Periorbital changes in patients with Poly(Lactic Acid/Caprolactone) threads for brow augmentation

Background: Overlooked compensatory brow ptosis can lead to patients dissatisfaction and poor surgical results. Objective: To evaluate the quantitative changes in periorbital dimensions in 11 patients with mild to moderate brow ptosis after browlift with Poly(Lactic Acid/Caprolactone) (P[LA/CL]) sutures. Method: Retrospective analysis and data collected from reviewing clinical records, 11 patients, with mild to moderate brow ptosis, whom only has P(LA/CL) browlift, fulfilled the criteria and included in the analysis. All patients had 2-dimensional clinical photos and 3-dimensional clinical pictures in 5 standard views at baseline and follow-up. All periorbital measurements determined by the computer and collected for analysis. Results: There was a significant difference in all periorbital measurements at 4 to 6 months’ follow-up when compared with baseline (p<0.05). Moderate lifting refers to changes in brow height of at least 2 mm at follow-up. A higher proportion of patients with moderate brow lift were able to achieve moderate lifting compared with mild brow ptosis. Moderate lifting is observed in 30% to 60% medial brow and 45% to 60% lateral brow for patients with moderate brow ptosis compared with 25% in those with mild brow ptosis. Infection, significant bruising, or scarring did not occur. Transient side effects, such as bruising and dimpling, eventually resolved. Conclusion: Preoperative examination is vital to identify pre-existing compensatory brow ptosis. P(LA/CL) thread-lifting for brow augmentation is a simple and effective procedure which can be used as an adjunct to upper eyelid surgery to prevent secondary brow ptosis following eyelid surgery and in turn, improve patients’ satisfaction.