ASJ Aesthetic Surgery Journal · 2013

Rhinoplasty and brow modification: a powerful combination

Daniel RK, Kosins A, Sajjadian A, Cakir B, Palhasi P, Molnar G.

What this paper says

In 24 patients who had rhinoplasty combined with a brow lift, 13 with a central brow lift and 11 with a full endoscopic forehead lift, followed a mean 18 months, one had a fluid collection needing drainage and one asked for further tip refinement.

Overview

Chin surgery is a well known partner to rhinoplasty, but the brow is rarely considered. Enlarging the middle third of the face makes the nose look smaller, and lifting the central brow changes the angle at the nasal root. The authors dissected cadavers to study the muscles between the brows and the nose, then reviewed their combined cases.

Sections of note

Two parts: dissection of the nose and central forehead in 7 fresh cadavers, and a chart review of 24 patients treated by the senior author (R.K.D.), July 2010 to June 2012.
Younger patients had a central brow lift (CBL) with screw fixation; older patients (34 to 60) had a full 5-incision endoscopic forehead lift.
Ages 14 to 60; 2 men, 22 women; 12 primary and 12 secondary rhinoplasties.
13 CBL and 11 endoscopic lifts; mean follow-up 18 months.
Complications: 1 persistent glabellar fluid collection requiring drainage; 1 request for additional tip refinement.
The authors state CBL with radix and glabellar muscle excision suits younger patients needing a defined nasion and older revision patients whose upper nose still looks heavy.

What it means for a patient

If the area between the brows is heavy or low, lifting it at the time of rhinoplasty can sharpen the root of the nose and make the whole nose look smaller.
The combination is presented as an option, not a routine; the abstract gives no satisfaction scores.
Small series, one surgeon, no comparison with rhinoplasty alone.

Why this paper matters

It extends the profile-balance idea from the chin to the brow and links it to the polygon analysis of the nasal root. Outcome data are limited to two complications in 24 patients.

Terms

Brow lift: surgery that raises the eyebrows and forehead tissue.
Central brow lift (CBL): a lift limited to the area between the brows, fixed with screws.
Endoscopic forehead lift: a brow lift done through small scalp incisions with a camera.
Radix: the root of the nose, between the eyes.
Glabella: the flat area of the forehead between the brows.
Nasion: the deepest point at the root of the nose in profile.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“Plastic surgeons have long recognized the importance of performing chin augmentation concurrent with a rhinoplasty to achieve facial balance. However, few surgeons consider the benefits of combining a rhinoplasty with brow modification to achieve a better aesthetic result. By increasing the size of the middle third of…”

Excerpt; the full abstract is on PubMed.