Rejuvenation of the Forehead and Eyelid Complex

Abstract

The goal of this article is to explain both the options and the techniques that are available when considering the rejuvenation of the eyelid and brow complex. We first explain the relevant anatomy. We then list and explain the different techniques with both the brow lift and the blepharoplasty. During this discussion we also explain a newer technique that we have been using. This combines the endoscopic technique with a trichophytic incision. The selection of patients is discussed in reference to which technique is appropriate given each patient's particular anatomy and desired effects. We also highlight the unique differences that the male patient presents.

Eyebrow Peak Position Redefined

“…[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Although endoscopic brow lifts have demonstrated remarkable success, insufficient knowledge of eyebrow anatomy creates variable incision and fixation sites. [4][5][6][7][8][9][10][11][12] The absence of a standardized brow lift procedure presumably stems from the reliance on subjective brow shape models. Examining the aesthetic appearance of different brow peak positions is an important factor in determining incision and fixation sites for endoscopic brow lifts, but the functional position of brow peak should also be considered.…”

“…With the rising popularity of endoscopic brow lifts, adequate knowledge of eyebrow anatomy becomes increasingly essential for the selection of proper incision and fixation points. [4][5][6][7][8][9][10][11][12] In addition, defining brow shape based on more empirical evidence will enable physicians to evaluate the surgical outcome of brow lifts with greater consistency.…”

Periorbital facial rejuvenation; applied anatomy and pre-operative assessment

“…The number finally increased to 112 articles after adding the pertinent references of the initial articles. Included articles for this review were 3 case reports, 14 , 15 , 16 1 discussion, 17 1 book chapter, 18 1 guideline, 19 26 review articles, 2 , 3 , 4 , 5 , 6 , 10 , 13 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 30 observational studies, 1 , 7 , 8 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 36 retrospective case series, 9 , 13 , 66 , 67 , 68 , 69 , 70 , …”

“…Prior to surgery it is important to ask about the patient's expectation from the surgery. 4 , 21 , 32 , 41 , 79 Some discrepancies may exist between patients' real problem and their will. The surgeon should discuss the problem of facial asymmetry with the patients 18 , 76 who are mostly not aware of it because the asymmetry is subtle.…”

Preoperative Classification System Used to Determine Release Performed during Endoscopic Brow Lift

“…Many other articles have been published about endoscopic brow lifts. 15 16 17 18 19 All these important publications discuss how there one operative approach can be used to perform brow lifts. None of these articles nor any others that the author is aware of stress the importance of pairing the preoperative exam of the patient to the performance of five different releases of the brow.…”