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Late-Breaking Scientific Oral Presentations

Facial Plastic and Reconstructive Surgery

Session: Late-Breaking Scientific Orals: Facial Plastic and Reconstructive Surgery and Pediatric Otolaryngology

A Comparison of Brow Elevation and Complications: Endoscopic Versus Pretrichial Brow Lift

Monday, September 30, 2024
8:12 AM – 8:18 AM EDT
Location: MBCC, 222
Disclosure(s):
Neha Garg, BA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Aarti M. Agarwal, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Angela E. Alnemri, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Howard D. Krein, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Ryan N. Heffelfinger, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Browlift is commonly utilized for facial rejuvenation in the setting of brow ptosis, dermatochalasis, and upper eyelid ptosis with the goal of providing lasting aesthetic results and minimal morbidity. The aim of this study was to investigate long term retention of brow elevation and complication rates in endoscopic versus pretrichial browlifts.

Methods: Demographic, intraoperative, and postoperative complication data were collected on patients who underwent endoscopic or pretrichial browlift at a tertiary care institution between May 2019 and February 2024. ImageJ Software was used for photographic assessment of preoperative and postoperative brow height by calculating the ratio of vertical brow height to distance between the lateral corneal limbus and medial canthus.

Results: In total, 50 patients underwent endoscopic browlift and 21 underwent pretrichial browlift. Both cohorts had significantly higher brow height ratios at first postoperative visit (p < 0.001). There was no significant difference in ecchymosis, edema, erythema, numbness, hematoma, seroma, brow weakness, scarring, or alopecia complications between the cohorts (p > 0.05). Techniques did not differ in aggregate complication, revision, or postoperative botox rates (p > 0.05). Percent change in brow height ratio at first postoperative visit was larger in the endoscopic (20%) versus pretrichial group (13%) (p < 0.01). Cohorts did not significantly differ in retention of eyebrow elevation at 1 to 6 months or greater than 6 months postoperatively (p > 0.05). Multivariate analysis revealed that technique is not a significant predictor of long-term brow height (p > 0.05).

Conclusions: While both browlift techniques provide adequate brow elevation, elevation with the endoscopic technique is significantly larger immediately postoperatively. Given the similar long-term brow height retention and likelihood of complications in both groups, these results show that factors such as anterior hairline position and forehead length should guide the technique used. Future studies are needed to identify patients who may be ideal candidates for each technique.

    Presenting Author(s)

  • Neha Garg, BA

    Medical Student
    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital
    Philadelphia, Pennsylvania, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Jefferson J. DeKloe, BS

    Medical Student
    Thomas Jefferson University Department of Otolaryngology
    Philadelphia, Pennsylvania, United States

    Disclosure information not submitted.

  • AB

    Alekya Bheemreddy, BA

    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital, United States

    Disclosure information not submitted.

  • AB

    Alessandra T. Baldari, BA

    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital, United States

    Disclosure information not submitted.

  • Aarti M. Agarwal, MD

    Resident Physician
    Department of Otolaryngology - Head & Neck Surgery, UCSF
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Angela E. Alnemri, MD

    Resident Physician
    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • AM

    Adam McCann, MD

    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital, United States

    Disclosure information not submitted.

  • Howard D. Krein, MD, PhD

    Professor
    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Ryan N. Heffelfinger, MD

    Professor, Department of OTO-HNS
    Department of Otolaryngology - Head & Neck Surgery, Thomas Jefferson University Hospital
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.