Longevity of Brow Elevation in Endoscopic Brow Lift with Endotine Fixation

Purpose

To quantitatively assess the degree of brow elevation that persists at postoperative intervals of greater than three years following endoscopic browlift with endotine fixation.

Methods

Of the 13 patients in this study, 11 were women and 2 were men. All were photographed in the Frankfort horizontal plane with pupils in midline gaze.  All patient photographs were taken with a single-model Nikon D3200. The age range of the patients was from 41 to 71 years of age, with a median age of 54.7. The range of postoperative follow up was from 36 to 80 months, with a median follow up of 49 months postoperatively.    

In order to standardize the quantitative evaluation of these endoscopic brow lifts with endotine fixation, we applied The Brow Elevation Ratio technique. The Brow Elevation Ratio uses three facial anatomic landmarks (the medial canthus, the lateral limbus, and the apex of the brow), which remain relatively constant over time, to determine changes in brow position.  This ratio has been demonstrated to remain constant for each brow, regardless of the distance of the subject from the lens of the camera or the zoom modification used.¹  

Using this technique, and the Adobe Photoshop program to measure the distances, Brow Elevation Ratios were calculated for each brow from pre and postoperative photographs.  The surgical effect of each endoscopic brow lift with endotine fixation was demonstrated by calculating the difference between the postoperative and preoperative Brow Elevation Ratios, and then translating this to a percentage change [(postoperative ratio - preoperative ratio)/preoperative ratio x 100%].   Statistical analysis of this data was then performed using The Microsoft Excel Statistical Software Package.

Results

Statistical analysis was used to compare the increase in Brow Elevation Ratios from the preoperative to the postoperative photographs for all the patients in the study. The mean percentage increase in the Brow Elevation Ratio for this study group was 22.7%. Paired t-tests confirm that these results are highly statistically significant (P<0.001).

Conclusions 

This study offers the longest follow up to date of patients who have undergone endoscopic brow lift with endotine fixation procedures by a single surgeon. It presents objective and statistically significant evidence of the efficacy and the longevity of the results of endoscopic brow lifting with endotine fixation.