
7. Raspaldo H, Gassia V, Niforos FR, Michaud T. Global, 3- dimensional approach to natural rejuvenation: part 1 - recommendations for volume restoration and the periocular area. J Cosmet Dermatol 2012;11:279–289.
8. Sundaram H, Cassuto D. Biophysical characteristics of hyaluronic acid soft-tissue fillers and their relevance to aesthetic applications. Plast Reconstr Surg 2013;132:5S–21S.
9. de Maio M, Swift A, Signorini M, Fagien S, Aesthetic Leaders in Facial Aesthetics Consensus C. Facial assessment and injection guide for botulinum toxin and injectable hyaluronic acid fillers: focus on the upper face. Plast Reconstr Surg 2017;140:265e–276e.
10. Chiang YZ, Pierone G, Al-Niaimi F. Dermal fillers: pathophysiology, prevention and treatment of complications. J Eur Acad Dermatol Venereol 2017;31:405–413.
11. Kashkouli MB, Sharepour M, Sianati H, Abdolalizadeh P. Acute primary angle closure after periorbital facial procedures report of four cases and literature review. Orbit 2018;37:348–351.
12. Briceno CA, Zhang-Nunes SX, Massry GG. Minimally invasive surgical adjuncts to upper blepharoplasty. Facial Plast Surg Clin North Am 2015;23:137–151.
13. Hubbard BA, Unger JG, Rohrich RJ. Reversal of skin aging with topical retinoids. Plast Reconstr Surg 2014;133:481e–490e.
14. McCord CD, Doxanas MT. Browplasty and browpexy: an adjunct to blepharoplasty. Plast Reconstr Surg 1990;86:248–254.
15. Broadbent T, Mokhktarzadeh A, Harrison A. Minimally invasive brow lifting techniques. Curr Opin Ophthalmol 2017;28:539–543.
16. Mokhtarzadeh A, Massry GG, Bitrian E, Harrison AR. Quantitative efficacy of external and internal browpexy performed in conjunction with blepharoplasty. Orbit 2017;36:102–109.
17. Baker MS, Shams PN, Allen RC. The quantitated internal suture browpexy: comparison of two brow-lifting techniques in patients undergoing upper blepharoplasty. Ophthalmic Plast Reconstr Surg 2016;32:204–206.
18. Burroughs JR, Bearden WH, Anderson RL, McCann JD. Internal brow elevation at blepharoplasty. Arch Facial Plast Surg 2006;8:36–41.
19. Eftekhari K, Peng GL, Landsberger H, Douglas R, Massry GG. The brow fat pad suspension suture: safety profile and clinical observations. Ophthalmic Plast Reconstr Surg 2018;34:7–12.
20. Zarem HA, Resnick JI, Carr RM, Wootton DG. Browpexy: lateral orbicularis muscle fixation as an adjunct to upper blepharoplasty. Plast Reconstr Surg 1997;100:1258–1261.
21. Tyers AG. Brow lift via the direct and trans-blepharoplasty approaches. Orbit 2006;25:261–265.
22. Clevens RA. Rejuvenation of the male brow. Facial Plast Surg Clin North Am 2008;16:299–312.
23. Pascali M, Bocchini I, Avantaggiato A, Carinci F, Cervelli V, Orlandi F, et al. Direct brow lifting: specific indications for a simplified approach to eyebrow ptosis. Indian J Plast Surg 2016;49:66–71.
24. Levine MR, Allen RC. Manual of oculoplastic surgery. 5th edition. Springer, New York; 2018.
25. Booth AJ, Murray A, Tyers AG. The direct brow lift: efficacy, complications, and patient satisfaction. Br J Ophthalmol 2004;88:688–691.
26. Green JP, Goldberg RA, Shorr N. Eyebrow ptosis. Int Ophthalmol Clin 1997;37:97–122.
27. Ueda K, Harii K, Yamada A. Long-term follow-up study of browlift for treatment of facial paralysis. Ann Plast Surg 1994;32:166–170.
28. Lycka B, Bazan C, Poletti E, Treen B. The emerging technique of the antiptosis subdermal suspension thread. Dermatol Surg 2004;30:41–44; discussion 44.
29. Sulamanidze M, Sulamanidze G. APTOS suture lifting methods: 10 years of experience. Clin Plast Surg 2009;36:281–306.
30. Trevidic P, Alkebaisi A. [Facial threads for face lift]. Rev Laryngol Otol Rhinol (Bord) 2006;127:57–59.
31. Tavares JP, Oliveira C, Torres RP, Bahmad F Jr. Facial thread lifting with suture suspension. Braz J Otorhinolaryngol 2017;83:712–719.
32. Sulamanidze MA, Fournier PF, Paikidze TG, Sulamanidze GM. Removal of facial soft tissue ptosis with special threads. Dermatol Surg 2002;28:367–371.
33. Flynn J. Suture suspension lifts: a review. Oral Maxillofac Surg Clin North Am 2005;17:65–76.
34. Lee H, Yoon K, Lee M. Outcome of facial rejuvenation with polydioxanone thread for Asians. J Cosmet Laser Ther 2018;20:189–192.
35. Rezaee Khiabanloo S, Jebreili R, Aalipour E, Saljoughi N, Shahidi A. Outcomes in thread lift for face and neck: a study performed with Silhouette Soft and Promo Happy Lift double needle, innovative and classic techniques. J Cosmet Dermatol 2019;18:84–93.
36. Gulbitti HA, Colebunders B, Pirayesh A, Bertossi D, van der Lei B. Thread-lift sutures: still in the lift? A systematic review of the literature. Plast Reconstr Surg 2018;141:341e–347e.
37. Rachel JD, Lack EB, Larson B. Incidence of complications and early recurrence in 29 patients after facial rejuvenation with barbed suture lifting. Dermatol Surg 2010;36:348– 354.
38. Obourn CA, Williams EF 3rd. A decade of thread-lifting: what have we learned over the last 10 years? JAMA Facial Plast Surg 2018;20:349–350.
39. Tong LX, Rieder EA. Thread-lifts: a double-edged suture? A comprehensive review of the literature. Dermatol Surg 2019;45:931–940.
40. Paul MD. Complications of barbed sutures. Aesthetic Plast Surg 2008;32:149.
41. Winkler E, Goldan O, Regev E, Mendes D, Orenstein A, Haik J. Stensen duct rupture (sialocele) and other complications of the Aptos thread technique. Plast Reconstr Surg 2006;118:1468–1471.
42. McGuire CS, Gladstone HB. Novel pretrichial browlift technique and review of methods and complications. Dermatol Surg 2009;35:1390–1405.
43. Adamson PA, Johnson CM Jr, Anderson JR, Dupin CL. The forehead lift. A review. Arch Otolaryngol 1985;111:325–329.
44. Withey S, Witherow H, Waterhouse N. One hundred cases of endoscopic brow lift. Br J Plast Surg 2002;55:20–24. 45. Dolsky RL. The forehead-brow lift – folding the flap to avoid bradycardia. Ann Plast Surg 1982;9:355.
46. Elkwood A, Matarasso A, Rankin M, Elkowitz M, Godek CP. National plastic surgery survey: brow lifting techniques and complications. Plast Reconstr Surg 2001;108:2143– 2150; discussion 2151–2142.
47. Riefkohl R, Kosanin R, Georgiade GS. Complications of the forehead-brow lift. Aesthetic Plast Surg 1983;7:135–138.
48. Kashkouli MB, Beigi B. Endoscopy in the field of oculofacial plastic surgery. J Curr Ophthalmol 2018;30:99–101.
49. Codner MA, McCord CD. Eyelid & periorbital surgery. 2nd ed. CRC Press, Florida; 2016.
50. Yeatts RP. Current concepts in brow lift surgery. Curr Opin Ophthalmol 1997;8:46–50.
51. Chiu ES, Baker DC. Endoscopic brow lift: a retrospective review of 628 consecutive cases over 5 years. Plast Reconstr Surg 2003;112:628–633; discussion 634–625.
52. Viksraitis S, Astrauskas T, Karbonskiene A, Budnikas G. Endoscopic aesthetic facial surgery: technique and results. Medicina (Kaunas) 2004;40:149–155.
53. Cho MJ, Carboy JA, Rohrich RJ. Complications in brow lifts: a systemic review of surgical and nonsurgical brow rejuvenations. Plast Reconstr Surg Glob Open 2018;6:e1943.
54. Jones BM, Grover R. Endoscopic brow lift: a personal review of 538 patients and comparison of fixation techniques. Plast Reconstr Surg 2004;113:1242–1250; discussion 1251–1242.
55. Georgescu D, Anderson RL, McCann JD. Brow ptosis correction: a comparison of five techniques. Facial Plast Surg 2010;26:186–192.
56. Tabatabai N, Spinelli HM. Limited incision nonendoscopic brow lift. Plast Reconstr Surg 2007;119:1563–1570.
57. Fattahi T. Trichophytic brow lift: a modification. Int J Oral Maxillofac Surg 2015;44:371–373.
58. Tower RN, Dailey RA. Endoscopic pretrichial brow lift: surgical indications, technique and outcomes. Ophthalmic Plast Reconstr Surg 2004;20:268–273.
59. Owsley TG. Subcutaneous trichophytic forehead browlift: the case for an ”open” approach. J Oral Maxillofac Surg 2006;64:1133–1136.
2. Kashkouli MB, Abdolalizadeh P, Abolfathzadeh N, Sianati H, Sharepour M, Hadi Y. Periorbital facial rejuvenation: applied anatomy and pre-operative assessment. J Curr Ophthalmol 2017;29:154–168.
3. Kashkouli MB, Jamshidian-Tehrani M, Sharzad S, Sanjari MS. Upper blepharoplasty and lateral wound dehiscence. Middle East Afr J Ophthalmol 2015;22:452–456.
4. Kashkouli MB, Pakdel F, Kiavash V, Ghiasian L, Heirati A, Jamshidian-Tehrani M. Transconjunctival lower blepharoplasty: a 2-sided assessment of results and subjects’ satisfaction. Ophthalmic Plast Reconstr Surg 2013;29:249–255.
5. Kashkouli MB, Amani A, Jamshidian-Tehrani M, Yousefi S, Jazayeri AA. Eighteen-point abobotulinum toxin a upper face rejuvenation: an eye plastic perspective on 845 subjects. Ophthalmic Plast Reconstr Surg 2014;30:219– 224.
6. Ahn MS, Catten M, Maas CS. Temporal brow lift using botulinum toxin A. Plast Reconstr Surg 2000;105:1129–1135; discussion 1136–1129.
7. Raspaldo H, Gassia V, Niforos FR, Michaud T. Global, 3- dimensional approach to natural rejuvenation: part 1 - recommendations for volume restoration and the periocular area. J Cosmet Dermatol 2012;11:279–289.
8. Sundaram H, Cassuto D. Biophysical characteristics of hyaluronic acid soft-tissue fillers and their relevance to aesthetic applications. Plast Reconstr Surg 2013;132:5S–21S.
9. de Maio M, Swift A, Signorini M, Fagien S, Aesthetic Leaders in Facial Aesthetics Consensus C. Facial assessment and injection guide for botulinum toxin and injectable hyaluronic acid fillers: focus on the upper face. Plast Reconstr Surg 2017;140:265e–276e.
10. Chiang YZ, Pierone G, Al-Niaimi F. Dermal fillers: pathophysiology, prevention and treatment of complications. J Eur Acad Dermatol Venereol 2017;31:405–413.
11. Kashkouli MB, Sharepour M, Sianati H, Abdolalizadeh P. Acute primary angle closure after periorbital facial procedures report of four cases and literature review. Orbit 2018;37:348–351.
12. Briceno CA, Zhang-Nunes SX, Massry GG. Minimally invasive surgical adjuncts to upper blepharoplasty. Facial Plast Surg Clin North Am 2015;23:137–151.
13. Hubbard BA, Unger JG, Rohrich RJ. Reversal of skin aging with topical retinoids. Plast Reconstr Surg 2014;133:481e–490e.
14. McCord CD, Doxanas MT. Browplasty and browpexy: an adjunct to blepharoplasty. Plast Reconstr Surg 1990;86:248–254.
15. Broadbent T, Mokhktarzadeh A, Harrison A. Minimally invasive brow lifting techniques. Curr Opin Ophthalmol 2017;28:539–543.
16. Mokhtarzadeh A, Massry GG, Bitrian E, Harrison AR. Quantitative efficacy of external and internal browpexy performed in conjunction with blepharoplasty. Orbit 2017;36:102–109.
17. Baker MS, Shams PN, Allen RC. The quantitated internal suture browpexy: comparison of two brow-lifting techniques in patients undergoing upper blepharoplasty. Ophthalmic Plast Reconstr Surg 2016;32:204–206.
18. Burroughs JR, Bearden WH, Anderson RL, McCann JD. Internal brow elevation at blepharoplasty. Arch Facial Plast Surg 2006;8:36–41.
19. Eftekhari K, Peng GL, Landsberger H, Douglas R, Massry GG. The brow fat pad suspension suture: safety profile and clinical observations. Ophthalmic Plast Reconstr Surg 2018;34:7–12.
20. Zarem HA, Resnick JI, Carr RM, Wootton DG. Browpexy: lateral orbicularis muscle fixation as an adjunct to upper blepharoplasty. Plast Reconstr Surg 1997;100:1258–1261.
21. Tyers AG. Brow lift via the direct and trans-blepharoplasty approaches. Orbit 2006;25:261–265.
22. Clevens RA. Rejuvenation of the male brow. Facial Plast Surg Clin North Am 2008;16:299–312.
23. Pascali M, Bocchini I, Avantaggiato A, Carinci F, Cervelli V, Orlandi F, et al. Direct brow lifting: specific indications for a simplified approach to eyebrow ptosis. Indian J Plast Surg 2016;49:66–71.
24. Levine MR, Allen RC. Manual of oculoplastic surgery. 5th edition. Springer, New York; 2018.
25. Booth AJ, Murray A, Tyers AG. The direct brow lift: efficacy, complications, and patient satisfaction. Br J Ophthalmol 2004;88:688–691.
26. Green JP, Goldberg RA, Shorr N. Eyebrow ptosis. Int Ophthalmol Clin 1997;37:97–122.
27. Ueda K, Harii K, Yamada A. Long-term follow-up study of browlift for treatment of facial paralysis. Ann Plast Surg 1994;32:166–170.
28. Lycka B, Bazan C, Poletti E, Treen B. The emerging technique of the antiptosis subdermal suspension thread. Dermatol Surg 2004;30:41–44; discussion 44.
29. Sulamanidze M, Sulamanidze G. APTOS suture lifting methods: 10 years of experience. Clin Plast Surg 2009;36:281–306.
30. Trevidic P, Alkebaisi A. [Facial threads for face lift]. Rev Laryngol Otol Rhinol (Bord) 2006;127:57–59.
31. Tavares JP, Oliveira C, Torres RP, Bahmad F Jr. Facial thread lifting with suture suspension. Braz J Otorhinolaryngol 2017;83:712–719.
32. Sulamanidze MA, Fournier PF, Paikidze TG, Sulamanidze GM. Removal of facial soft tissue ptosis with special threads. Dermatol Surg 2002;28:367–371.
33. Flynn J. Suture suspension lifts: a review. Oral Maxillofac Surg Clin North Am 2005;17:65–76.
34. Lee H, Yoon K, Lee M. Outcome of facial rejuvenation with polydioxanone thread for Asians. J Cosmet Laser Ther 2018;20:189–192.
35. Rezaee Khiabanloo S, Jebreili R, Aalipour E, Saljoughi N, Shahidi A. Outcomes in thread lift for face and neck: a study performed with Silhouette Soft and Promo Happy Lift double needle, innovative and classic techniques. J Cosmet Dermatol 2019;18:84–93.
36. Gulbitti HA, Colebunders B, Pirayesh A, Bertossi D, van der Lei B. Thread-lift sutures: still in the lift? A systematic review of the literature. Plast Reconstr Surg 2018;141:341e–347e.
37. Rachel JD, Lack EB, Larson B. Incidence of complications and early recurrence in 29 patients after facial rejuvenation with barbed suture lifting. Dermatol Surg 2010;36:348– 354.
38. Obourn CA, Williams EF 3rd. A decade of thread-lifting: what have we learned over the last 10 years? JAMA Facial Plast Surg 2018;20:349–350.
39. Tong LX, Rieder EA. Thread-lifts: a double-edged suture? A comprehensive review of the literature. Dermatol Surg 2019;45:931–940.
40. Paul MD. Complications of barbed sutures. Aesthetic Plast Surg 2008;32:149.
41. Winkler E, Goldan O, Regev E, Mendes D, Orenstein A, Haik J. Stensen duct rupture (sialocele) and other complications of the Aptos thread technique. Plast Reconstr Surg 2006;118:1468–1471.
42. McGuire CS, Gladstone HB. Novel pretrichial browlift technique and review of methods and complications. Dermatol Surg 2009;35:1390–1405.
43. Adamson PA, Johnson CM Jr, Anderson JR, Dupin CL. The forehead lift. A review. Arch Otolaryngol 1985;111:325–329.
44. Withey S, Witherow H, Waterhouse N. One hundred cases of endoscopic brow lift. Br J Plast Surg 2002;55:20–24. 45. Dolsky RL. The forehead-brow lift – folding the flap to avoid bradycardia. Ann Plast Surg 1982;9:355.
46. Elkwood A, Matarasso A, Rankin M, Elkowitz M, Godek CP. National plastic surgery survey: brow lifting techniques and complications. Plast Reconstr Surg 2001;108:2143– 2150; discussion 2151–2142.
47. Riefkohl R, Kosanin R, Georgiade GS. Complications of the forehead-brow lift. Aesthetic Plast Surg 1983;7:135–138.
48. Kashkouli MB, Beigi B. Endoscopy in the field of oculofacial plastic surgery. J Curr Ophthalmol 2018;30:99–101.
49. Codner MA, McCord CD. Eyelid & periorbital surgery. 2nd ed. CRC Press, Florida; 2016.
50. Yeatts RP. Current concepts in brow lift surgery. Curr Opin Ophthalmol 1997;8:46–50.
51. Chiu ES, Baker DC. Endoscopic brow lift: a retrospective review of 628 consecutive cases over 5 years. Plast Reconstr Surg 2003;112:628–633; discussion 634–625.
52. Viksraitis S, Astrauskas T, Karbonskiene A, Budnikas G. Endoscopic aesthetic facial surgery: technique and results. Medicina (Kaunas) 2004;40:149–155.
53. Cho MJ, Carboy JA, Rohrich RJ. Complications in brow lifts: a systemic review of surgical and nonsurgical brow rejuvenations. Plast Reconstr Surg Glob Open 2018;6:e1943.
54. Jones BM, Grover R. Endoscopic brow lift: a personal review of 538 patients and comparison of fixation techniques. Plast Reconstr Surg 2004;113:1242–1250; discussion 1251–1242.
55. Georgescu D, Anderson RL, McCann JD. Brow ptosis correction: a comparison of five techniques. Facial Plast Surg 2010;26:186–192.
56. Tabatabai N, Spinelli HM. Limited incision nonendoscopic brow lift. Plast Reconstr Surg 2007;119:1563–1570.
57. Fattahi T. Trichophytic brow lift: a modification. Int J Oral Maxillofac Surg 2015;44:371–373.
58. Tower RN, Dailey RA. Endoscopic pretrichial brow lift: surgical indications, technique and outcomes. Ophthalmic Plast Reconstr Surg 2004;20:268–273.
59. Owsley TG. Subcutaneous trichophytic forehead browlift: the case for an ”open” approach. J Oral Maxillofac Surg 2006;64:1133–1136.