Multiple surgical techniques allow for management of brow ptosis

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William J. Lipham, MD, FACS, an OSN Oculoplastic and Reconstructive Surgery Board Member, said at OSN New York 2012 that patients who have excess upper eyelid skin, or dermatochalasis, are the best candidates for this surgery."/><meta id="metaKeywords" name="keywords" content="Ocular Surgery News,Ophthalmology,Oculoplastics,Meeting News Coverage"/><meta id="Meta1" name="scID"/><meta id="scID" name="scID"/><meta name="PostedDate" content="2012-11-20"/> <meta name="specialties" content="Ophthalmology"/> <meta name="specialty" content="Ophthalmology"/> <meta name="primary_specialty" content="Ophthalmology"/> <meta name="subspecialties" content="Oculoplastics"/> <meta name="subspecialty" content="Oculoplastics"/> <meta name="primary_subspecialty" content="Oculoplastics"/> <meta name="departments" content="Meeting News Coverage"/> <meta name="department" content="Meeting News Coverage"/> <meta name="content_type" content="News Article"/> <meta name="pageid" 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href="/web/20130903024504/http://www.healio.com/ophthalmology/oculoplastics/news"> News</a> </p>   <div id="SeeAlso" class="related-links"><h3>See Also</h3><ul><li><a href="https://web.archive.org/web/20130903024504/http://www.healio.com/ophthalmology/oculoplastics/news/online/%7B0d2be519-f60e-4082-8756-21ec0513724d%7D/distinguishing-cause-of-droopy-eyelids-determines-management-approach">Distinguishing cause of droopy eyelids determines ...</a></li><li><a href="https://web.archive.org/web/20130903024504/http://www.healio.com/ophthalmology/oculoplastics/news/print/ocular-surgery-news/%7B655e0036-5076-4413-b39a-d2c9a7d76351%7D/evaluation-and-management-of-congenital-ptosis">Evaluation and management of congenital ptosis</a></li><li><a href="https://web.archive.org/web/20130903024504/http://www.healio.com/ophthalmology/oculoplastics/news/print/ocular-surgery-news/%7B090bfcb5-760d-46f4-9b1c-d84aa1f21941%7D/ptosis-can-be-treated-with-supra-brow-single-stab-incision-frontalis-sling-surgery">Ptosis can be treated with supra-brow single-stab incision ...</a></li></ul></div>  <div class="content"> <h2> Multiple surgical techniques allow for management of brow ptosis</h2> <h3 class="deck"> </h3> <p class="main-subtitle"> </p> <div class="social-links-top"> <ul class="share"> <li class="l1"><a href="javascript:void(0)" class="facebook-link" target="_new">Facebook</a></li> <li class="l2"><a href="javascript:void(0)" class="twitter-link" target="_new">Tweet</a></li> <li class="l3"><a href="javascript:void(0)" class="linkedin-link">Share</a></li> </ul> </div> <ul class="meta-info"> <li> Ocular Surgery News U.S. Edition, January 10, 2013</li> </ul> <div class="wyContent"> <p class="Bodytext1">NEW YORK — <a href="https://web.archive.org/web/20130903024504/http://www.healio.com/ophthalmology/search.aspx?q=%22Brow+ptosis%22&requiredfields=specialty:Ophthalmology&client=healio_frontend&output=xml_no_dtd&proxystylesheet=healio_frontendCME&site=healio-production&lr=lang_en&filter=p&getfields=*&ie=UTF-8&ip=192.168.100.144&access=p&entqr=3&oe=UTF-8&ud=1&sort=date%3AD%3AS%3Ad1" target="_blank">Brow ptosis</a> is most manageable through the use of a direct brow lift, an internal browpexy or an endoscopic brow lift, according to a speaker here. </p> <p class="Bodytext"><strong>William J. Lipham, MD, FACS, </strong>an OSN <a href="https://web.archive.org/web/20130903024504/http://www.healio.com/ophthalmology/oculoplastics" target="_blank">Oculoplastic and Reconstructive Surgery</a> Board Member, said at <a href="https://web.archive.org/web/20130903024504/http://www.healio.com/ophthalmology/meetings/meeting-news-coverage?setid={A674D394-E846-4A5D-916D-E0EA07FE3209}" target="_blank">OSN New York 2012</a> that patients who have excess upper eyelid skin, or dermatochalasis, are the best candidates for this surgery.</p> <p class="Bodytext">Direct brow lift is the most functional eye lift, he said, and works best on older men with deep transverse forehead lines because the technique allows for the greatest amount of elevation per millimeter of tissue resected.</p> <p class="Bodytext">Internal browpexy may be used for either functional or cosmetic reasons and is best for patients with thin or absent brow hair, Lipham said. This technique will reduce the rate of brow descent over time but will also cause postoperative discomfort to the patient.</p> <p class="Bodytext">According to Lipham, female patients with a low or normal hairline who have mild to moderate brow ptosis are ideal candidates for endoscopic browlift. Because men typically have stronger, heavier brows and higher hairlines that may reveal incisions, they are less than ideal candidates for this technique.</p> <p class="Bodytext">Physicians should perform individual patient counseling to determine the best surgical technique, he said.</p> <p class="disclosure"><strong>Disclosure</strong>: Lipham has no relevant financial disclosures.</p> <p class="disclosure"> </p> <p><em>OSN New York 2013 will be held September 6-8 at the Waldorf-Astoria in New York City. Learn more at </em><a href="https://web.archive.org/web/20130903024504/http://www.osnny.com/"><em>www.osnny.com</em></a><em>.</em></p> <p> </p> </div>  <div class="fig left"> <p class="figcaption"> </p> </div> <div class="wyPagination">   </div>  <div class="follow"> <img src="/web/20130903024504im_/http://www.healio.com/~/media/Images/News/FollowUs.jpg" id="layout_0_maincontent_1_SocialFollow_socialfollow" name="socialfollow" alt="Follow us" usemap="#followus" border="0"/> <map id="followus" name="followus"> <area id="layout_0_maincontent_1_SocialFollow_followfb" shape="rect" coords="51,5,5,51" target="_blank" href="https://web.archive.org/web/20130903024504/http://www.facebook.com/ocularsurgerynews" alt="Follow us on Facebook"></area> <area id="layout_0_maincontent_1_SocialFollow_followtw" shape="rect" coords="241,3,281,50" target="_blank" href="https://web.archive.org/web/20130903024504/https://twitter.com/OSNSuperSite" alt="Follow us on Twitter"></area> </map> </div> </div>  <div class="social-links"> <div class="fb-like" data-send="false" data-width="300" data-show-faces="true" data-action="recommend"></div> <ul class="share"> <li><a href="javascript:void(0)" id="twitter" class="twitter-link" target="_new">Tweet</a></li> <li><a href="javascript:void(0)" id="facebook" class="facebook-link" target="_new">Share</a></li> <li class="linkedin"><a href="javascript:void(0)" id="linkedin" class="linkedin-link">Link</a></li> <li><span class="db-wrapper"><span class="g-plusone" data-size="tall" data-annotation="none"></span></span></li> <li><a href="javascript:void(0)" id="email">Email</a></li> <li class="last"><a href="javascript:void(0)" id="print">Print</a></li> </ul> <input name="layout_0$maincontent_1$SocialMedia$articleItemForTweet" type="hidden" id="layout_0_maincontent_1_SocialMedia_articleItemForTweet" value="{6C346288-7A83-47C6-9F83-63D28F98B17F}"/> </div>  <div id="respond"> <h4> Comments</h4> <script language="javascript" type="text/javascript"> var idcomments_acct = 'aa6ff53f9870e40f92f83e1b5df3cddf'; var idcomments_post_id = '{6C346288-7A83-47C6-9F83-63D28F98B17F}'; var idcomments_post_url; </script> <span id="IDCommentsPostTitle" style="display: none"></span> <script type="text/javascript" src="https://web.archive.org/web/20130903024504js_/http://www.intensedebate.com/js/genericCommentWrapperV2.js"></script> <p class="comment-notes"> Healio is intended for health care provider use and all comments will be posted at the discretion of the editors. 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Multiple surgical techniques allow for management of brow ptosis | Ocular Surgery News