Infra-Brow Volume Contouring Surgery

The periorbital region plays a key role in facial aging, with notable ethnic variations in brow and eyelid morphology. Eurodescendientes patients with high or normal eyebrow positions often present with excess infra-brow volume and lateral hooding. The infra-brow volume contouring fat lift surgery was developed to address this condition by integrating principles from previously described Asian sub-brow blepharoplasty methods, adapted to Eurodescendientes anatomy.

A retrospective study was conducted on 40 Eurodescendientes female patients (mean age: 39.5 years) who underwent this surgical technique between October 2023 and October 2024. The procedure consisted of a five-step technique: elliptical skin and subcutaneous excision, en bloc removal of the orbicularis oculi muscle (OOM) and retro-orbicularis oculi fat (ROOF), contouring of the remanent ROOF, fixation of the lower muscle flap through the sub-frontalis fascia to the supraorbital rim periosteum using absorbable sutures, followed by layered muscle and skin closure. Postoperative outcomes were assessed over a follow-up period ranging from 11 to 19 months, focusing on patient satisfaction, scar appearance, and complications.

All patients demonstrated satisfactory esthetic outcomes, with a 100% reported satisfaction rate. Postoperative swelling resolved within 1-3 months, and no unaesthetic scars were observed. Transient sensory symptoms, including paresthesia and hypoesthesia, occurred in all cases but resolved within 3-5 months. No permanent sensory deficits or major complications were reported.

This technique provides an effective, stable, and esthetically reliable correction for infra-brow bulging in patients with high or normal eyebrow positions. Combining all five steps of the technique ensures durable results and minimal scarring.

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