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Brow elevation ratio: a new method of brow analysis
Brian P Kim1, Richard L Goode, James P Newman
1Facial Plastic Surgery Division, Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, San Mateo, CA 94401, USA.
Objective:
To introduce a novel quantitative method measuring preoperative and postoperative brow position and apply it to a cohort of patients undergoing endoscopic brow suspension.
Design:
Retrospective review of patients who underwent endoscopic brow- and forehead-lift using a consistent operative technique and method of fixation. Changes in brow position were measured using standardized digital photographs of patients taken before and after surgery. Brow elevation was determined using a novel measurement system based on the ratio of the vertical height of the brow to the distance between the lateral corneal limbus and the medial canthus.
Results:
Sixteen consecutive patients (32 eyebrows) underwent surgery between January 7, 2003, and January 15, 2006, without any major complications. With follow-up ranging from 6 to 31 months (mean follow-up, 18 months), a statistically significant elevation of brow position was found. Mean brow ratio measurements increased by 18.0% on the right side and 16.1% on the left side, for an overall mean increase in brow position of 17.1%. The brow elevation ratio remained increased by a mean of 16.8% for patients who were followed up for almost 2 years and beyond.
Conclusions:
The brow elevation ratio can be applied to patients undergoing brow suspension procedures with standard office photography. The ratios provide the surgeon with a quantitative dimension for assessing outcomes of brow elevation and can be used in comparative analysis of each patient's baseline brow position.
