Comparison Between Traditional Eyebrow Lift And Combination Of Eyebrow Lift And Periorbital Muscle Treatment

BackgroundEyebrows and eyes are important aesthetic marks in face.Facial expressions of eyebrow and eye sends the message in social activities.At the same time,eyebrows and eyes are the most prone area in the face of aging,and also the key to the appearance of the old face.The main clinical manifestations are laxity of the upper eyelid skin,eyebrow ptosis and obvious periperiorbital wrinkles.With the improvement of economy and living standard,more and more beauty seekers are seeking cosmetic surgery to improve the appearance of periperiorbital aging.By reviewing the research at home or at abroad,there are many methods to treat periperiorbital aging,such as blepharoplasty,double-eyelid operation,coronal brow lift,endoscopic brow lift and so on.But their therapeutic results are not well,and their shortcoming are such as the lack of correction of the upper eyelid,the unnatural formation of the double eyelid,and the secondary ptosis of the eyebrow.Direct brow lift is a common operation on solving periperiorbital aging at home and at abroad.The incision option include supra-brow excision,trans-brow excision,sub-browexcision.Asian women are recognized as higher eyebrows,wider upper eyelids and more orbital fat than caucasian women.Thus sub-brow excision is more suitable for asian women.However,in sub-brow excision,the long-term follow-up study of the traditional brow lift showed the following shortcomings: 1.the secondary eyebrow ptosis and the distance between eyebrow and eye will narrow;2.the upper eyelid will fall back and the operation effect will reduce after surgery;3.periperiorbital wrinkle has no obvious improvement.We adopt combination of eyebrow lift and periorbital muscle treatment to treat periperiorbital aging on the basic the mechanism of periperiorbital aging in histology and anatomy.In addition,we treat the orbicularis oculi and corrugator supercilii on the basic of trational brow lift in order to improve eyebrow ptosis,sagging of upper eyelid and periperiorbital wrinkles(including static and dynamic wrinkles).At current,in sub-brow excision,there is no research on the combination of eyebrow lift and periorbital muscle treatment and comparison of traditional eyebrow traditional brow lift and excision eyebrow surgery and the combination of eyebrow lift and periorbital muscle treatment.ObjectiveTo evaluate the efficacy and complications of traditional brow lift and the combination of eyebrow lift and periorbital muscle treatment in periperiorbital aging.MethodsThirty-six patients(Thirty-six females)who seeked to improve periperiorbital aging were selected January 2017 to December 2017 in xijing Hospital in this study.There were15 patients in traditional brow lift group.There were 21 patients in combination of eyebrow lift and periorbital muscle treatment group.A randomized controlled method was used to randomly divide the patients into traditional brow lift group and combination of eyebrow lift and periorbital muscle treatment group.The surgical method of traditional eyebrow lift was to only remove the sagging upper eyelid skin.The surgical method of the combination of eyebrow lift and periorbital muscle treatment was to treat the orbicularis oculi and corrugator supercilii in addition to remove the sagging upper eyelid skin.1 month,3 months and 6 months after operation,the improvement effect of upper eyelid,morphological changes of eyebrow andpostoperative complications were evaluated.Six months after operation,the improvement of periperiorbital wrinkles and the satisfaction of patients were evaluated.The results were displayed as mean values±SD.repeated measures data ANOVA for comparison in the same group,paired t-test for comparison between groups,The Wilcoxon signed rank test for ranked data.The statistical tests were two sided,and a p-value of less than 5% was considered statistically significant.And correlations with Statistical Package for the Social Sciences version 19.0.Results1.The effect of upper eyelid laxity correction: Two kinds of surgeries were effective in treating.One month,there months and six months after operation,combination of eyebrow lift and periorbital muscle treatment group was superior to traditional eyebrow lift group on laxity of the upper eyelid skin at medial limbus,middle pupil and lateral canthus(p<0.05).2.Stability of upper eyelid laxity correction: One month,there months and six months after operation,the lifted upper eyelid in traditional eyebrow lift group showed a tendency to fall back,especially at the lateral canthus.The lifted upper eyelid in combination of eyebrow lift and periorbital muscle treatment group was stable without significant change.3.Changes in eyebrow morphology: One month after operation,eyebrow morphology of traditional eyebrow lift group,including medial limbus eyebrow,middle pupil eyebrow and lateral canthus eyebrow moved down due to skin pull and the lateral canthus was the most obvious.They were stable there months and six months after operation.The clinical manifestation were the flat eyebrow and the reduced distance between eyebrow and eye.One month after operation,eyebrow morphology of combination of eyebrow lift and periorbital muscle treatment group,including medial limbus eyebrow,middle pupil eyebrow and lateral canthus eyebrow declined and the lateral canthus was the most obvious.There is no change in preoperation and 3 months and 6 months after surgery.The whole eyebrow earlierly moved down due to skin pull and returned to the level of preoperation.4.Periperiorbital wrinkle improvement:(1)The improvement of the static periperiorbital wrinkle: In traditional eyebrow lift group,the degree of improvement in frown lines is 0 while the degree of improvement in crow's feet wrinkle is 0.93±0.78.In combination of eyebrow lift and periorbital muscle treatment group,the degree of improvement in frown lines is 0.71±0.93 while the degree of improvement in crow's feet wrinkle is 1.24±1.06.There was obvious difference absolute value between two groups and combination of eyebrow lift and periorbital muscle treatment group was superior to traditional eyebrow lift group(p<0.05).(2)The improvement of the dynamic periperiorbital wrinkle: In traditional eyebrow lift group,the degree of improvement in frown lines is 0 while the degree of improvement in crow's feet wrinkle is 0.27±0.12.In combination of eyebrow lift and periorbital muscle treatment group,the degree of improvement in frown lines is 2.23±0.93 while the degree of improvement in crow's feet wrinkle is 1.1±0.18.There was obvious difference absolute value between two groups and combination of eyebrow lift and periorbital muscle treatment group was superior to traditional eyebrow lift group(p<0.05).5.Patients satisfaction: In improvement of upper eyelid laxity,patients satisfaction of traditional eyebrow lift group is 3.86±0.71 while patients satisfaction of combination of eyebrow lift and periorbital muscle treatment group is 4.48±0.73.There was obvious difference absolute value between two groups and combination of eyebrow lift and periorbital muscle treatment group was superior to traditional eyebrow lift group(p<0.05).In eyebrow morphology,patients satisfaction of traditional eyebrow lift group is 4.1±0.81 while patients satisfaction of combination of eyebrow lift and periorbital muscle treatment group is 4.76±0.53.There was obvious difference absolute value between two groups and combination of eyebrow lift and periorbital muscle treatment group was superior to traditional eyebrow lift group(p<0.05).6.Postoperative complications: In scalp numbness,there was no case of scalp numbness in 15 cases of traditional eyebrow lift group and the incidence rate was 0.There was 11 cases of scalp numbness in 21 cases of traditional eyebrow lift group and the incidence rate was 0.524.There was obvious difference absolute value between twogroups and traditional eyebrow lift group was superior to combination of eyebrow lift and periorbital muscle treatment group(p<0.05).ConclusionIn sub-brow excision,trational eyebrow lift and combination of eyebrow lift and periorbital muscle treatment group had definite curative effect on the treatment of periperiorbital aging.combination of eyebrow lift and periorbital muscle treatment was superior to traditional eyebrow lift in the effect of upper eyelid laxity correction,stability of upper eyelid laxity correction,the effect on the eyebrow shape and periperiorbital wrinkle improvement.Traditional eyebrow lift group was superior to combination of eyebrow lift and periorbital muscle treatment group in postoperative complications(scalp numbness).Both of two groups adopted sub-brow excision,and postoperative scar of them reduced and no hyperplasia changed.