Upper blepharoplasty combined with preoperative forehead botulinum toxin A injection for aging eyelids with asymmetric eyebrows—Case report

Upper blepharoplasty combined with preoperative forehead botulinum toxin A injection for aging eyelids with asymmetric eyebrows—Case report

Sung-Chuan Chao, MD¹, Yuan-Sung Kuo, MD, PhD²

Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Yun-Lin branch, Yun-Lin, Taiwan¹

Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Chu-Tong branch, Hsin-Chu, Taiwan²

Blepharoplasty is the standard procedure for aging eyelids. For those with associated saggy frontalis muscle, even asymmetric position of eyebrows, auxiliary operations such as browlift are necessary. We report a simple method for a 62-year-old male and a 64-year-old female who sought surgery for their saggy eyelids. We injected botulinum toxin A (Botox®) into their floppy forehead skin, one week later, the forehead wrinkles disappeared and their eyelids became symmetric. After blepharoplasty, the ptotic eyelids were also corrected. The patients were satisfied and had an uneventful recovery in the one-year follow-up. This method can be expanded to treat any aging eyelids associated with saggy forehead with no need of browlift surgery, regardless of the eyebrow positions.