Small-Incision Frontalis Muscle Transposition Flap for Lateral Eyebrow Ptosis Repair

PURPOSE: To describe a novel technique to correct lateral eyebrow ptosis using a frontalis muscle transposition flap. METHODS: The charts of all patients undergoing eyebrow ptosis repair using a frontalis muscle transposition flap from December 2013 through April 2014 were reviewed to describe the surgical technique. RESULTS: Sixteen patients underwent eyebrow ptosis repair using a frontalis muscle pedicle flap during the study period. Briefly, after local infiltration, a lateral forehead rhytid was marked and incised for approximately 1.5 cm. Blunt dissection exposed the frontalis-orbicularis angle, the frontalis-orbicularis insertion, and the lateral extent of the frontalis muscle. A pedicle flap of lateral frontalis muscle was created, trimmed, and transposed laterally in graded fashion to achieve the optimal eyebrow height and contour. The incision was closed with 5-0 polypropylene suture. All patients reported improvement in eyebrow position. CONCLUSIONS: This novel technique provides frontalis muscle elevatory force to the lateral eyebrow through a small incision to improve eyebrow ptosis. Further study, including objective measures of long-term results, is required.