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Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)
CPT4 code
Name of the Procedure:
Repair of Brow Ptosis (Supraciliary, Mid-Forehead, or Coronal Approach)
Summary
Repair of brow ptosis is a surgical procedure performed to lift a drooping eyebrow, which can obstruct vision and affect facial aesthetics. The surgery can be done using a supraciliary approach (along the eyebrow), a mid-forehead approach, or a coronal approach (across the scalp).
Purpose
The procedure addresses brow ptosis, a condition where the eyebrow sags due to aging, nerve damage, or other conditions, leading to vision impairment and aesthetic concerns. The goal is to improve the field of vision and facial appearance.
Indications
- Drooping eyebrow causing vision obstruction
- Asymmetry of the eyebrows
- Cosmetic concern due to sagging skin in the forehead and brow area
- Patients who have not responded to non-surgical treatments
Preparation
- Fasting for 6-8 hours before the procedure if general anesthesia is used
- Avoiding blood thinners and certain medications as advised by the physician
- Pre-operative diagnostic tests such as blood work and possibly imaging studies
Procedure Description
- The patient is placed under local or general anesthesia.
- Depending on the approach:
- Supraciliary: An incision is made just above the eyebrow.
- Mid-Forehead: An incision is made in the forehead creases.
- Coronal: An incision is made across the top of the scalp, from ear to ear.
- Excess skin and tissue are removed, and the brow is repositioned.
- The incisions are closed with sutures.
- A sterile bandage may be applied.
Duration
The procedure typically takes 1 to 2 hours.
Setting
The procedure is usually performed in a hospital or outpatient surgical center.
Personnel
- Surgeons specialized in plastic or reconstructive surgery
- Surgical nurses
- Anesthesiologist or nurse anesthetist
Risks and Complications
- Infection
- Bleeding
- Scarring
- Asymmetry
- Nerve damage leading to numbness or weakness
- Poor wound healing
Benefits
- Improved field of vision
- Enhanced facial appearance
- Symmetrical brow positioning
- Results can be seen immediately, with further improvement as swelling reduces
Recovery
- Initial swelling and bruising for 1-2 weeks
- Stitches are usually removed within a week
- Avoid strenuous activities for 3-4 weeks
- Follow-up appointments to monitor healing
Alternatives
- Non-surgical treatments like Botox or fillers (temporary and less effective)
- Less invasive procedures such as thread lifts
- Each alternative has its pros and cons in terms of efficacy, duration, and recovery time
Patient Experience
- Mild to moderate pain, manageable with prescribed pain medication
- Sensation of tightness in the forehead area
- Temporary numbness or tingling around the incision sites
- Patients are advised to keep their heads elevated and apply cold compresses to reduce swelling