Randomised controlled trial of direct brow lift: conventional technique versus fixed-periosteum technique in brow ptosis
Year: 2026
Type: article
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Objectives To determine whether periosteal fixation improves the durability of brow elevation compared with the conventional direct brow lift and to evaluate its impact on postoperative outcomes.Methods In this patient- and assessor-blinded pilot randomised controlled trial, 10 patients with bilateral brow ptosis were randomised 1:1 to conventional direct brow lift or a fixed-periosteum modification with three-point orbicularis-to-periosteum fixation. The primary outcome was change in brow height from 2 weeks to 12 months. Bilateral measurements were averaged within participants for the primary analysis; a mixed-effects model accounting for fellow-eye correlation was supportive. Secondary outcomes included scar quality, satisfaction, operative time and complications.Results At 12 months, mean patient-level brow descent was 5.60±2.07 mm with conventional direct brow lift and 3.50±1.27 mm with fixed-periosteum lift, a between-group difference of 2.10 mm (95% CI −0.50 to 4.70, p=0.097). The supportive mixed-effects model yielded the same estimated difference (2.10 mm; 95% CI −0.03 to 4.23, p=0.054). Secondary outcomes were similar between groups.Conclusions In this pilot randomised trial, fixed-periosteum direct brow lift showed an estimated 2.1 mm reduction in brow descent at 12 months compared with the conventional technique. The estimate was consistent after accounting for bilateral correlation, although CIs included the null. These preliminary findings warrant evaluation in adequately powered multicentre trials.Trial registration number TCTR20231002002.
Source: BMJ Open Ophthalmology
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,085
OpenAlex ID: W7225197253