January 16, 2017
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Browpexy considered as adjunct to blepharoplasty

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KOLOA, Hawaii — Ophthalmologists should consider browpexy as an adjunct for patients undergoing blepharoplasty, according to a speaker here.

“Consider browpexy as an adjunct to blepharoplasty. It’s easy to do and I think you’ll be pleased with the results. But understand, and voice to the patient, they are augmentations to the procedure; this is not a formal brow lift,” Andrew R. Harrison, MD, said at Hawaiian Eye 2017.

Andrew R. Harrison

Andrew R. Harrison

Insurance companies note there are two main indications for functional brow lifting: when brow tissues are below the orbital rim or brow drooping contributes to loss of superior visual field. However, brow lifting can also be used for periorbital rejuvenation, Harrison said.

A structured facial exam of the forehead and periorbital area is necessary to ensure a successful small-incision brow lift. Notation of the patient’s level and character of the hairline, the degree of symmetry and the temporal brow position for the forehead examination and notation of the lateral hooding, upper and lower eyelid skin and fat, and the lateral canthal lines for the periorbital examination are both important to the success of the blepharoplasty, he said.

Harrison encouraged ophthalmologists to use an internal or external browpexy technique.

If a patient has thinner tissue, marked asymmetry and brow cilia to hide a scar, an external browpexy may be appropriate. If not, or if the patient has voiced concern about scarring, then an internal approach is appropriate, he said.

“If [the patient has] thick tissues, I’ll consider an internal browpexy, I think there’s less chance of causing a traction line,” Harrison said. – Robert Linnehan

Reference:

Harrison AR. Small incision browlifting. Presented at: Hawaiian Eye; Jan. 14-20, 2017; Koloa, Hawaii.