Transpalpebral Brow Lift During Blephaplasty

asked 10 months ago by GAboomer in Georgia
Latest answer by Sam Naficy, MD
Question viewed 227 times
Tags: hooding, opinion, technique

(Female/47) Two years ago, I had a mid-face and neck lift along with excision of xanthalasma, around the inner upper/lower orbital area, with good results except alopecia began above my ears as the scars widened. (I wear my hair in a short wedge with bangs. I have a high forehead.) I'm now perimenopausal (low prog and test) taking BIO hormones. Thoughts on a upper bleph and transpalpebral brow vs endo lift given my now hooded eyes and hair loss concerns? Lateral brow is above orbital bone.

10 answers to Transpalpebral Brow Lift During Blephaplasty

Endotine Direct (Transblepharoplasty) Browlift is a Reasonable Compromise

It sounds to me that you are in the "less is more" approach to cosmetic surgery. I have experience with the Endotine Direct Browlift, in which the brow is raised from an upper eyelid incision. Thebrowlift results are improved by the use of an implant made from a carbohydrate which eventually resorbs, but does hold the eyebrow against gravity until the healing is complete. I find it important to use Botox before and during the healing to minimize the downward pull of the... more

Edward Szachowicz, MD, PhD
Minneapolis Facial Plastic Surgeon

www.facialplasticsurgery.com

Transpalpebral Brow Lift with Upper Blepharoplasty

If you have brow ptosis with a high hairline I suggest you have a Irregular Trichophytic Hairline Brow Lift, a technique we described many years ago. With this approach, we make an incision at the hairline which enables us to lower your hairline when elevating your brows. We bevel the hairline incision so hair will grow through and in front of the resulting scar so it will not be seen.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Transpalpebral browlift can often produce inadequate results.

I understand your concerns regarding hairline and scar alopecia, but compromising on the best operative approach to avoid the scar may end up giving an inadequate lift that often does not last (if it even makes a visible difference in the first place). Previous scar alopecia may be related to surgical technique and/or suture material choice rather than "your" innate scar healing (stretching). You may also find that a proper bicoronal or trichophytic (hairline) incision forehead... more

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon

Brow lift for high hairline

If you have a high forehead your best and longest-lasting bet is a trichophytic hairline brow lift - even with thin hair the incision typically heals very nicely.

Sam Naficy, MD
Seattle Facial Plastic Surgeon

Transpalpebral brow lift

I frequenly include this in my upper lid blepharoplasties because I think it does make a difference. It avoids the hairline and scarring concerns and can improve the surgical outcome. Great question. Clearly, there is more than one option in facial rejuvenation surgery and you are wise to research various options to enable you to discuss them with your plastic surgeon.

Robert L. Kraft, MD
New York Plastic Surgeon

Transpalpebral Brow Lift?

Photos of your eyes and eyebrows would be helpful in your evaluation. Transpalpebral brow lifts are far less effective than proper Brow Lifts and you might want to have several consultations to discuss your particular case.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

Consider an endoscopic browlift

I have tried these transpalpebral browlifts and am always underwhelmed by them. They use the premise of pushing and resting the brow and with time and gravity they tend not to hold up well. The endoscopic brow lift works well and like other successful browlift methods they tend to pull and not push the brow upwards and allow for a more thorough dissection of th etissue with release of the tissue that is preventing it from coming up.

Robert Schwarcz, MD
New York Oculoplastic Surgeon

The transpalpebral browlift is very disappointing.

This procedure is primarily used at the time of functional blepharoplasty in an attempt to provide inexpensive browlifting. Attempt being the operative word here. If you need brow lifting, the endoscopic brow lift is the answer. I would recommend this approach and then consider having hair grafting to improve your focal hair loss.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Transpalpebral Browlift Produces Only A Minimal Lifting Effect

While a transpalpebral browlift avoids any hairline scars, the 'price' to be paid for that decision is that it does a relatively poor job of lifting the brow. At best, it can only make a minor elevation of the tail of the eyebrow. It illustrates a basic principle that you can't really lift much when all you are doing is pushing up from below. With your already high forehead, I would strongly consider a hairline or trichophytic browlift technique. That would achieve the dual... more