Techniques in facial reanimation—upper eyelid and eyebrow

Upper eyelid and eyebrow position may both be affected by facial nerve paralysis due to innervation of the frontalis and orbicularis muscles by branches of the facial nerve. The two are interconnected and function as a complex; consequently, brow position has mechanical effects on eyelid position. For example, descent and deflation of tissues may lead to brow ptosis, exacerbating underlying dermatochalasis, or eyelid ptosis. In cases of facial nerve paralysis, management of eyebrow ptosis should be weighed against underlying lagophthalmos due to weakness of eyelid closure, and brow elevation be titrated so as not to worsen underlying lagophthalmos.