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A. S. Davis, D. Holck; Minimally Invasive Internal Browlift Using Unidirectional Barbed Propylene Sutures. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5223.
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To evaluate the clinical outcomes of minimally invasive internal browlift using unidirectional barbed propylene sutures.
50 patients with mild to moderate brow ptosis underwent a one week pre-operative injection of botulinum toxin type A into the glabellar and lateral orbicularis oculi muscles followed by a minimally invasive internal browlift using unidirectional propylene sutures. Each case was evaluated for surgical complications, and patients were examined pre-operatively and at post-operative day 7 and at months 1, 3, 6 and 9 for photographic documentation, discomfort, brow position and post-operative healing.
All 40 patients had at least 9 months of follow-up. 4 were male (10%) and 36 female (90%). Ages ranged from 36-76 (mean 57). At 3 months, 32/40 (80%) had mild brow elevation (improved compared to pre-operative state), 8/40 (20%) had no change in brow position, and 36/40 (90%) of patients were pleased with results. At 6 months, 25/40 (62.5%) had mild brow elevation, 14/40 (35%) had no change in brow position, and 1/40 (2.5%) had lower brow position compared to pre-operative state. At 9 months, 6/40 (15%) had mild brow elevation, 33/40 (82.5%) had no change in brow position, and 1/40 (2.5%) had lower brow position compared to pre-operative state. Surgical complications were suture abscess 1/40 (2.5%), migrated suture 2/40 (5%), and pain or tenderness to palpation and/or elevation 13/40 (32.5%) at 3 months and 6/40 (15%) at 6 months. 36/40 (90%) patients had concomitant upper lid blepharoplasty without complication related to the blepharoplasty.
Minimally invasive internal browlift using unidirectional barbed propylene sutures appears to provide a majority of patients (>85%) with brow elevation at the preoperative level 6-9 months post-operatively, can be safely performed at the same time as upper eyelid blepharoplasty, and is associated with a low but definite complications risk.
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