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Purpose

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Purpose

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  1. The purpose of this study is to evaluate the postoperative changes in quality of life and cosmesis in patients who underwent direct brow lifting procedures. The direct brow lift is a superjacent surgical technique designed to improve brow ptosis. The purpose of the procedure is to improve ptosis and expand the patient’s visual field. The procedure is traditionally reserved for patients with thick upper eyelid skin and who are elderly. Advantages of the procedure include overall effectiveness and minimal bleeding. In addition, the procedure is often of short duration with minimal recuperation time. Disadvantages include a visible facial scar and a potentially unnatural eyebrow contour, that can result in a “surprised” look. Moreover, patients may experience paresthesia over the eyebrow and forehead area. Moreover, 21 (84%), patients denied light sensitivity, 25 (100%) denied any new headaches/pain, and 24 (96%) denied forehead/scalp numbness. Direct brow surgery is a straight forward procedure to improve brow ptosis. The surgery provides an improvement in vision and an overall positive surgical result. Negative outcomes—including scar formation, post-operative paresthesias and headaches—are minimal. Purpose Objectives Patients who underwent direct brow surgery from 2005 to 2012 were asked to participate in a fourteen question survey. Patients who had concurrent eyelid surgeries, such as blepharoplasty, were excluded. Questions included: Did you have your eyebrow surgery for cosmetic or functional reasons or both? Do you notice a scar from your brow surgery? • If yes, do you notice the scare on one side more than another? • If yes, does it bother you that the scar is visible? • If you had a medical brow lift and were now offered the choice to instead do a cosmetic out-of-pocket surgery in order to hide the scar, would you? Do other people notice your scar? Are you happy with the result of your surgery? Do you feel your appearance has changed since your eyebrow surgery? Do you find it easier to participate in activities/hobbies since your surgery? Has the brow surgery improved your self-confidence? Since your surgery, do you feel your vision has improved? • If yes, do you specifically notice an improvement in your peripheral or side vision? Has your ability to read newspaper print improved since your eyebrow surgery? Since your surgery healed, do you have any new light sensitivity? Since your surgery healed, have you had any increases in headaches or pain? Has your ability to drive improved since your eyebrow surgery? Have you noticed an numbness in your forehead or scalp since your eyebrow surgery? Methods 25 patients participated in the study. When asked if they were happy with their surgery, patients responded: When asked, since your surgery, do you feel your vision has improved, patients responded: When asked, do you notice a scar from your brow surgery, patients responded: Results Results References Contact SrinivasSai A. Kondapalli, M.D., PGY-2 Loyola University Medical Center 2160 South 1st Avenue Maywood, IL 60154 skondapalli@lumc.edu Primary author acknowledges  The Richard A. Perritt Charitable Foundation. To evaluate patient expectations prior to direct browplasty. To examine cosmetic benefit of direct brow surgery. To note functional improvement in overall vision as well as visual field peripherally after direct brow surgery. To assess overall satisfaction with the direct brow procedure and in comparison to alternative brow ptosis repair methods. To evaluate post operative complications after direct brow surgery specifically with light sensitivity, paresthesias and headaches. To note changes to quality of life in patients who undergo direct brow surgeries. 1Ophthalmology, Loyola University Medical Center, Maywood, IL; 2Ophthalmology, Ohio University, Doctor’s Hospital, Columbus, OH; 3Ophthalmology, The Ohio State University, Columbus, OH SrinivasSai A. Kondapalli1, Craig N. Czyz2, Jill A. Foster3, Kenneth V. Cahill3 Cosmetic and Quality of Life Outcomes of the Direct Brow Lift Angelos PC, Stallworth CL, Wang TD. “Forehead Lifting: State of the Art.” Facial Plastic Surgery. 2011 Feb; 27(1):50-7. Barker L, Naveed H, Adds PJ, Uddin JM. “Supraorbital Notch and Foramen: Positional Variation and Relevance to Direct Brow Lift.” Ophthalmic Plastic and Reconstructive Surgery. 2013 Jan;29(1):67-70. Booth AJ, Murray A, Tyers AG. “The Direct Brow Lift: Efficacy, Complications and Patient Satisfaction.” British Journal of Ophthalmology. 2004 May;88(5):688-91. Har-Shai Y, Gil T, Metanes I, Scheflan M. “Brow Lift for the Correction of Visual Field Impairment.” Aesthetic Surgery Journal. 2008 Sep-Oct;28(5):512-7. Pollock H, Pollock TA. “Subcutaneous Brow Lift with Precise Suture Fixation and Advancement.” Aesthetic Surgery Journal. 2007 Jul-Aug;27(4):388-95. Walrath JD, McCord CD. “The Open Brow Lift.” Clinical Plastic Surgery. 2013 Jan;40(1):117-24. Conclusions YES 60% YES-Bothered 16% YES-Not Bothered 28% NO 56%