CHEMICAL BROWLIFT

Objective: To determine if the medial brow can be elevated following a dministration of botulinum toxin type A (Botox, Allergan, Irvine, Cali f). Design: A before-after interventional study comparing pretreatment and posttreatment brow height. Objective measurements and subjective comparisons of pretreatment and posttreatment slides were made by 7 in dependent observers unaware of treatment status. All measurements and observations were based on standardized photographs taken with identic al lens settings. Setting: Private facial plastic surgery practice. Al l injections were performed in office examination rooms without anesth esia or sedation. Patients: Thirty adult patients electively seeking i mprovement of glabellar frown lines or low-positioned medial brews (an gry appearance). Intervention: Twenty units of botulinum toxin type A was injected into the corrugator supercilli and procerus muscles. An e lectromyographic needle was used for the initial 10 injections, and a 30-gauge needle was used for the remainder. Outcome Measures: In the o bjective arm, change in brow height was measured from the medial canth us and midpupil directly vertical to the brow hairs; the change in int erbrow distance was also measured. In the subjective arm, the number o f patients who were found to have an elevated medial brow by the indep endent observers was noted. Objective and subjective findings were cor related. Results: Objective measurements yielded a raise in the medial brow in 8 (32%) of 25 patients from the medial canthus and in 12 (48% ) of 25 from the midpupil and an increase in interbrow distance in 17 (59%) of 29 patients. Subjective comparison found 18 (62%) of the 29 p atients to have higher medial brews after treatment. Conclusions: Botu linum toxin type A treatment can create a chemical browlift. Further s tudies with more specific selection criteria are needed to better eval uate this effect.