Lateral Browlift Using Temporal (Pretrichial) Subcutaneous Approach Under Local Anesthesia

Lateral brow ptosis is a common aging phenomenon, contributing to the lateral upper eyelid hooding, in addition to dermatochalasis. Lateral brow lift complements upper blepharoplasty in achieving a youthful periorbital appearance. In this study, the author reports his experience in utilizing a temporal (pretrichial) subcutaneous lateral brow lift technique under local anesthesia. A retrospective analysis of all patients undergoing the proposed technique by one surgeon from 2009 to 2016 was conducted. Additional procedures were recorded. Preoperative and postoperative photographs at the longest follow-up visit were used for analysis. Operation was performed under local anesthesia. The surgical technique included a temporal (pretrichial) incision with subcutaneous dissection toward the lateral brow, with superolateral lift and closure. Total of 45 patients (44 females, 1 male; mean age: 58 years) underwent the temporal (pretrichial) subcutaneous lateral brow lift technique under local anesthesia in office setting. The procedure was unilateral in 4 cases. Additional procedures included upper blepharoplasty (38), ptosis surgery (16), and lower blepharoplasty (24). Average follow-up time was 1 year (range, 6 months to 5 years). All patients were satisfied with the eyebrow contour and scar appearance. One patient required additional brow lift on one side for asymmetry. There were no cases of frontal nerve paralysis. In conclusion, the temporal (pretrichial) subcutaneous approach is an effective, safe technique for lateral brow lift/contouring, which can be performed under local anesthesia. It is ideal for women. Additional advantages include ease of operation, cost, and shortening the hairline (if necessary).