Long-Term Brow Lift Outcomes: A Systematic Review and Meta-Analysis

Purpose: To examine long-term outcomes of brow lift procedures, comparing surgical and fixation methods. Methods: Inclusion required original human research, at least 1 brow lift surgery cohort, quantitative measurements for brow elevation with a measure of statistical spread, and a mean follow-up of at least 6 months. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, article screening and data collection were conducted by 2 independent reviewers. Random-effects models were conducted to estimate pooled lateral, central, and medial brow elevation and pooled complication rates. Results: Of the 22 studies included, there were 2,127 brows, and the weighted average of follow-up intervals was 20.9 months. The lateral, central, and medial brow elevated significantly (p < 0.0001) by 3.8 mm, 3.02 mm, and 2.41 mm, respectively, with small/moderate heterogeneity. There were no significant differences between pre- and post-trichial long-term elevation or complication rates. Tined implant fixation had significantly greater lateral elevation (p = 0.0192) and significantly greater dysesthesia rates (p = 0.027) compared with suture fixation. Conclusions: This study provides evidence supporting the long-term efficacy of brow lifts with a favorable safety profile. When choosing a technique, physicians should understand that while there were no significant differences between pretrichial and post-trichial brow lifts, tined implants for brow fixation trended towards greater lateral brow elevation and increased rates of dysesthesia compared to using sutures.