Can My Direct Browlift Result Be Improved By A Temporal Lift

Q: Dr. Eppley I had a direct brow lift done for which the surgeon decided to alter the Orbicularis muscles. This has been catastrophic to me and my surgeon doesn’t know how to fix it now. I would like to repair or clean this up in some way shape or form. The most noticeable problem is at the outter corners of the eyes and at the temples. From the temple area at about brow bone level  the removal of support has caused this area of my face to drop down and slid inward toward as if towards the nose. My ENT doctor says this “dropping” is also causing my new sinus problems because of the sinuses at the maxillary sinus. Is there a procedure to repair this sort of thing? Any information to help direct me would be extremely appreciated. Thank you for your time. Sincerely and hoping for good news. 

A: In answer to your questions, I first assume by a direct browlift you mean where the incision was placed directly over the brow. I will make that assumption in my comments:

1) A direct browlift does not disturb the orbicularis muscles. They are outside of the excisional zone of a direct browlift. Most likely the effect you are seeing is that once the brows are raised, the unlifted areas (corner of the eyes, temples) now looks by comparison sunken in and drooping downward. A direct browlift would not cause loss of support of these areas. It is a very limited procedure that, unlike all other types of browlifts, does not change anything around it. A temporal lift is the solution to uplifting these apparently ‘fallen’ areas.

2) Any drooping tissues around the eyes is not making any contribution to a maxillary sinus problem. That makes no anatomic sense whatsoever.

Dr. Barry Eppley

Indianapolis, Indiana