Brow Elevation Ratio: A New Method of Brow Analysis

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To introduce a novel quantitative method measuring preoperative and postoperative brow position and apply it to a cohort of patients undergoing endoscopic brow suspension.


Retrospective review of patients who underwent endoscopic brow- and forehead-lift using a consistent operative technique and method of fixation. Changes in brow position were measured using standardized digital photographs of patients taken before and after surgery. Brow elevation was determined using a novel measurement system based on the ratio of the vertical height of the brow to the distance between the lateral corneal limbus and the medial canthus.


Sixteen consecutive patients (32 eyebrows) underwent surgery between January 7, 2003, and January 15, 2006, without any major complications. With follow-up ranging from 6 to 31 months (mean follow-up, 18 months), a statistically significant elevation of brow position was found. Mean brow ratio measurements increased by 18.0% on the right side and 16.1% on the left side, for an overall mean increase in brow position of 17.1%. The brow elevation ratio remained increased by a mean of 16.8% for patients who were followed up for almost 2 years and beyond.


The brow elevation ratio can be applied to patients undergoing brow suspension procedures with standard office photography. The ratios provide the surgeon with a quantitative dimension for assessing outcomes of brow elevation and can be used in comparative analysis of each patient's baseline brow position.

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