Hollowness Under Brows 1 Year After Brow Pexy. Could This Have Been Prevented? How To Correct? (photo)

Question

I had a brow pexy over a year ago. I now have very hollow areas directly under my brows. What could have been done to prevent this. How can it be permanently fixed? I am a 52 year old female.

Jed H. Horowitz, MD, FACS · Answer

hollowness underbrow after browpexy:

	
		fillers are probably best at this time
	
		juvederm, restylane are simple and good for a trial
	
		fat can be more permanent

Peter Lee, MD, FACS · Answer

Unfortunately, you do not say what technique was used for your "brow pexy".  It is possible that some of these procedures may accentuate certain defects that were present preoperatively, or, alternatively, cause a degree of atrophy of the soft tissues in some areas, depending on the techniques employed. At this juncture, you would be best served by undergoing fat transfer to the affected area.

	In general, it is advisable for the surgeon performing this procedure to "over-correct" this area, anticipating that not all of the transferred fat will survive. It is also important for you to know that complete correction and contouring of this area may require more than a single fat transfer procedure, but in the hands of a surgeon experienced with fat grafting techniques, the likelihood of your ultimately attaining a satsifactory result is good.

George Marosan, MD · Answer

Thank you for the photos. This is a small area of depression, but quite obvious. It is easily corrected with micro fat graft injections to get a permanent or long lasting result.This can be done under local anesthesia with no down time. Talk to your surgeon about this. Good luck.

Miguel Delgado, MD · Answer

This is a slight in the bone in this area in my opinion. Nothing is removed in the location with a brow lift unless something else was performed with the the procedure that you had. This area can be easily filled with fat injections or more temporary products to see if you like the result.

Evan H. Black, MD · Answer

It looks like some fat may have been removed or the "brow pexy" technique caused some atrophy (shrinkage) of the sub brow fat. Your best options would be a long lasting filler or a fat injection. Neither of these is likely to be permanent, but should offer significant improvement with minimal downtime or hassle.

Joseph A. Eviatar, MD, FACS · Answer

Depending on the lift of the brow, you can get some hollowing. But, hollowing also happens over time as people age. In any case, the best way to fix this is with injectable fillers such as Restylane. Restylane used around the eye is considered “off-label”, but can last for several years. Permanent solutions, such as fat injections, are not generally good around the eyes because you will continue to age and your face will continue to change. Permanent solutions cannot be customized ongoing. You will be stuck with whatever result given. For this reason, I recommend long term treatments rather than permanent solutions.

Tal T. Roudner, MD, FACS · Answer

The pictures show and area of hollowing after your browpexy. It is hard to say if the surgery itself caused it. To treat soft tissue deficiencies your options include temporary fillers such as Restylane, Radiesse or more permanent procedures such as fat grafting that require slightly more invasive procedures.

	 

	Good luck

Steven Schuster, MD, FACS · Answer

This would not be unheard of depending upon the technique used. Since the degree of hollow appears minor, I would discuss this with your plastic surgeon and probably correct this with micro droplet fat injections. Good luck. Dr. Schuster from Boca Raton

Harrison C. Putman III, MD (retired) · Answer

It appears that you have very small areas of soft tissue atrophy causing the hollows. This is basically loss of soft tissue volume or fat. Micro fat injections or soft tissue fillers such as Juvederm, Restylane, or Belotero (new) can also correc this easily. Good luck.

Hollowness Under Brows 1 Year After Brow Pexy. Could This Have Been Prevented? How To Correct? (photo)

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