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Muscles for Facial Expressions

Muscles for Facial Expressions

The craniofacial muscles are a collection of approximately 20 thin skeletal muscles situated beneath the skin of the face and scalp. These muscles, primarily responsible for the vast array of human facial expressions, originate from the bones or fibrous structures of the skull and extend outwards to connect with the skin. While most skeletal muscles in the body are enveloped in thick fascia, facial muscles generally have a more delicate fascial covering, with the buccinator muscle being a...

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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction

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Redefining the Direct Brow Lift: The Key Role of Raising the ROOF.

Narmien Murdock^1,2, Henry Bair², Cat Burkat³

¹Department of Oculoplastic and Orbital Surgery, Morgenstern Medical, Wayne, Pennsylvania.

Ophthalmic Plastic and Reconstructive Surgery

|February 25, 2026

Summary

This summary is machine-generated.

A new direct brow lift technique repositions the retro-orbicularis oculi fat (ROOF) to correct brow ptosis. This surgical modification effectively reduces eyelid heaviness and improves brow aesthetics in male patients.

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Area of Science:

Plastic Surgery
Ophthalmology

Background:

Brow ptosis, characterized by drooping brows, leads to hooding and heaviness.
Age-related changes, including fat descent, contribute to brow ptosis.

Purpose of the Study:

To introduce a modified direct brow lift technique.
To address the descent of the retro-orbicularis oculi fat (ROOF) in brow ptosis.

Main Methods:

A case series involving 9 male patients with age-related brow ptosis.
Bilateral direct brow lift utilizing a novel ROOF mobilization technique.

Main Results:

Significant improvement in brow-reflex distance (5.17 mm to 11.76 mm).
Successful elevation of the temporal ROOF, resolving temporal hooding in all patients.
Patients reported reduced brow heaviness, enhanced visual function, and high satisfaction.

Conclusions:

The modified technique effectively restores volume and reduces heaviness in mature male patients.
Superior ROOF placement enhances functional direct brow lift outcomes.
The technique preserves natural brow mobility without complications like frontalis paresis.