Current concepts of browpexy

The excess skin of the upper lid is not uncommonly secondary to the ptosis of the eyebrows. Blepharoplasty not only fails to correct this deformity but, in fact, may aggravate the sagging of the eyebrow, imparting a sad and elderly appearance to the face. A gracefully arching eyebrow at or slightly above the supraorbital rim renders the face more alert and beautiful. Of many procedures described, three browpexy techniques have withstood the test of time, each with its own set of advantages and limitations: (1) direct, (2) midforehead, and (3) frontal lift. Particular emphasis is given to the coronal-type forehead lift which, in addition to browpexy, can deal with the ptosis of the forehead, transverse forehead wrinkles, and glabellar rhytids.