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The Brow Fat Pad Suspension Suture: Safety Profile and Clinical Observations

Eftekhari, Kian, M.D.*; Peng, Grace, L., M.D.; Landsberger, Hannah; Douglas, Raymond, M.D.§‖; Massry, Guy, G., M.D.‖¶

Ophthalmic Plastic and Reconstructive Surgery: January/February 2018 - Volume 34 - Issue 1 - p 7–12
doi: 10.1097/IOP.0000000000000831
Original Investigations
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Purpose: To evaluate the safety, subjectively assess outcome, and emphasize surgical pearls and critical clinical observations of upper blepharoplasty performed in conjunction with the brow fat pad suspension suture procedure, previously referred to as a “browpexy variant” or “brassiere suture procedure.”

Methods: A retrospective 4-year analysis of patients who underwent the brow fat pad suspension suture with upper blepharoplasty was performed. Adjunctive procedures (brow lift and ptosis repair) were categorized. The surgical technique is detailed with emphasis placed on nuances to aid in optimal outcome.

Results: Two hundred and sixteen patients (149 women and 47 men) underwent upper blepharoplasty with the brow fat pad suspension suture. The average patient age is 54 years and follow up is 11 months. One hundred patients had adjudicative brow lift or ptosis repair, and in 20 patients the blepharoplasty was a revision procedure. Subjective assessment of outcome showed excellent aesthetic results with improved brow projection, and enhanced lateral tarsal platform show and eyebrow/eyelid contour. Surgical complications were infrequent and patient satisfaction was high.

Conclusions: This initial large series description of the brow fat pad suspension suture demonstrates that it is a safe adjunct to upper blepharoplasty, which the authors believe subjectively improves overall outcome. Evidence-based quantitative assessments of objective measures of surgical results are currently underway.

The brow fat suspension suture is a safe adjunct to upper blepharoplasty, which the authors have found enhances the brow/eyelid transition and contour and leads to a more youthful and aesthetic result to surgery.

*Oculoplastic Surgery, Inc., Salt Lake City, Utah; Department of Otolaryngology, Head and Neck Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California; Tufts University, Medford, Massachusetts; §Division of Oculoplastic Surgery, Department of Ophthalmology, University of Michigan Medical School, Ann Arbor, Michigan; Beverly Hills Ophthalmic Plastic and Reconstructive Surgery, Beverly Hills, California; and Division of Oculoplastic Surgery, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California, U.S.A.

Accepted for publication October 9, 2016.

Supported by royalties from Elsevier and Springer (to G.G.M.) and royalties from Springer (to R.D.).

The authors have no conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (www.op-rs.com.).

Address correspondence and reprint requests to Guy G. Massry, M.D., Beverly Hills Ophthalmic Plastic Surgery, Beverly Hills, California, 150 N. Robertson Blvd. # 314, Beverly Hills, CA 90211. E-mail: gmassry@drmassry.com

© 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.