PURPOSE: The basic goal of a brow lift is to elevate the brow in order to produce a more youthful appearance. A successful technique requires reproducibility while providing a consistent position that is symmetrical. This presentation is not a comparison of open to endoscopic but instead offers a means for a consistent, symmetrical result. In 1985 the senior author developed this technique after completing two brow lifts that he felt were under corrected. He has continued to use this technique for 28 years.
METHOD:
Depending on the height of the forehead, an anterior hairline or coronal incision is made with the forehead elevated in a subgaleal plane to the superior orbital rims (SOR). The dermal attachments are released from the SOR. A transverse line is drawn on the edge of the SOR. One side is marked with vertical lines at the medial orbital rim (MOR), the lateral orbital rim (LOR) and the central orbital rim (COR). The COR is defined as one third the distance from the MOR to the LOR. These vertical lines are transposed to the contra-lateral side by measurements from the midline to the existing MOR, COR, and LOR marked lines, thus insuring that the vertical lines are in identical positions on both sides. Next a vertical distance from the SOR line is marked at the MOR, COR and LOR. Based on prior experience the distances used by the senior author are MOR 8mm, COR 15mm and LOR 12 mm (figure 1). At this point a hypodermic needle is placed through the brow at medial, central and lateral locations. Using a 4-0 monocryl suture the medial, central and lateral brow positions are sutured to the periosteum at the vertical marks on the MOR, COR and LOR positions.  At this point both brows are fixed in the exact same position on each side of the face. The forehead skin is re-draped and firmly pulled toward the superior incision. The excess skin is removed.
RESULTS: The” brow pexy” sutures prevent asymmetrical, inadequate, or excessive pull on the forehead skin. The monocryl suture absorbs in approximately one month.
CONCLUSION:
“”brow lift for dummies” provides a simple, reproducible technique that places the brow in a consistent and symmetrical position.