Direct Brow Lift: A Prospective Study on Aesthetic, Long-Term Efficacy, Scar-Related Outcomes and Patient Satisfaction.

INTRODUCTION

Various surgical approaches have been developed to address brow ptosis. The direct brow lift allows a precise correction of brow ptosis by targeting the head, body and/or tail of the brow.

OBJECTIVE

The aim of this study was to evaluate the clinical efficacy, long-term positional stability, aesthetic satisfaction and scar-related outcomes of the direct brow lift procedure.

METHODS

This prospective monocentric study included 41 patients who underwent direct brow lift surgery with the Castanares technique between September 2020 and April 2024. In 35 patients, upper blepharoplasty was performed concurrently. Objective morphometric assessments of brow position were performed at preoperative (T0), 1-month (T1) and 12-month (T12) post-operative evaluating standardized photographic images with ImageJ software. Patient satisfaction was measured through the FACE-Q questionnaire ("Satisfaction with Forehead and Eyebrows"), while scar perception was assessed using the SCAR-Q. Data were analysed using ANOVA for repeated measures.

RESULTS

A statistically significant post-operative increase in the distance from point A (brow's tail) and point C (brow's head) to the interpupillary line was observed at one month, with only a slight decrease at 12 months, indicating long-term surgical stability. In contrast, the brow's body (point B) exhibited minimal variation overall. In terms of patient satisfaction, FACE-Q scores improved at all time points and across all patient groups. The overall SCAR-Q scores reflected improved patient perception of the scar with time.

CONCLUSIONS

The direct brow lift is a reliable and effective technique for achieving stable, long-term correction of brow ptosis. It demonstrates high patient satisfaction and acceptable scar perception over time.

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