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Letters to the Editor, Aesthetic Surgery Journal, Volume 25, Issue 1, January 2005, Page 54, https://doi.org/10.1016/j.asj.2005.01.007
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Dr. Zarem replies:
The browpexy procedure is simple, which tends to confound plastic surgeons today who insist on making things complex through references to “vectors” and “algorithms.” I dislike disappointing my colleagues, but neither of these concepts applies to the browpexy.
Suturing the superior cut edge of the orbicularis muscle to the arcus marginalis after completing an upper blepharoplasty simply prevents the brow from descending below the supraorbital rim and enhances the sulcus at the juncture of the upper border of the eyelid with the brow. The browpexy as I have described it does not “deal” with the ptotic brow unless the brow is below the supraorbital rim. The browpexy takes nothing away and therefore does not “skeletonize” the sulcus. If the surgeon feels that an enhanced sulcus creates an unnatural crease “associated with aging” (a concept that is dubious in my experience), then the surgeon is forfeiting an opportunity to produce a visible upper eyelid, an improvement that patients appreciate after not seeing their upper eyelid for years.
