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Implications of upper eyelid ptosis and blepharodermatochalasis on fixed horizontal forehead lines
Yuewei Wu-Fienberg
Kunaal Bafna
Bahman Guyuron
University Hospitals Cleveland Medical Center
2018-02-15
Presenter: Yuewei Wu-Fienberg
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting.
Director Name: Anand Kumar
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Background: In patients with ptosis or dermatochalasis of the upper eyelid, greater frontalis activation compensates to increase the visual field. This has been increasingly implicated in the development of fixed horizontal forehead lines. We examine the correlation between ptosis, brow ptosis, and blepharodermatochalasis with development of forehead lines in a facial rejuvenation patient population.
Methods: Photos of patients presenting to the senior author (B.G.)'s practice for facial rejueventation between July 2015 and July 2017 were retrospectively reviewed for the presence of forehead lines, ptosis, brow ptosis, and blepharodermatochalasis. Inclusion criteria were patients over age 50 with high-quality frontal facial photographs. Patients with previous eyelid or forehead surgery, congenital abnormalities, or post-traumatic deformities were excluded. Patients were divided into a group with and a group without forehead lines. A two-tailed Fisher's exact test was used to evaluate statistical significance for categorical variables, and a two-tailed t-test was used for continuous variables. Significance was assessed at P<0.05.
Results: One hundred sixty patients met inclusion criteria for the study, including 100 patients and 60 patients without fixed forehead lines. Patients with forehead lines were more likely to be older (age 61.56±8.93 vs. 58.58±7.59; P=0.0337), to be male (36% vs. 11.67%; P=0.0008), to have ptosis (90% vs. 76.67%; P=0.0377), and to have blepharodermatochalasis (20% vs. 5%; P=0.0097). All patients with unilateral fixed forehead lines were noted to have ptosis on the ipsilateral side.
Conclusions: These findings suggest that ptosis and blepharodermatochalasis may contribute to the development of fixed forehead lines through compensatory frontalis activation.
