Temporal and lateral brow lift

What it treats

• The lateral brow usually drops earlier than the medial brow; lateral to the temporal fusion line the brow lacks frontalis support and the soft tissue slides down over the temporalis fascia (PMID 8643714).
• Women aged 50 to 60 had brows 22.4 mm above the lateral canthus against 21.3 mm in women aged 20 to 30; the age difference was significant only at the medial and mid brow, and the authors favor selective lateral lifting (PMID 19935315).
• 244 people: with age the brow moves up, the distance between the inner eye corners widens and the lid axis drops laterally; women's brow shape comes to resemble men's (PMID 30819648).
• The lateral third of the brow ages first and most; brow shape depends on the level of the lateral brow; brow lifts often succeed medially and fail laterally (PMID 19371849).
• The temple and eye region have a consistent framework of fascial planes and retaining ligaments, with nerves and vessels in fixed relation to them (PMID 10744245).
• The frontal branch of the facial nerve crosses the temple; Pitanguy and Ramos described its course and variations for face lifting in 1966 (PMID 5926990).
• 18 cadaver hemifaces: over the zygomatic arch the frontal branch runs in the innominate fascia, deep to the SMAS, and moves into the superficial temporal fascia 1.5 to 3.0 cm above the arch (PMID 20124839).

How it is done

Skin-level (subcutaneous) temporal lift

• The senior author of a 2022 review moved from coronal, hairline and endoscopic lifts to the lateral subcutaneous temporal lift (PMID 35710152).
• 28 patients treated under local anesthesia in the office, with no combined procedures (PMID 21131449).
• Lateral temporal subcutaneous brow lift, more than 500 consecutive cases over 20 years (PMID 42224034).
• Combined with upper blepharoplasty in 28 women: the lateral brow measurement rose from 46 mm to 71 mm (PMID 40820029).

Deep temporal lift (on the deep temporal fascia)

• Byrd 1996: multiplanar temporal approach that frees the orbital orbicularis from the rim and releases the zygomatic cutaneous ligament (PMID 8618995).
• 150 patients: corrugator divided through the eyelid incision, periorbital retaining ligaments released, dissection above the deep temporal fascia joined to the subperiosteal plane, galea advanced with sutures, extra skin removed (PMID 31624658).
• Multi-point suture fixation of the lateral brow and orbicularis to the galea, 519 patients (PMID 26430629).
• Fogli galeapexy: subgaleal then subcutaneous dissection, the cut galea anchored to the temporal aponeurosis (fascia), scalp closed without tension or hair removal; 270 patients (PMID 14534826).
• Two-level (biplanar) temple lift, 37 patients: skin that could be removed rose from 15.1 mm with one-level dissection to 21.8 mm, a 48% increase in lift (PMID 18330618).
• Endoscopic temporal brow lift combines the endoscopic and temporal approaches (PMID 31764641).
• Temporal modified orbicularis repositioning (MORE), 212 patients: FACE-Q score 34.29 before and 80.11 at 12 months (PMID 39288448).

Gliding brow lift

• Skin of the forehead, brow and temple freed from the muscle beneath through minimal incisions; the new brow shape held by a hemostatic net of temporary skin stitches; 124 patients (PMID 31511923).
• Done through 1 or 2 small incisions with blunt dissectors and upward traction (PMID 35710153).
• The surgical net is now used for "gliding surgery" such as the gliding brow lift, beyond its first use against hematoma (PMID 38806160).
• Extended version adds deep-plane dissection in the hair-bearing scalp joined to the skin-level dissection, 122 patients (PMID 41217905).

Results and evidence

• Fogli-type temporal lift, 923 cases: over 90% improvement in hooding and brow position at 5 years or more; relapse under 10% after 5 years (PMID 25502857).
• Multi-point suture lift, 519 patients: satisfactory lateral elevation in 94.41% (PMID 26430629).
• Galeapexy, 270 patients: 225 good to very good, 13 average, 13 unsatisfactory (PMID 14534826).
• Lateral brow lift, 150 patients: lateral hooding resolved in all; revision 7% (PMID 31624658).
• Endoscopic temporal lift, 71 patients: mean elevation 1.8 mm at the lateral canthus; complications 1.4% (PMID 31764641).
• Gliding lift, 124 patients, mean 17 months: adequate repositioning in 118; recurrence in 6 (PMID 31511923).
• Gliding lift, 63 patients: significant lift held at 12 months at all points, largest at the lateral canthus (3.09 mm) and brow tail (2.74 mm) (PMID 39487802).
• Whole-brow gliding lift, 30 patients (60 brows): 5.2 mm at the medial canthus, 6.3 mm at midpupil, 7.1 mm at the lateral canthus at 10.5 weeks; loss by 8.4 months only laterally, 0.4 mm (PMID 42535924).
• Extended gliding lift, 122 patients: brow tail up 3.2 mm; 38.5% very satisfied, 53.3% satisfied (PMID 41217905).
• Systematic review to 2023: 4 studies, 181 gliding lift patients, mostly retrospective with subjective measures (PMID 39150844).
• 86 patients: endoscope-assisted polypropylene mesh lift and gliding lift had similar results and complications; the gliding lift lost more height between months 3 and 12 (PMID 37315493).
• Randomized trial, 32 women having blepharoplasty: internal browpexy raised the lateral brow (15.09 to 17.43 mm) at 6 months; temporal brow lift did not change it (15.7 to 15.8 mm) (PMID 28975711).
• Temporal subcutaneous lift with orbicularis repositioning, 194 patients followed 2 years or more: 182 had crow's feet scores fall to 0 or 1, with no change between months 3, 12 and 24 (PMID 42202561).

Risks and complications

• Systematic review, 76 studies: temporal/lateral lifts had the highest asymmetry rate of all brow lift types, 1.5% (PMID 30534495).
• Galeapexy, 270 patients: 5 hematomas needing evacuation, 4 temporary hair loss, 8 temporary frontal muscle weakness resolved in 1 to 3 months (PMID 14534826).
• 519 patients: total relapse 8, partial relapse 21, frontal branch weakness 5, limited temporal hair loss 9 (PMID 26430629).
• 150 patients: 2 temporary frontal branch weaknesses, no permanent nerve injury, delayed temporal wound healing 3% (PMID 31624658).
• Lateral temporal subcutaneous lift, over 500 cases: mainly temporary temple numbness; no permanent nerve injury, hair loss or infection (PMID 42224034).
• Temporal facelift, 250 patients: one-sided frontal branch weakness 5.6%, resolved in a mean 2.8 months; revision 2.4% (PMID 39641911).
• Gliding lift, 30 patients: subjective brow asymmetry in 5 cases (13.33%), one frontalis weakness, one small area of skin necrosis; no hematoma or hair loss (PMID 42535924).
• Cadaver study: the gliding lift's skin stitches lay closer to the frontal branch than the periosteal stitches of a suture-suspension lift; nerve injuries reported clinically so far were temporary (PMID 41286172).
• Hemostatic net meta-analysis (facelift, brow lift, neck lift), 8 studies, 1,617 patients: hematoma 0.14 per 100; red suture marks 12.70 per 100, gone in 2 to 3 months (PMID 41936137).
• Extended gliding lift: minor complications in 12 of 122 patients (9.8%) (PMID 41217905).

Recovery

• Subcutaneous temporal lift done under local anesthesia in the office (PMID 21131449).
• 150 patients: 97% had the lift under sedation, 52 of them (35%) in the office with light oral sedation (PMID 31624658).
• Temporal facelift aftercare: taping, lymphatic massage, botulinum toxin for uneven brow movement and steroid injections for midface swelling; skin dimples (2.8%) resolved by month 5 (PMID 39641911).
• Temporal MORE: the authors report fast recovery and a low complication rate (PMID 39288448).
• Net suture marks resolved in 2 to 3 months without lasting pigment (PMID 41936137).

Combined procedures

• Fogli series: 170 of 270 temporal lifts done during a three-stage (forehead, face, neck) lift (PMID 14534826).
• 923 Fogli-type temporal lifts: 80% combined with a minimal access cranial suspension (MACS) facelift (PMID 25502857).
• 380 MACS facelifts (2018-2024): brow lift added in 72.6%; no major complications (PMID 40906287).
• Deep temporal lift designed as a lateral brow, temporal and upper face lift that also benefits the lateral canthus, lower lid and cheek (PMID 8618995).
• High-SMAS facelift anatomy, 16 nerves in 8 cadaver heads: the frontal branch lies under a separate parotid-temporal fascia over the arch and stayed intact after a high-SMAS lift (PMID 20335873).
• Temple hairline incisions in facelifts: temporal follicles angle 16 degrees to the skin, so a 30-45 degree beveled incision lets hair grow through the scar (227 follicles, 16 cadavers) (PMID 17440370).
• Facelift hairline incisions, 30 patients with one side cut parallel to and one side across the hair follicles: the across-follicle side scarred better in 95% (PMID 8982181).
• Gliding lift series: the one return to the operating room for hematoma came from the facelift done at the same time, not the brow (PMID 39487802).
• Crow's feet treatment during facelift or temporal lift: 14 studies, no single most effective method (PMID 38170976).

Current questions

• Gliding lift evidence base: 181 patients in 4 low-level studies to 2023 (PMID 39150844); 2025-2026 series add objective measurements (PMID 39487802, PMID 42535924).
• Gliding lift durability against mesh suspension (PMID 37315493).
• Frontal branch safety of percutaneous net stitches (PMID 41286172).
• Temporal brow lift against internal browpexy for the lateral brow at blepharoplasty (PMID 28975711).
• Orbicularis release and repositioning for crow's feet during temporal lifts (PMID 42202561, PMID 38170976).
• Practice shift: the 2020 ASPS survey found isolated temporal lifts and hairline lifts increasing while coronal lifts decreased (PMID 37409963).

Terms

• Lateral hooding: skin overhanging the outer upper eyelid from a low lateral brow (PMID 31624658).
• Temporal fusion line: ridge on the side of the skull; lateral to it the frontalis does not hold the brow (PMID 8643714).
• Deep temporal fascia: firm layer over the temple muscle used as the dissection plane and as an anchor (PMID 31624658, PMID 18330618).
• Galeapexy: anchoring the cut galea of the temple to the temporal fascia (Fogli) (PMID 14534826).
• Frontal branch: facial nerve branch to the forehead muscle; temporary injury shows as frontal muscle weakness (PMID 14534826, PMID 20124839).
• Parotid-temporal (innominate) fascia: layer deep to the SMAS that carries the frontal branch over the zygomatic arch (PMID 20335873, PMID 20124839).
• Retaining ligaments: fibrous attachments that tether skin and soft tissue to bone in the temple and around the eye (PMID 10744245).
• Gliding brow lift: skin-level release through small incisions, with the brow held by a surgical net (PMID 31511923).
• Hemostatic (surgical) net: rows of temporary stitches through the skin that hold the lifted skin in place (PMID 38806160).
• MACS lift: minimal access cranial suspension facelift (PMID 25502857).

Papers