Fixing Eyelid Surgery
Aesthetic Restorative Concern: 43-year old woman concerned about the fall in her eyebrow following eyelid surgery. She also had laser resurfacing at the time of her upper eyelid surgery and developed hyperpigmentation.
Diagnosis:
- Brow ptosis following eyelid surgery.
- Post laser resurfacing hyperpigmentation.
Treatment:
- Endoscopic forehead lift.
- Lower eyelid chemical peel
Discussion:
The position of the eyebrow is determined by the balance of the forehead lifting muscles and the muscles in the eyelid that pull the eyebrow down. In turn, gravity and forehead laxity have a bearing on the activity of these muscles. In particular, when the brow tissue encroaches on the upper eyelid, the motor tone of the forehead lifting muscles increase. Removing skin from the upper eyelid fold decreases the need for the forehead lifting muscles to work resulting in a relaxation in the eyebrow position. Therefore, it is not surprising that her eyebrows relaxed after upper eyelid surgery.
Hyperpigmentation is a known complication of laser resurfacing. Often this resolves spontaneously with time. When it does not go away on its own, the pigment needs to be mobilized and this can best be done with an appropriate chemical peel. It this case, the peel was able to lift out the extra pigmentation.
