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The treatment of the ptotic brow and forehead and glabellar rhytids continues its evolution as an extremely important aspect of the aging-face syndrome. There is controversy concerning the best incision placement to obtain scar camouflage with the most natural hairline and brow.
Brow lifting is important in functional as well as in cosmetic facial plastic surgery. Excessive upper eyelid skin resection in the patient with brow ptosis may even make the patient's visual-field defect worse. To obtain the best cosmetic and functional improvement, the brow should be repositioned prior to the upper eyelid blepharoplasty.
Direct brow lifting (Fig 1) provides the most direct effect but gives the least camouflaged scar. The incision results in distortion of normal forehead furrows and some loss of fine upper brow hairs, giving a sharply demarcated upper eyelid margin. Dr Ike Matta, Sayre, Pa, at the recent 1988 AAFPRS spring meeting, reviewed his experience with
QUATELA VC. Foreheads and Brows Revisited. Arch Otolaryngol Head Neck Surg. 1988;114(11):1236–1237. doi:10.1001/archotol.1988.01860230030016
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