Assessment of Eyebrow Position Before and After Upper Eyelid Blepharoplasty

Objective: Assess the occurrence of secondary brow ptosis after upper lid blepharoplasty. Methods: Forty-five individuals (n = 90 brows) submitted to upper lid blepharoplasty, were assessed by means of a comparative analysis using pre- and post-operatively digital photographs, in the primary position of the eye. The images were processed using ImageJ "software", transferred to a computer, to an electronic Microsoft Excel 2002 (R) worksheet. Angular measurements were used, taking the lateral canthal angle of the brow, the most medial point of the brow, the medial canthal angle and the lateral canthal angle of the lid as anatomical reference points. When the outer angles were reduced or the inner angles increased after surgery this was considered a brow ptosis. Individuals who had undergone lid surgery associated with the eyebrow, previous eyebrow surgery and those with eyelid ptosis were excluded. The difference between the pre-operative and post-operative measurements were analyzed statistically using the Student's t-test for paired samples and the angular variation was compared with their corresponding contralateral sample using Wilcoxon's non-parametric test. Results: The measurements obtained after the blepharoplasty show significant variations from those before the surgery, indicating that the correction of redundant tissues in the brow accentuates the tendency of the eyebrow to move down. The alterations are more important in the lateral portion of the eyebrow and they occur bilaterally. Conclusion: The assessment of angular measurements obtained pre- and post-operatively showed that there are secondary changes in the position of the eyebrow as a result of upper eyelid blepharoplasty.