Change in brow position after upper blepharoplasty or levator advancement

Brow position after blepharoplasty is somewhat controversial. Some authors insist that brow position remains unchanged after surgery. On the other hand, there is also an opinion that brow position changes after surgery.We evaluate the influence of upper blepharoplasty or correction of ptosis on brow position in East Asians. Sixty patients (120 eyes) who underwent upper blepharoplasty or levator advancement were evaluated for change in brow position. Marginal reflex distance 1, brow height from medial canthus, upper eyelid margin on midpupillary level, lateral canthus, and brow height from the center of the pupil were measured before surgery and 6 months after surgery. The distance between the upper lid margin and the brow was shortened after upper blepharoplasty or levator advancement, which could cause brow depression. Change in brow height was greater after levator advancement than after blepharoplasty. These findings might be helpful for the prediction of brow position after surgery. Our study also implies that the possibility of a change in postoperative brow position change should be explained to patients before surgery, particularly ptosis patients.