Successful aesthetic rejuvenation of the eyelids and periorbital soft tissues requires a detailed knowledge of not only the relevant anatomy and normal aging changes, but also the advanced surgical techniques to comprehensively address the presenting deficits in order to attain natural results. Over the past few decades, a paradigm shift has occurred, in which it has become clear that facial aging is a more complex, three-dimensional process, affecting all tissue planes (skin, muscle, fat, and bone). As a result, it has become more common to see surgical and nonsurgical treatments combined for optimal results.
This article focuses on minimally invasive options to rejuvenate the brow and upper lid complex, with a review of the relevant anatomy and contemporary concepts in upper facial aging. Below is a summary of the key points of the article:
- Aging if the brow and upper eyelid occurs in all tissue planes and involves cutaneous changes, volume loss, and tissue descent.
- Volume restoration and neuromodulation have become an integral part of eyebrow/eyelid aesthetic rejuvenation.
- Surgical lifting techniques alone, without addressing volume loss, are insufficient to address aging of the brow/upper eyelid complex.
- Preservation and restoration of skin quality can have dramatic rejuvenating effects to the brow and upper eyelid.
The increase in injectable treatments has been driven by reduction in procedural risk, recovery, and cost. As such, for surgeons to stay current and provide a complete array of treatment options to patients, it is incumbent to become familiar and comfortable with the varied nonsurgical interventions.