Aesthetic Plast Surg. 2026 May 18. doi: 10.1007/s00266-026-05909-w. Online ahead of print.
ABSTRACT
INTRODUCTION: Various surgical approaches have been developed to address brow ptosis. The direct brow lift allows a precise correction of brow ptosis by targeting the head, body and/or tail of the brow.
OBJECTIVE: The aim of this study was to evaluate the clinical efficacy, long-term positional stability, aesthetic satisfaction and scar-related outcomes of the direct brow lift procedure.
METHODS: This prospective monocentric study included 41 patients who underwent direct brow lift surgery with the Castanares technique between September 2020 and April 2024. In 35 patients, upper blepharoplasty was performed concurrently. Objective morphometric assessments of brow position were performed at preoperative (T0), 1-month (T1) and 12-month (T12) post-operative evaluating standardized photographic images with ImageJ software. Patient satisfaction was measured through the FACE-Q questionnaire (“Satisfaction with Forehead and Eyebrows”), while scar perception was assessed using the SCAR-Q. Data were analysed using ANOVA for repeated measures.
RESULTS: A statistically significant post-operative increase in the distance from point A (brow’s tail) and point C (brow’s head) to the interpupillary line was observed at one month, with only a slight decrease at 12 months, indicating long-term surgical stability. In contrast, the brow’s body (point B) exhibited minimal variation overall. In terms of patient satisfaction, FACE-Q scores improved at all time points and across all patient groups. The overall SCAR-Q scores reflected improved patient perception of the scar with time.
CONCLUSIONS: The direct brow lift is a reliable and effective technique for achieving stable, long-term correction of brow ptosis. It demonstrates high patient satisfaction and acceptable scar perception over time.
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 .
PMID:42151608 | DOI:10.1007/s00266-026-05909-w
