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At least 19 recordsLinked to original sources
PubMed2004

Eyebrow reconstruction: options for reconstruction of cutaneous defects of the eyebrow.

BACKGROUND: Reconstruction of cutaneous eyebrow defects is a challenge, as eyebrow positioning provides an important role in communication, cosmesis, and signaling age, gender, and emotional status. Special consideration must be paid in order to maintain eyebrow symmetry and to avoid distortion of the hairline. OBJECTIVE: To demonstrate reconstructive options for the eyebrow that preserve maximal function and cosmesis. METHODS: The anatomy and function of the eyebrow are reviewed. Descriptions of five techniques of eyebrow reconstruction are then presented, including specific limitations and benefits of each closure option. Pertinent details regarding flap mechanics, design, and patient selection are also included. RESULTS: There are several options available for reconstruction of the eyebrow. Each closure method has advantages and disadvantages. The selection must be individualized, depending on the extent and location of the eyebrow defect relationship to other structures, gender, and age of patients. Each of the five closure options aid to maintain the function and aesthetic appearance of the eyebrow. CONCLUSION: Understanding the unique anatomy and function of the eyebrow, including its movement in facial expression, is useful in achieving good reconstructive outcomes while maintaining normal eyebrow function.

Eyebrows↗
PubMed2004

Removing eyebrows impairs recognition of famous faces, or doesn't, depending on how the eyebrows are removed.

Matching photos of famous people's faces with their names was as fast with photos that had eyebrows masked by adhesive plaster as with unretouched original photos. But matching was slower with photos that had eyebrows erased and replaced with adjacent skin texture and colour than with original photos. The conjecture that erasure impairs recognition because it alters a face's configuration was examined by repeating the experiment with the photos shown upside down, the rationale being that because configural information is difficult to encode from inverted faces the erasure effect should diminish. With inverted faces, matching was no different for original, eyebrows-masked, and eyebrows-erased photos. Eyebrows appear to be less important for face recognition as informative parts and features than as sources of information about a face's configuration.

Analysis of Variance↗
PubMed2002

Eyebrow island flap for reconstruction of a partial eyebrow defect.

A diverse variety of methods for reconstructing eyebrow defects has been described previously, and each procedure has inherent advantages and disadvantages. The authors present a case of reconstruction of a partial eyebrow defect using two eyebrow island flaps, which are modifications of the subcutaneous pedicle flap.

Adult↗
PubMed1996

An anatomically based study of the mechanism of eyebrow ptosis.

The development of eyebrow ptosis with aging is commonly attributed to progressive laxity of scalp and forehead soft tissues. If the change in eyebrow position with aging resulted entirely from this basic mechanism of tissue stretching, uniform lowering of the medial and lateral eyebrow segments should occur. Clinical observations show, however, that the lateral eyebrow segment usually becomes ptotic earlier than the medial segment, indicating that a more complex mechanism exists. To clarify this process, anatomic studies were done on 20 (40 half-head) fresh cadaver specimens. Histologic studies also were performed to complement the gross anatomic findings. These studies confirm that the mechanism producing eyebrow ptosis has a relatively greater effect on the lateral eyebrow segment. The lateral eyebrow has less support from deeper structures than the medial eyebrow, and the balance of forces acting on the eyebrow selectively depresses the lateral segment. Structures that may promote mobility and gravitational descent of the eyebrow, especially the lateral eyebrow segment, are (1) the galea fat pad, (2) the preseptal fat pad, and (3) the subgalea fat pad glide plane space. Three forces that act on the lateral eyebrow are (1) frontalis muscle resting tone, which suspends that eyebrow segment medial to the temporal fusion line of the skull, (2) gravity, which causes the soft-tissue mass lateral to the temporal line to slide over the temporalis fascia plane and push the lateral eyebrow segment downward, and (3) corrugator supercilii muscle hyperactivity in conjunction with action of the lateral orbicularis oculi muscle, which can antagonize frontalis muscle activity and directly facilitate descent of the lateral eyebrow. The axis point for these forces is the temporal fusion line of the skull near the superior orbital rim. The interaction of those structures and forces contributing to the mechanism producing eyebrow ptosis is discussed. Derived concepts are applied to the execution of the forehead lift procedure.

Cadaver↗
PubMed1996

Correlation between brow lift outcomes and aesthetic ideals for eyebrow height and shape in females.

This study correlates brow lift outcomes published in the plastic surgical literature with aesthetic criteria for ideal female eyebrow height and shape. Aesthetic criteria were determined by testing the opinions of 11 cosmetic surgeons and 9 cosmetologists. Eyebrow height and shape were altered with computer graphics to isolate those changes as the only variables of appearance. Plastic surgeons and cosmetologists preferred (p = 0.01) medial eyebrows below or at the supraorbital rim and disliked the medial eyebrow above the rim. Both groups preferred (p = 0.01) eyebrow shape to have an apex lateral slant. One hundred preoperative and 100 postoperative photographs from 16 frequently referenced articles on brow lifts were evaluated. There was a significant (p = 0.0008) increase in the number of medial eyebrows elevated above the rim. The number of medial apex eyebrows increased, and the number of flat brows decreased (p = 0.01). There was no significant increase in the number of apex lateral eyebrows. Three conclusions are made about female eyebrows: (1) The medial eyebrow should be located at or below the supraorbital rim but not above it. (2) Eyebrow shape should have an apex lateral slant. (3) Standard open and endoscopic brow lift operations frequently result in unsatisfactory eyebrow height and shape, judged by these criteria.

Esthetics↗
PubMed2001

Eyebrow transplantation.

BACKGROUND: Reconstruction of the eyebrow has historically been accomplished with temporal scalp pedicle flap formation or free composite scalp grafts. These two techniques may be associated with substantial morbidity and a false, overly dense eyebrow appearance. Hair transplantation of the eyebrows has been described with excellent results, but is relatively underreported in the literature. OBJECTIVE: To determine whether modern techniques of micrograft hair transplantation can suitably re-create an aesthetic eyebrow in a case of iatrogenic eyebrow alopecia. METHODS: A 33-year-old woman with iatrogenic eyebrow alopecia underwent four sessions of eyebrow micrograft hair transplantation to re-create both eyebrows. RESULTS: Suitable aesthetic eyebrows were re-created in a symmetric fashion with proper hair orientation. The process was time consuming and tedious, but highly effective. CONCLUSION: Eyebrow transplantation is a suitable alternative to pedicle flap formation and composite scalp grafting. It is a straightforward procedure that can be performed in the office under local anesthesia with minimal attendant morbidity. The result may be superior to that seen with more involved eyebrow replacement procedures.

Adult↗
PubMed2005

The male eyebrow: a topographic anatomic analysis.

PURPOSE: To study and quantify the topographic anatomy of the male eyebrow and its 3-dimensional relation, based on age and location, relative to the eye and the supraorbital rim. METHODS: A prospective cohort of male patients seen for routine ophthalmic evaluation age 10 years and older had several eyebrow measurements incorporated in the examination. The presence or absence of brow ptosis was noted on the basis of observation. The location of the eyebrow relative to the center of the pupil, the lateral canthus, and the depth of the supraorbital rim was measured. The data were subjected to statistical analysis. RESULTS: The study included 444 eyebrows of 222 patients ranging in age from 10 to 86 years, with a mean age of 46.75 years. The incidence of brow ptosis was 7.4%. The mean distance between the lateral canthus and inferior brow (LIBD) was 11.23 mm. The mean distance between the pupil and the inferior brow and the superior brow border was 11.15 mm (PIBD) and 19.8 mm (PSBD), respectively. Statistical analysis demonstrated that the mean brow position did not vary with age. However, there was a significant negative correlation between the position of the eyebrow and the depth of the superior sulcus below the supraorbital rim (correlation coefficient, 0.431 for PIBD and depth and 0.381 for LIBD and depth, respectively). Deeper-set eyes had lower brow position. CONCLUSIONS: The male eyebrow sits along the supraorbital ridge and has a flat contour. In men without frank brow ptosis, the eyebrow position relative to the pupil and the lateral canthus does not significantly fall with age despite the periocular changes associated with aging. However, 3-dimensional analysis demonstrates that individuals with deep-set eyes have a lower positioned eyebrow then those with a more shallow depth below the supraorbital rim. These findings are helpful in surgical management of the eyelid-eyebrow continuum. The age-related changes in the eyebrow area should be thought of as a 3-dimensional construct with collapse of the structure and not simply descent of the eyebrow.

Adolescent↗
PubMedDate not supplied

Modifications of eyebrow position with botulinum exotoxin A.

OBJECTIVE: To determine if clinically used botulinum exotoxin A (Botox) injections to the forehead and glabellar and crow's-feet regions result in modifications of eyebrow position. DESIGN: Prospective study. SETTING: Academic medical center in St Louis, Mo. SUBJECTS: Twenty-nine adult patients treated with botulinum exotoxin A injections for rhytids. INTERVENTION: The eyebrow position at 13 different sites was measured before injection and 2 weeks after treatment. The areas injected were based on patient preference and physician assessment. Of the 29 patients, 14 received injections into the glabella only and 15 received injections into the glabella and forehead, with or without treatment of the crow's-feet. RESULTS: In 29 patients at rest, we found no significant (P value range,.17 to.97) change in eyebrow position, except for a point depression at the right lateral eyebrow. The 15 patients who received injections into the forehead and glabella, with or without treatment of the crow's-feet, had no significant (P value range,.11 to.84) change in eyebrow position, except for a point of depression at the left medial eyebrow. Both groups exhibited eyebrow depression in the active state (eyebrow maximally elevated). CONCLUSIONS: Botulinum exotoxin A injections into the forehead and glabellar, and crow's-feet regions did not significantly change the resting eyebrow position. However, forehead injections contributed to eyebrow depression in the active state.

Adult↗
PubMed2003

Anthropometric measurements of the endoscopic eyebrow lift in the treatment of facial paralysis.

Endoscopic eyebrow lift was performed on 51 patients presenting with eyebrow ptosis due to facial paralysis. The resulting anthropometric measurements of eyebrow position were analyzed statistically to evaluate the effectiveness of this method. When preoperative eyebrow differences between the paralyzed and nonparalyzed sides were measured, the average difference at midpoint was 4.4 mm, and at the highest point, 4.6 mm. When the same points were measured postoperatively, the average difference at midpoint was 2.4 mm, and at the highest point, 2.3 mm. The difference in eyebrow height between the paralyzed and nonparalyzed sides correlated positively with age, both preoperatively and postoperatively. However, differences between preoperative and postoperative eyebrow height (which reflects the effectiveness of endoscopic eyebrow lift) at the highest point did not correlate with age and at the midpoint displayed a slightly negative correlation with age. These results suggest that endoscopic eyebrow lift is effective among young patients whose eyebrow ptosis is minor and is relatively ineffective among elderly patients whose eyebrow ptosis is severe. The conventional method of juxta-brow excision is indicated for elderly patients, for whom the operative scar is almost inconspicuous.

Adolescent↗
PubMed2002

[Aesthetic eyebrow reconstruction by using follicular-unit hair grafting technique].

OBJECTIVE: To search a new option for aesthetic reconstruction of the eyebrow. METHODS: Under local anesthesia, a scalp strip was harvested from the back of the head, closed to the hairline. Under 2 times magnification, the strip was then divided into a series of follicular-unit micrografts with 1-3 hairs. Usually, 150 micrografts were needed per eyebrow in a man whereas 100 micrografts in a woman. After the micro-slits or micro-slots were prepared in the recipient site, the grafts were implanted into the holes, parallel to the original hair directions. RESULTS: From Apr 1998 to Feb 2000, thirty-two patients with 48 eyebrow-losses, resulted from burn scar, skin grafting, chemical peeling, lesion excising or congenital loss, were treated by this one-session operation. All of the patients were satisfied with the results. The grafted hairs grow in the direction of normal eyebrow, which achieve 95%-96% survival even in a scarring area. The appearance of the reconstructed eyebrows was more natural, close to the normal eyebrow, compared to the traditional methods. CONCLUSION: The above-mentioned technique is a simple, safe and effective method for eyebrow reconstruction. It might be an ideal method for eyebrow reconstruction with the appearance much closer toa normal eyebrow.

Adolescent↗
PubMed1982

The anatomy of eyebrow ptosis.

An anatomical study was performed to gain a better understanding of the pathogenesis of eyebrow ptosis. Through cadaver dissection, we sought to establish the anatomy of the normal eyebrow, to determine why the temporal part of the eyebrow becomes ptotic earlier than the medial portion, and to locate precisely the regional nerves and vessels to aid the eyebrow surgeon. a fat-pad exists beneath the eyebrow. Dense attachments on the underside of the eyebrow fat-pad secure the eyebrow to the supraorbital ridge. Because the supraorbital ridge extends only over the medial one half to two thirds of the orbit, the lateral part of the eyebrow lacks deep support and droops with the frontal skin and muscle relaxation seen in age. Vertical lateral orbicularis fibers are consistently seen in the cadaver. Because of their location, they may play a role in producing "laugh lines."

Aging↗
PubMed2004

Cicatricial eyebrow reconstruction with a dense-packing one- to two-hair grafting technique.

Scarring eyebrow loss is usually repaired with a hair-bearing island scalp flap or scalp strip grafting technique. The results, however, are usually not desirable with regard to appearance. In this article, a one- or two-hair graft with a dense-packing technique was developed for cicatricial eyebrow reconstruction. It was carried out by harvesting a scalp strip close to the hairline of the back, then dividing it into a series of one- or two-hair grafts, and finally implanting the grafts into the prepared recipient holes of the eyebrow with a desired hair direction. With the authors' experience in treating 96 patients (154 eyebrows) in cases of burn, skin grafting, traumatic scarring, and chemical peeling scar after tattoo removal, the eyebrows could be restored in only one session. In general, 150 to 200 grafts with 200 to 250 hairs were needed for a complete male eyebrow reconstruction and 100 to 150 grafts with 150 to 200 hairs were needed for a complete female eyebrow reconstruction. The maximal hair density was 91.5 hairs/cm per session. Over a 6-month follow-up period, the mean graft survival rate reached 98.1 percent. All of the patients achieved satisfactory results, with a very natural appearance. These results indicate that the above-mentioned technique could be a practical, effective, and probably ideal method for cicatricial eyebrow reconstruction.

Adolescent↗
PubMed1994

Involvement of the eyebrow fat pad in Graves' orbitopathy.

Involvement of the eyebrow fat pad in Graves' disease has never been reported. We noted that Graves' orbitopathy patients had bulkier eyebrows due to a larger eyebrow fat pad not associated with the preaponeurotic fat. A cadaver model was used to show that the eyebrow fat could be identified with magnetic resonance imaging (MRI) scans. Then, a series of Graves' orbitopathy patients were sent for orbital MRI scans, and the eyebrow fat was measured with maximum lengths and widths. The averages were compared to two groups of patients, one without orbital pathology, and one with orbital pathology causing proptosis but not due to Graves' disease. Graves' patients with early orbitopathy and incipient optic neuropathy or congestive orbits where optic neuropathy had to be ruled out had statistically significant larger eyebrow fat pads than either comparison group. This has clinical significance: The eyebrow fat may need to be debulked during operations such as blepharoplasty. Furthermore, periorbital fat may play a larger role in the disease process than previously thought.

Adipose Tissue↗
PubMed2003

Eyebrow reconstruction with intermediate hair from the hairline of the forehead on the pedicled temporoparietal fascial flap.

Although various reconstructive procedures for the eyebrow have been reported, few have proved satisfactory for large-tissue defects. The authors describe two cases of eyebrow reconstruction with intermediate hair from the hairline of the forehead on the pedicled temporoparietal fascial flap (TPF flap) after malignant tumor resection. The first patient was a 24-year-old man with an adnexal carcinoma of the left eyebrow. An intermediate hair flap was prepared at the hairline of the forehead in accordance with the defect. The second patient was a 48-year-old woman with Bowen's disease of the left eyebrow. Tumor resection was performed on the frontal muscle with a 5-mm surgical margin. An intermediate hair flap was prepared at the hairline of the forehead in accordance with the defect. Both reconstructed eyebrows have maintained their shapes well. There have been several reports of the use of a TPF flap for eyebrow reconstruction, but none have used intermediate hair from the hairline. The authors are convinced that use of intermediate hair from the hairline of the forehead on the pedicled TPF flap is effective for reconstruction of the eyebrow and large defects extending to nonhairy subbrow skin.

Adult↗
PubMed2005

Eyebrow colour in diabetics.

BACKGROUND: Hair colour may be affected by a metabolic disease. Systematic investigations in diabetics are missing. OBJECTIVE: A clinical study was performed to evaluate whether dark colour of eyebrows in greying males is associated with diabetes or not. SETTING: Academic teaching hospital, inpatient and outpatient department. METHODS: In an uncontrolled analysis two groups of male patients between 50 to 70 years of age were investigated for evidence of diabetes mellitus. Inclusion criteria were original scalp hair colour brown to black with more than 50% greying hair, no chemotherapy, hormone (except insulin) or interferon treatment, current or previous, no artificial colouring of hair, and absence of total alopecia. Group A consisted of 50 males with dark eyebrow colour, group B of 50 males with greying of eyebrows. A careful medical history and clinical examination was performed. In patients without known diabetes, blood sugar levels (profile during the day) and HbA1c were evaluated. RESULTS: In group A 38 of 50 patients (76%) were diabetics type II. The mean duration of diabetes was 3.4 years (SD 6.8 years; range 1 year to 31 years). Six patients were diagnosed as having diabetes for the first time. In group B 9 of 50 patients (18%) were diabetics, two of type I and 7 of type II. One patient with a newly detected diabetes type II was seen. The mean duration of diabetes was 4.1 years (SD 7.6 years; range: 1 year to 39 years). The difference in diabetes frequency is statistically highly significant (two-sided t-test: p<0.0001). Odds ratios (OR) for diabetes are higher in greying males with dark eyebrows (OR 3.17) vs. those with greying eyebrows and scalp hair (OR 0.19) in this age group. CONCLUSIONS: In male diabetics at the age of 50 years or more greying of the eyebrows seems to be inhibited or delayed. The presence of dark eyebrows with greying scalp hair in males might be a clinical sign for patients at risk of diabetes type II.

Aged↗
PubMed1997

The effect of blepharoplasty on eyebrow position.

OBJECTIVE: To determine if upper eyelid blepharoplasty causes eyebrow position to drop in a cosmetic surgery population. DESIGN: Retrospective, observational study. A treatment group that underwent upper eyelid blepharoplasty was compared with a matched control group that did not undergo the surgery. SETTING: Private facial plastic surgery practice. All surgery was performed at an ambulatory surgical facility on an outpatient basis. PATIENTS: A total of 82 patients (164 eyes) were included in this study: 54 (8 men and 46 women; average age, 46.8 years) in the treatment group and 28 (6 men and 22 women; average age, 43.8 years) in the control group. The treatment group was chosen in a retrospective fashion to include only those patients (1) for whom preoperative and postoperative photographs were available and (2) who had undergone upper eyelid blepharoplasty by the senior author (F.M.K). These patients underwent no other procedures, either before or during the time span between the photographs, that could affect eyebrow position. The control group consisted of patients who had an available set of matching photographs taken over time. These patients did not undergo blepharoplasty or any other procedure that could alter eyebrow position between their initial and final photographs. INTERVENTION: Upper eyelid blepharoplasty performed by the senior surgeon (F.M.K.). The surgical technique was identical in all cases. OUTCOME MEASURE: The change in eyebrow height reflected as a percentage of the pretreatment height. Results are based on measurements taken from standardized photographs. RESULTS: Original treatment and control groups of 108 and 56 eyes, respectively, were restricted to a smaller number to create similar populations for comparison. Therefore, 40 eyes in the treatment group were matched with 28 eyes in the control group to control for the duration between measurements. A t test found no significant difference (P = .94) in eyebrow height between patients who had a blepharoplasty and those who had not. CONCLUSION: In a cosmetic surgery population, upper eyelid blepharoplasty does not cause a lowering of the eyebrow.

Eyebrows↗