Forehead and Eyebrow Rejuvenation

Aesthetically attentive male patients commonly present with complaints of looking tired and having “heavy” eyelids, even when they are well rested. In many cases, the anatomical issue is upper eyelid dermatochalasis. However, the contribution of eyebrow ptosis to the appearance of periorbital aging and peripheral visual field is often overlooked. Brow shape, symmetry, position, and hyperactivity of the frontalis and corrugator muscles are integral parts of forehead rejuvenation. An upper blepharoplasty should not be performed for the treatment of periocular aging until brow position and symmetry are fully evaluated and treated. Therefore, it is incumbent upon the surgeon to evaluate the periorbital area thoroughly and identify which patients require brow lifting. This may or may not be performed in conjunction with upper eyelid blepharoplasty. Furthermore, the surgeon must determine the optimal approach for brow lifting for each individual patient. Options include open and endoscopic surgical techniques.