Infra-Brow Volume Contouring Surgery.

INTRODUCTION: The periorbital region plays a key role in facial aging, with notable ethnic variations in brow and eyelid morphology. Eurodescendientes patients with high or normal eyebrow positions often present with excess infra-brow volume and lateral hooding. The infra-brow volume contouring fat lift surgery was developed to address this condition by integrating principles from previously described Asian sub-brow blepharoplasty methods, adapted to Eurodescendientes anatomy. MATERIALS AND METHODS: A retrospective study was conducted on 40 Eurodescendientes female patients (mean age: 39.5 years) who underwent this surgical technique between October 2023 and October 2024. The procedure consisted of a five-step technique: elliptical skin and subcutaneous excision, en bloc removal of the orbicularis oculi muscle (OOM) and retro-orbicularis oculi fat (ROOF), contouring of the remanent ROOF, fixation of the lower muscle flap through the sub-frontalis fascia to the supraorbital rim periosteum using absorbable sutures, followed by layered muscle and skin closure. Postoperative outcomes were assessed over a follow-up period ranging from 11 to 19 months, focusing on patient satisfaction, scar appearance, and complications. RESULTS: All patients demonstrated satisfactory esthetic outcomes, with a 100% reported satisfaction rate. Postoperative swelling resolved within 1-3 months, and no unaesthetic scars were observed. Transient sensory symptoms, including paresthesia and hypoesthesia, occurred in all cases but resolved within 3-5 months. No permanent sensory deficits or major complications were reported. CONCLUSION: This technique provides an effective, stable, and esthetically reliable correction for infra-brow bulging in patients with high or normal eyebrow positions. Combining all five steps of the technique ensures durable results and minimal scarring. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .