The upper face analysis includes the boney structure, the position of the hairline and wrinkling of the forehead and frown lines. The position of the eyebrows and the upper eye lid analysis is of extreme importance in defining the beauty of the eye area.This area is key to the beauty of the face. A downward descent of the eyebrow is aesthetically unappealing as it results in an angry, tired look. However, most important is the effect of the brow’s over-hooding of the upper eyelid,and differentiating it from excess eye lid skin. Such deformities should be analyzed and approached on an individual basis, because the thick, hair bearing of the brow skin. Should be set apart from the thin, flexible skin of the upper eyelid. If the surgeon does not take this into consideration, the thick brow skin may be pulled down to the eyelid skin, resulting in an abnormal appearance.

Treatment to the muscles of the forehead, brow, eyes, and nose will soften the wrinkles of a frown, as well as the upper nose and crow’s feet. It is of the utmost importance for the surgeon to understand the interaction of those muscles; otherwise, abnormal asymmetry could occur. All options are discussed. Bortox cosmetic is a possible modality, an upper face lioft and Blepheroplasy (eye lid lift) are available.

Brow lift, or forehead lift can be approached in several methods. New endoscopic techniques, for forehead lift and the upper face leave a minimal amount of scarring. Endoscopic surgery leaves a few small scars one-inch or shorter, instead of a scar from ear to ear. However in some conditions one of the traditional incisions is preferable.High forehead or high hair line are best dealt with by a trditional incision for forehead lift. The amount the brow lift is also important; too much elevation of the brow gives one a perpetually surprised expression. Reversal of a brow rendered too high is possible, but requires significant surgery and great expertise. It is very possible to lower the surprised elevated brow to normal position.

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