Endoscopic forehead lift: anatomic basis

We have described the anatomic features of the central forehead. Each anatomic layer has special significance for the surgeon seeking to rejuvenate the forehead. Wrinkles have both a skin and muscle component. Their location and severity are often the result of the underlying muscles whose contracture must be lessened to decrease the severity of the wrinkle. The forehead fascia comprises a distinct SMAS layer and thus provides the missing link in the concept of an entire facial SMAS. The forehead muscles have a superficial, an intermediate, and a deep layer. The existence of an anatomically distinct depressor supercilii muscle is described. The brow fat pad should be considered a single anatomic unit that enables movement of the eyebrows.