Brow ptosis: are we measuring the right thing? The impact of surgery and the correlation of objective and subjective measures with postoperative improvement in quality-of-life

Mellington, Faye; Khooshabeh, R

doi:10.1038/eye.2012.78

Cited by 18 publications

(7 citation statements)

References 20 publications

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“…After 3 months, we recorded eyebrow height 8.46 ± 0.2 mm in point A, 8.40 ± 0.3 mm in point B and 7.25 ± 0.2 mm in point C (Figs. 5,6,7,8). After 6 months, we recorded eyebrow height 7.46 ± 0.2 mm in point A, 8.20 ± 0.2 mm in point B and 7.35 ± 0.2 mm in point C (Table 1).…”

Section: Macroscopic Findingsmentioning

confidence: 96%

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Hyaluronic Acid Fillers Enriched with Glycine and Proline in Eyebrow Augmentation Procedure

et al. 2021

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Background The eyebrow area is a clinically critical district due to the anatomical complexity and the propensity to aging-related atrophy. Hyaluronic acid fillers have been proposed to recover the dermal volume of the facial and lips regions. Aim The aim of the present investigation was to evaluate hyaluronic acid fillers enriched with glycine and proline for the treatment of eyebrow augmentation. Methods A total of 15 healthy patients were treated with eyebrow augmentation procedure. The distance between mid-bipupil to lateral eyebrow and mid-eyebrow to the medial eyebrow was measured before, immediately after treatment and at follow-up of 6 months. Results The healing period was uneventful, and no evidence of inflammation or swelling associated with the treatment was reported. No macroscopical alteration was reported in the surrounding tissues with no evidences of visible wheals or lumps in the treated sites at the follow-up. Before treatment, the angle was equal to 9.32 ± 0.2°, while after treatment it was 11.21 ± 0.4° (p < 0.01); after three and 6 weeks, it was, respectively, 10.66 ± 0.2° (p<0.05) and 10.02 ± 0.3°(p > 0.05). Conclusions The study results suggest that the hyaluronic acid fillers enriched with glycine and proline treatment resulted as being a useful procedure for augmentation, contour and volume definition and elevation of the eyebrow region with a high-level aesthetic result. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Section: Macroscopic Findingsmentioning

confidence: 96%

“…The perioral and eye are very important for the appearance of patients. The aging of this area is characterized by reduction of the volume and shape, curvature and ptosis which can impair normal peripheral vision [ 7 ]. The eyes together with the mouth have important functions related to facial expressions.…”

Section: Introductionmentioning

confidence: 99%

Hyaluronic Acid Fillers Enriched with Glycine and Proline in Eyebrow Augmentation Procedure

et al. 2021

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“…The importance of patient reported outcome measures in healthcare is widely recognised [ 21 , 22 ]. Where studies of ptosis have measured patient reported outcomes, these tend to focus on changes to vision and related functional quality of life [ 18 , 23 , 24 ]. However, studies focusing on changes to health-related quality of life (HRQL) following ptosis surgery indicate long-term benefits [ 12 , 25 ], and recent qualitative work suggests a clear psychosocial benefit of successful ptosis treatment for some patients [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Patient reported psychosocial functioning following successful ptosis surgery

Richards

Jenkinson

White

et al. 2021

Eye

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Background Ptosis may result in increased anxiety, appearance-related distress and social avoidance, and impacts visual function. Previous work demonstrates the benefits of ptosis surgery for health-related quality of life, but there is a paucity of research comparing such outcomes before and after surgery. The aim of this study was to determine potential patient benefits in health-related quality of life, social dysfunction and anxiety following successful ptosis surgery using validated measures. Methods Adult ptosis correction surgery patients completed validated measures of appearance-related social anxiety and avoidance, anxiety and depression, and fear of negative evaluation pre-surgery. Following successful surgery, these measures were repeated post-discharge in addition to another health-related quality of life measure. Results Of 61 patients recruited, follow-up measures were sent to 33 and completed by 23. Paired samples t-tests demonstrated positive significant changes in appearance-related social distress pre-op m = 30.94, post-op m = 23.67 (t(17) = 3.46, 95% CI 2.84–11.72, p = 0.003), anxiety pre-op m = 7.6, post-op m = 4.9 (t(19) = 4.27, 95% CI 1.38–4.02, p < 0.001) and fear of negative evaluation pre-op m = 34.79, post-op m = 31.26 (t(18) = 2.47, 95% CI 0.52–6.53, p = 0.024). There was no significant difference in depression scores pre-op m = 3.6; post-op m = 3.2 (t(19) = 0.672, 65% CL −0.85 to 1.65, p = 0.510). In total, 85% of patients reported positive benefit to well-being following surgery. Conclusion Increasingly, evidence suggests ptosis surgery may benefit patient’s well-being, appearance-related social anxiety and avoidance, as well as improving visual function. These psychosocial benefits should be considered alongside functional benefits in the provision of ptosis surgery.

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“…11 Absorbable multipoint fixation devices such as Endotine or Endotine ST (Microaire Corporation, Charlottesville, Virginia) have been used for 15 years to correct cosmetic deformities of the eyebrow and midface. [12][13][14][15][16] However, there are clinical situations that require functional (noncosmetic) repositioning of the forehead, eyebrow, and midface. Examples include obscured visual fields from a mechanical eyebrow ptosis, midface descent or paralysis contributing to lower eyelid retraction, and impairment of upper lip or oral commissure dysfunction.…”

Section: Introductionmentioning

confidence: 99%

“…18 Consequently, patients may complain of upper eyelid heaviness and difficulty with peripheral vision, seeing things up high over the forehead, or having to manually elevate the eyelid and eyebrow complex to permit optimal vision. 14,19,20 Moreover, due to prolonged frontalis muscle contraction, patients may complain of tension headaches that are often exacerbated by reading or prolonged computer use. 21 To our knowledge, there are no previous studies investigating the use of bio-absorbable implants in the treatment of functional deficits of the forehead, eyebrow, or midface.…”

Section: Introductionmentioning

confidence: 99%

Functional Reconstruction of Forehead and Midface Deficits Using the Endoscopic Technique and Bio-Absorbable Implants

et al. 2020

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Objectives: Functional deficits of the forehead and midface can pose significant problems for patients varying from mild asymmetry to various degrees of functional impairment including total paralysis. Our objectives were to analyse the use of bio-absorbable implants to reconstruct forehead and midface deficits, all of which were for functional (noncosmetic) reasons. Methods: This study was a retrospective case series between 2008 and 2018. Institutional review board approval was obtained from the Beaumont Health Human Investigation Committee. Surgeries were performed at a tertiary care centre. We evaluated 50 patients who underwent correction of functional deficits of forehead, eyebrow, and midface using the endoscopic technique and bio-absorbable implants. Patient demographics and indicated etiologies and characterization of minor and major complications and their occurrence rates were characterized. Results: Fifty patients were included in the study from 2008 to 2018, with 68% female and 32% male. Combined blepharoplasty and brow lift was the most commonly performed procedure, followed by midface lift and browplasty. The mean follow-up time was 372 days. No major operative complications including stroke, permanent nerve paralysis, or mortality occurred. There was a 4% rate of temporary nerve paresthesia that resolved, 2% rate of infection, and 6% rate of implant migration requiring revision surgery. Conclusion: The endoscopic approach and use of bio-absorbable implants to reconstruct functional deficits of the forehead and midface are safe and effective. There were zero major complications and most of the minor complications were temporary. There was a significant association between non-age-related functional impairment and risk of complication.

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Brow ptosis: are we measuring the right thing? The impact of surgery and the correlation of objective and subjective measures with postoperative improvement in quality-of-life

Abstract: Introduction To assess the effect of brow ptosis on visual function and quality-of-life

Cited by 18 publications

References 20 publications

Hyaluronic Acid Fillers Enriched with Glycine and Proline in Eyebrow Augmentation Procedure

Hyaluronic Acid Fillers Enriched with Glycine and Proline in Eyebrow Augmentation Procedure

Patient reported psychosocial functioning following successful ptosis surgery

Functional Reconstruction of Forehead and Midface Deficits Using the Endoscopic Technique and Bio-Absorbable Implants

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