Determinative factors in surgical planning of eyebrow cosmetic and reconstructive surgery

The purpose of this study was to identify the different factors that an oculoplastic surgeon should consider while practicing cosmetic or reconstructive eyebrow surgery in order to have the final patient's satisfaction.

In an observational case series study, five photographs were taken from each of 60 females to show ideal eyebrow positioning with fingers. Eyebrow landmarks, including tarsal plate show (TPS) and eyebrow height, were measured in the ideal position. Brow apex position and brow apex angle were evaluated in the desired position of eyebrow.

The mean desired apex angle of eyebrow was measured as 135±9 mm. In all, 48.33% of our subjects preferred a wider brow angle, 28.33% a narrower one, and 23.33% a brow angle without any change. The location of brow peak was transferred to the lateral canthus in the desired position. The ideal brow peak in the lateral canthus and between lateral canthus and lateral limbus was assigned to 33.3% and 66.6% of cases, respectively. The desired eyebrow apex angle in two age groups of our subjects (>40 years and ≤40 years) was not statistically different.

Landmarks of the eyebrow and its desired position are somehow different between different studies, which may be explained by the variation in race, gender, culture, and age. As there is not any uniform rule in planning of cosmetic surgeries of eyebrow, oculoplastic surgeons should consider the difference in culture, race, age, and desire of the patients and have their surgical plans for every individual patient distinctively.