Abstract: Comprehensive Surgical Treatment of Visual Field Obstruction Due to Brow Ptosis: A Treatment Algorithm (Plastic Surgery 2013)

Saturday, October 12, 2013

Jessica A Ching, MD , Division of Plastic Surgery, University of South Florida, Tampa, FL

Umbareen Mahmood, MD , University of South Florida, Tampa, FL

Laurie Small, MD , Ophthalmology, University of South Florida, Wesley Chapel, FL

Charles Slonim, MD , Ophthalmology, University of South Florida, Tampa, FL

William Carter, MD , University of South Florida, Tampa, FL

Paul R. Albear, MD , University of South Florida, Wesley Chapel, FL

PDF file

E-Poster

Purpose: Brow ptosis is a common aesthetic complaint which also can contribute to significant visual field obstruction^1,2. Although brow ptosis is discussed frequently in the literature, to our knowledge there is no currently published algorithm for the surgical treatment of brow ptosis. Based on review of the literature to date and institutional experience, the authors sought to develop a surgical treatment algorithm for brow ptosis that addresses associated visual field obstruction while yielding an aesthetic result.

Methods: A review of the literature was performed utilizing PubMed, searching combinations of “brow ptosis”, “brow lift”, “browplasty”, “browpexy”, and “forehead”. Search results were subsequently narrowed according to inclusion and exclusion criteria. Inclusion criteria included: adults with brow ptosis older than 21 years old, a description of the surgical technique(s) used (coronal, pretrichial, endoscopic, temporal, midforehead, direct, intraciliary, browpexy), the quantitative or qualitative outcome data was reported, and the complete article text was available in English. The exclusion criteria included: pediatric or congenital ptosis, preoperative facial paralysis (unilateral or bilateral), revisionary or secondary brow lift procedures, or the complete article text was unavailable or not in English.

Results: The initial literature search yielded 174 articles. After applying our inclusion and exclusion criteria, the 29 selected articles were further analyzed for relevant information. A wide spectrum of reported techniques and outcome data existed; thus, few findings were directly comparable but did prove useful in overall treatment guidance. The outcomes reported in the reviewed publications were combined with our institutional experience to construct a comprehensive surgical treatment algorithm (Figures 1 and 2).

Conclusion: Utilizing available literature on brow ptosis and our institutional experience, the authors describe a comprehensive treatment algorithm that effectively addresses the functional and aesthetic issues of brow ptosis.

21933 Comprehensive Surgical Treatment of Visual Field Obstruction Due to Brow Ptosis: A Treatment Algorithm