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. 2025 May;49(9):2385-2398.
doi: 10.1007/s00266-025-04775-2. Epub 2025 Mar 10.

Deep Plane Direct Brow Lift

Nabil Fakih-Gomez  1 , Lessandro Martins  2 , Elie Dagher  3 , Pia Maria Obeid  4 , Yader Antonio Guzmán-Velázquez  5 , Cristina Muñoz-Gonzalez  6
Affiliations

Deep Plane Direct Brow Lift

Nabil Fakih-Gomez et al. Aesthetic Plast Surg. 2025 May.

Abstract

Introduction: Brow ptosis, a key sign of aging, affects the eye area's appearance, with lifted brows conveying vitality. The direct brow lift, known for its precision in shaping the brow, has seen renewed interest despite concerns over visible scarring. This study introduces a refined deep plane approach to improve brow elevation, suspend fat brow relapse, and minimize scarring.

Methods: A prospective study was conducted with 45 patients (10 men and 35 women) with an average age of 48 years. The surgical technique used was a deep plane approach that involved transecting and suspending the orbicularis oculi muscle (OOM). This method aimed to elevate the brow, suspend the brow fat, and reduce the depressor action of the OOM, ensuring a stable, long-term lift. Postoperative outcomes were assessed over a follow-up period ranging from 3 to 18 months, focusing on brow position, symmetry, scar appearance, and patient satisfaction.

Results: All patients experienced satisfactory brow elevation with minimal scarring. The deep plane technique resulted in stable, long-lasting outcomes, with 97.8% of patients achieving symmetrical brow positioning. Scarring was generally inconspicuous, especially in patients with thick brow hair or tattoos. Transient sensory complications were noted but resolved within 3-5 months. The technique proved effective in providing a natural appearance within three months postoperatively.

Conclusion: The deep plane direct brow lift technique offers a reliable, reproducible approach to brow elevation, integrating the advantages of traditional methods while minimizing scarring and enhancing long-term stability.

Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Keywords: Brow ptosis; Direct brow lift; Periorbital rejuvenation; Periosteal suspension.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that they have no conflict of interest. Ethical Approval: This study was performed in line with the principles of the Declaration of Helsinki. Consent to Publish: All participants have provided consent for the publication of their photographs.

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