Subbrow Lift Using Frontalis Sling to Correct Lateral Orbital Laxity

Area of Science:

• Ophthalmology
• Plastic Surgery
• Facial Aesthetics

Background:

• Upper lid laxity is commonly addressed with upper blepharoplasty, subbrow excision, and forehead lifts.
• Existing methods may inhibit periorbital gliding planes, affecting natural movement.
• A novel subbrow excision technique is introduced to enhance result longevity.

Purpose of the Study:

• To evaluate a new subbrow excision technique that attaches the orbicularis oculi muscle to the frontalis muscle.
• To assess the efficacy and safety of this method in correcting upper eyelid laxity.

Main Methods:

• A cohort of 564 patients (523 female, 41 male; average age 59.5) underwent the procedure between January 2016 and July 2018.
• The technique involves attaching a portion of the orbicularis oculi muscle to the frontalis muscle via horizontal mattress sutures.
• Patient satisfaction was assessed using a Likert scale three months post-operation.

Main Results:

• Orbital laxity improved in all but two patients, with follow-up of at least six months.
• The technique demonstrated good wound healing without significant complications like keloids or nerve entrapment.
• A slight lowering of the brow's lateral third was noted where the frontalis muscle is absent.

Conclusions:

• The described subbrow lift is a novel and effective method for correcting upper eyelid skin hooding.
• The technique preserves the eyebrow gliding plane and natural eyebrow movement, avoiding periosteal fixation.
• No significant complications were reported, including injury to the supraorbital nerve or poor wound healing.