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June 1982, Vol 100, No. 6 >
ARTICLE | June 1982

The Anatomy of Eyebrow Ptosis FREE

Orkan George Stasior, MD; Bradley N. Lemke, MD
[+] Author Affiliations

Accepted for publication July 24, 1981.

Reprint requests to Department of Ophthalmology, University Hospitals, 600 Highland Ave, Madison, WI 53792 (Dr Lemke).


Arch Ophthalmol. 1982;100(6):981-986. doi:10.1001/archopht.1982.01030030989019
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• An anatomical study was performed to gain a better understanding of the pathogenesis of eyebrow ptosis. Through cadaver dissection, we sought to establish the anatomy of the normal eyebrow, to determine why the temporal part of the eyebrow becomes ptotic earlier than the medial portion, and to locate precisely the regional nerves and vessels to aid the eyebrow surgeon. A fat-pad exists beneath the eyebrow. Dense attachments on the underside of the eyebrow fat-pad secure the eyebrow to the supraorbital ridge. Because the supraorbital ridge extends only over the medial one half to two thirds of the orbit, the lateral part of the eyebrow lacks deep support and droops with the frontal skin and muscle relaxation seen in age. Vertical lateral orbicularis fibers are consistently seen in the cadaver. Because of their location, they may play a role in producing "laugh lines."

REFERENCES

1 +
Bames HO:  Frown disfigurement and ptosis of eyebrows . Plast Reconstr Surg 1957;;19:337-345.
2 +
Breitinger E:  Zur Morphogenese und Typologie der Brauen . Homo 1953-1955;;4-6:5-19.
3 +
Castanares S: Forehead wrinkles:  Glabellar frown and ptosis of the eyebrows . Plast Reconstr Surg 1964;;31:106-113.
4 +
Charpy A:  Le coussinet adipeux du sourcil . Bibl Anat 1909;;19:47.
5 +
Desfosses P:  Les formes du front et des sourcils . Presse Med 1941;;49:83-85.
6 +
Donders FC:  Entwickelung und den Wechsel der Cilien . Albrecht Von Graefes Arch Klin Exp Ophthalmol 1858;;4:286-300.
7 +
Futamura R:  Uber die Entwicklung der facialismuskulatur des Menschen . Anat Hefte 1906;;30:433-516.
8 +
Gasser RF:  The development of facial muscles in man . Am J Anat 1967;;120:357-376.
9 +
Gutman E, Hanzlikova V:  Basic mechanisms of aging in the neuromuscular system . Mech Aging Dev 1972-1973;;1:327-349.
10 +
Huber E:  Zur Morphologie der Supraorbital und Glabellarmuskulatur des Menschen: Experimentelle Bestimmung der Innervation des M. procerus nasi (M. depressor, Zurich-Baltimore) . Anat Anz 1926-1927;;62:25-36.
11 +
Jarrett A:  Aging of the dermis , in Jarrett A (ed): The Physiology and Pathophysiology of the Skin . London, Academic Press Inc, 1974;, vol 3, pp 911-933.
12 +
Johnson C, Anderson JR, Katz RB, et al:  The brow-lift 1978 . Arch Otolaryngol 1979;;105:%124-126.
13 +
Johnson J, Hadley R:  The aging face , in Converse JA (ed): Reconstructive Plastic Surgery . Philadelphia, WB Saunders Co, 1964;, pp 1306-1342.
14 +
Jones L, Wilson W:  Transplantation of the corrugator supercilii muscle for the cure of ptosis . Trans Am Acad Ophthalmol Otolaryngol 1967;;71:889-896.
15 +
Kidd W:  Notes on the eyebrows of man . J Anat Physiol 1903-1904;;38:3-21.
16 +
Merkel F: Handbuch der Gasammten Augenheilkunde , Graefe A, Saemisch T (eds). Leipzig, East Germany, Engelmann, 1874;, vol 1, pp 60-166.
17 +
Merkel F:  Der Musculus superciliaris . Anat Anz 1887;;2:17-18.
18 +
Montagna W:  Histology and cytochemistry of human skin . Arch Dermatol 1970;;101:257-263.
19 +
Paonessa DF, Goldstein JC:  Anatomy and physiology of head and neck infections (with emphasis on the fascia of the face and neck) . Otolaryngol Clin North Am 1976;;9:561-579.
20 +
Spira M, Hardy S:  The brow lift , in Conley J, Dickenson JT (eds): Plastic and Reconstructive Surgery of the Face and Neck: First International Symposium . New York, Grune & Stratton Inc, 1970;, vol 1, pp 17-20.
21 +
Stricker M:  Vascularization du sourcil: Incidences reparatrices . Ann Chir Plast 1970;;15:64-66.
22 +
Verzar F:  The aging of connective tissue . Gerontologia 1957;;1:363-378.
23 +
Vinas J, Caviglia C, Cortinas JL, et al:  Forehead rhytidoplasty and brow lifting . Plast Reconstr Surg 1976;;57:445-454.
24 +
Whitnall SE: Anatomy of the Human Orbit and Accessory Organs of Vision , ed 2. London, Oxford University Press, 1932;, pp 109-115.

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1 +
Bames HO:  Frown disfigurement and ptosis of eyebrows . Plast Reconstr Surg 1957;;19:337-345.
2 +
Breitinger E:  Zur Morphogenese und Typologie der Brauen . Homo 1953-1955;;4-6:5-19.
3 +
Castanares S: Forehead wrinkles:  Glabellar frown and ptosis of the eyebrows . Plast Reconstr Surg 1964;;31:106-113.
4 +
Charpy A:  Le coussinet adipeux du sourcil . Bibl Anat 1909;;19:47.
5 +
Desfosses P:  Les formes du front et des sourcils . Presse Med 1941;;49:83-85.
6 +
Donders FC:  Entwickelung und den Wechsel der Cilien . Albrecht Von Graefes Arch Klin Exp Ophthalmol 1858;;4:286-300.
7 +
Futamura R:  Uber die Entwicklung der facialismuskulatur des Menschen . Anat Hefte 1906;;30:433-516.
8 +
Gasser RF:  The development of facial muscles in man . Am J Anat 1967;;120:357-376.
9 +
Gutman E, Hanzlikova V:  Basic mechanisms of aging in the neuromuscular system . Mech Aging Dev 1972-1973;;1:327-349.
10 +
Huber E:  Zur Morphologie der Supraorbital und Glabellarmuskulatur des Menschen: Experimentelle Bestimmung der Innervation des M. procerus nasi (M. depressor, Zurich-Baltimore) . Anat Anz 1926-1927;;62:25-36.
11 +
Jarrett A:  Aging of the dermis , in Jarrett A (ed): The Physiology and Pathophysiology of the Skin . London, Academic Press Inc, 1974;, vol 3, pp 911-933.
12 +
Johnson C, Anderson JR, Katz RB, et al:  The brow-lift 1978 . Arch Otolaryngol 1979;;105:%124-126.
13 +
Johnson J, Hadley R:  The aging face , in Converse JA (ed): Reconstructive Plastic Surgery . Philadelphia, WB Saunders Co, 1964;, pp 1306-1342.
14 +
Jones L, Wilson W:  Transplantation of the corrugator supercilii muscle for the cure of ptosis . Trans Am Acad Ophthalmol Otolaryngol 1967;;71:889-896.
15 +
Kidd W:  Notes on the eyebrows of man . J Anat Physiol 1903-1904;;38:3-21.
16 +
Merkel F: Handbuch der Gasammten Augenheilkunde , Graefe A, Saemisch T (eds). Leipzig, East Germany, Engelmann, 1874;, vol 1, pp 60-166.
17 +
Merkel F:  Der Musculus superciliaris . Anat Anz 1887;;2:17-18.
18 +
Montagna W:  Histology and cytochemistry of human skin . Arch Dermatol 1970;;101:257-263.
19 +
Paonessa DF, Goldstein JC:  Anatomy and physiology of head and neck infections (with emphasis on the fascia of the face and neck) . Otolaryngol Clin North Am 1976;;9:561-579.
20 +
Spira M, Hardy S:  The brow lift , in Conley J, Dickenson JT (eds): Plastic and Reconstructive Surgery of the Face and Neck: First International Symposium . New York, Grune & Stratton Inc, 1970;, vol 1, pp 17-20.
21 +
Stricker M:  Vascularization du sourcil: Incidences reparatrices . Ann Chir Plast 1970;;15:64-66.
22 +
Verzar F:  The aging of connective tissue . Gerontologia 1957;;1:363-378.
23 +
Vinas J, Caviglia C, Cortinas JL, et al:  Forehead rhytidoplasty and brow lifting . Plast Reconstr Surg 1976;;57:445-454.
24 +
Whitnall SE: Anatomy of the Human Orbit and Accessory Organs of Vision , ed 2. London, Oxford University Press, 1932;, pp 109-115.

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