Application of suspension technique between dermal fascia and frontalis in upper lid lift and eyebrow augmentation

Objective To explore the application of the technique of eyelid lift combined with eyebrow arch augmentation in the correction of upper eyelid skin ptosis. Methods The incision was taken below or above the eyebrow, the superficial epithelium removed from the skin area with subcutaneous dermis and fascia preserved; the eyebrow skin flap was separated from the underlying muscles plane through the incision near the eyebrow and to expose the muscle superior to the eyebrow arch. The reserved dermis and fascia flap was folded and fixed to the muscle near the eyebrow arch area. Results Using this method we corrected 186 patients with upper eyelid skin relaxation from August 2008 to October 2018, including 178 females and 8 males. 52 patients were followed up from 6 to 50 months post operation. All the incision healed well with improved skin lift and augmented eyebrow arch, the incision scar were almost invisible. 45 patients were very satisfied with their appearance; asymmetry was encountered in 3 cases and 2 of them experienced revision surgery. 3 patients were not satisfied with the insufficient skin lift. 1 case was complaint of her unilateral dog ear in the early stage post operation. Conclusions This technique can augment the low eyebrow arch while improve the upper eyelid ptosis. The preserved dermis and fascia folding technique can also reduce the incision tension and obtain a invisible incision scar as a result. Key words: Eyelids; Skin aging; Dermis and fascia muscle; Muscle suspension; Eyelid skin ptosis