Background factors for postoperative eyebrow descent in blepharoptosis: A retrospective case-control study of 93 patients.

Upper blepharoplasty for ptosis aims to achieve functional and aesthetic outcomes. However, postoperative eyebrow descent is a potential complication that can affect surgical outcomes. This descent reflects the return of the brow to its normal position due to the release of compensatory frontalis muscle activity for ptosis. Identifying patients with this outcome may improve aesthetic results. This retrospective case-control study analyzed 93 patients who underwent upper blepharoplasty to identify factors associated with postoperative eyebrow descent and measure eyebrow positions before and 1.5 months after surgery. Data included patient age, sex, pre- and postoperative margin reflex distance-1, skin excision height, and levator aponeurosis advancement distance. The results showed that postoperative eyebrow descent (≥5%) occurred in 61% of the patients. Significant associations were found between postoperative eyebrow descent and sex (p = 0.028), preoperative eyebrow descent at eyelid closure (p < 0.001), and skin excision height (p = 0.012). Male patients had a significantly higher incidence of postoperative eyebrow descent, most likely due to larger skin excisions. For patients with preoperative eyebrow descent at eyelid closure and those requiring larger skin excisions, considering the possibility of postoperative eyebrow descent may improve aesthetic outcomes.