Summary
Eyebrow descent commonly occurs after ptosis repair or blepharoplasty surgery. The
procedures used to correct acquired blepharoptosis are primarily classified into four
groups. These procedures target the levator aponeurosis, Müller's muscle, both the
aponeurosis and Müller's muscle, or the frontalis muscle. In this study, we used a
new technique called external Müller's muscle tucking (EMMT) on 51 patients (94 eyelids),
which targets the Müller's muscle for involutional blepharoptosis. The patients were
assessed by comparative analysis using pre- and post-operative digital photographs.
The distances between the medial canthi, in addition to the eyebrow heights at the
medial canthus, pupil and lateral canthus, were measured on a computer screen. Eyebrows
descended after surgery at the medial canthus in 53 eyelids (56.4%), at the center
of the pupil in 55 eyelids (58.5%) and at the lateral canthus in 48 eyelids (51.1%).
The mean distances of eyebrow descent in the 94 eyelids were 0.24, 0.51 and 0.32 mm
at the medial, center and lateral positions, respectively. The mean preoperative margin
reflex distance (MRD) was −0.05 mm, the mean postoperative MRD was 3.79 mm and the
mean change in MRD was 3.83 mm. Preoperative MRD and change in MRD were weakly associated
with changes in eyebrow position in 94 eyelids. In conclusion, these findings suggest
that eyebrow drooping distance is related to the preoperative severity of ptosis.
Keywords
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References
- Objective evaluation of the eyelids and eyebrows after blepharoplasty.J Oral Maxillofac Surg. 1996; 54: 297-302
- The effect of upper eyelid blepharoplasty on eyebrow position.J Plast Reconstr Aesthet Surg. 2014; 67: 1242-1247
- Does upper blepharoplasty affect frontalis tonicity?.J Plast Reconstr Aesthet Surg. 2015; 68: 638-644
- The effect of blepharoplasty on eyebrow position.Arch Otolaryngol Head Neck Surg. 1997; 123: 393-396
- Assessment of eyebrow position before and after upper eyelid blepharoplasty.Orbit. 2012; 31: 222-226
- Change in brow position after upper blepharoplasty or levator advancement.J Craniofac Surg. 2012; 23: 434-436
- Mueller's Muscle Conjunctival Resection with Skin-Only Blepharoplasty: effects on Eyelid and Eyebrow Position.Ophthal Plast Reconstr Surg. 2015; 31: 290-292
- Digital analysis of eyelid features and eyebrow position following CO2 laser-assisted blepharoptosis surgery.Plast Reconstr Surg Glob Open. 2016; 4: e1063
- The effect of ptosis surgery on brow position and the utility of preoperative phenylephrine testing.Ophthal Plast Reconstr Surg. 2016; 32: 195-198
- Evaluation of the eyebrow position after levator resection.J Plast Reconstr Aesthet Surg. 2017; 70: 85-90
- Ptosis repair options and algorithm.Curr Opin Ophthalmol. 2008; 19: 428-434
- Levator resection for minimal ptosis: another simplified operation.Arch Ophthalmol. 1961; 65: 493-496
- Müller's muscle-conjunctiva resection. Technique for treatment of blepharoptosis.Arch Ophthalmol. 1975; 93: 619-623
- Superior tarsal muscle resection to correct blepharoptosis.Ophthalmology. 1979; 86: 1883-1891
- Open sky Müller's muscle-conjunctiva resection for ptosis surgery.Eye (Lond). 2003; 17: 1008-1012
- Electrical stimulation to the trigeminal proprioceptive fibres that innervate the mechanoreceptors in Müller's muscle induces involuntary reflex contraction of the frontalis muscles.J Plast Surg Hand Surg. 2013; 47: 14-20
Article info
Publication history
Published online: January 14, 2019
Accepted:
January 6,
2019
Received:
August 27,
2018
Identification
Copyright
© 2019 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
