Rejuvenation of the brow

Aging of the upper face is a frequent complaint in patients seeking a more youth appearance. Sometimes muscle dynamics are excessively forceful and cause marked lines of expression relatively early in life. Regardless of chronologic age, it is imperative that the surgeon perform a problem-oriented, detailed analysis of the face and each subunit, so that imperfections can be individually assessed as they apply to the harmonic balance of the whole face. Various factors, such as degree of eyebrow ptosis, vertical dimension of the forehead, preexisting scars, and level of hairline, will determine the best approach to surgical correction of the aging brow. In the authors' opinion treatment of the forehead, when done together with a rhytidectomy, requires previous blocking of the cervicofacial flaps so as not to distort important anatomic landmarks when traction is applied to the frontal flap, respecting the patient's desire for a natural aesthetic result.