Eyebrow Position Changes After Double Eyelid Surgery: Influence of Preoperative Compensatory Brow Elevation

Postoperative eyebrow position change after double-eyelid surgery can affect aesthetic outcomes, but its mechanism remains unclear. This study aimed to investigate the influence of preoperative eyebrow elevation and other factors using the buried-suture technique to reduce confounding from tissue manipulation.

This retrospective study analyzed patients who underwent buried-suture double-eyelid surgery performed by the senior author. Eyebrow height was measured pre- and postoperatively using standardized photographs, and changes were compared between groups stratified by preoperative eyebrow elevation. Subgroup analyses were also performed based on crease height, fixation method, sex, and laterality.

A total of 108 patients (216 eyelids) were included. The average rate of eyebrow position change across all patients was 4.8%. Patients with marked preoperative eyebrow elevation exhibited more pronounced postoperative eyebrow descent, and all such eyelids showed a downward shift. Subgroup analyses by crease height, fixation method, sex, and laterality revealed no significant differences in eyebrow-position change.

Preoperative eyebrow elevation is a strong predictor of postoperative descent. This factor should be considered during surgical planning and patient counseling to improve accuracy in outcome prediction after double-eyelid surgery.