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LETTERS

Brow Suspension: A Minimally Invasive Technique

Agaoglu, Galip M.D.; Erol, O Onur M.D.

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Plastic and Reconstructive Surgery: January 2008 - Volume 121 - Issue 1 - p 336-337
doi: 10.1097/01.prs.0000294948.54905.71
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Sir:

We are writing with regard to the recent article by Tabatabai and Spinelli entitled “Limited Incision Nonendoscopic Brow Lift” (Plast. Reconstr. Surg. 119: 1563, 2007). The authors compared the limited incision nonendoscopic brow lift technique to the endoscopic technique. They concluded that the nonendoscopic brow lift is as safe and effective as the endoscopic procedure, with equivalent brow elevation and many advantages. We congratulate the authors on their new technique and good results. We suggest that there are additional references to nonendoscopic or minimally invasive methods for the correction of brow ptosis in the literature.

A paper on brow suspension as a minimally invasive technique to improve facial rejuvenation was presented by the senior author at different international meetings in 2000.1–4 The paper was subsequently published in Plastic and Reconstructive Surgery in 2002.5 We were surprised when we could not find our article among the references that the authors presented. We assume that our technique of brow suspension was unintentionally overlooked by the authors.

In our technique, under local anesthesia, four stab incisions are made, two just above the brow and two at the temporal hairline. A nylon suture is introduced through these stab incisions, and the knot is tightened in the temporal area enough to keep the brows at the position that they assume when the patient is supine. As of 2001, we have performed 387 brow suspension procedures, and since then more than 473 cases have been performed with excellent results and no significant complications.

Brow suspension is a simple, safe, effective, and minimally invasive method of brow suspension. Unlike previously described methods, it is a nondissecting method of brow elevation. However, it is not a replacement for the established techniques of forehead rejuvenation. Again, we congratulate the authors on the limited incision nonendoscopic brow lift technique that they have introduced into the armamentarium of upper third facial rejuvenation.

Galip Agaoglu, M.D.

O. Onur Erol, M.D.

ONEP Plastic Surgery Science Institute

Istanbul Bilim University

Istanbul, Turkey

REFERENCES

1. Erol, O. O. The use of brow suspension to improve rejuvenation in laser resurfacing. Presented at the International Consortium of Aesthetic Plastic Surgeons, Siena, Italy, May 24-26, 2000.
2. Erol, O. O., and Sozer, O. Brow suspension technique. Presented at the Third European Appointed 35th Meeting of the British Association of Plastic Surgeons, Birmingham, England, July 5–7, 2000.
3. Sozer, S. O., and Erol, O. O. Brow suspension technique. Presented at the American Society of Plastic Surgeons meeting, Los Angeles, California, October 14-18, 2000.
4. Erol, O. O. The use of brow suspension to improve rejuvenation in laser resurfacing. Presented at the International Symposium of Plastic and Aesthetic Surgery, Orlando, Florida, December 14-16, 2000.
5. Erol, O. O., Sozer, O., and Velidedeoglu, H. V. Brow suspension: A minimally invasive technique in facial rejuvenation. Plast. Reconstr. Surg. 109: 2521, 2002.

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