Soft Tissue Augmentation of the Temporal Brow in Browlifting Surgery

The document discusses a technique for soft tissue augmentation of the temporal brow in browlifting surgery, which is aimed at addressing age-related brow ptosis by managing both descent and deflation for optimal facial rejuvenation. Traditional techniques for browlifting, such as open or endoscopic methods, have been updated to include volume augmentation in addition to lifting. The authors describe a procedure where the patient's own dermal/subcutaneous tissue, obtained during brow elevation surgery, is used to augment the temporal brow region. This not only facilitates brow elevation but also enhances soft tissue volume. The technique involves excising segments of scalp, removing the epidermis, and placing the subcutaneous tissue along the temporal superior orbital rim, which can be sutured in an open technique or fixed with a percutaneous suture in an endoscopic technique. The material can also be used after corrugator muscle extirpation to prevent muscle reapproximation and subcutaneous depressions. Follow-up of nearly 1 year showed that the soft tissue augmentation appears to persist, with magnetic resonance imaging at 9 months postoperatively confirming the persistence of the graft. The conclusion of the document is that managing both descent and deflation with this technique may provide the optimal rejuvenation of the brow region.