I commend guest editors Babak Azizzadeh, Guy Massry, and the four section editors for their vision in bringing together experts from four specialties in this issue of Clinics in Plastic Surgery . The topic, “The Multidisciplinary Approach to Brow and Upper Eyelid,” is very timely given the dramatic and rapid changes in our approach to the brow and upper eyelid rejuvenation over the past few years. This is an up-to-date, state-of-the-art review. We have come a long way since the early 1990s where all we had to offer were coronal browlifts and perhaps collagen injections.

The development and popularity of the endoscopic approach to browlifting in the early 1990s were seen as a “disruptive technology” that changed our approach to browlifting and significantly reduced the number of open coronal browlifts. Later in the mid-1990s the emergence of toxins and their role in forehead rejuevenation and brow shaping was an even more impactful “disruptive technology.” So effective was the impact of toxins that, in the years between 1997 and 2007, the number of browlifts performed dropped by a dramatic 51% according to the statistics reported in 2008 by the American Society for Aesthetic Plastic Surgery. Soon after, the rapid popularity of toxins for brow rejuvenation and the role of fillers emerged for brow, the temporal area, and the upper and lower eyelids. The injectables have proven to be efficacious, safe, and, at least in the short term, economical, with minimal down time or risk.

Parallel with the developing role of injectables, other approaches for brow rejuvenation emerged, the lateral or temporal browlift in isolation or in combination with a transpalpebral approach to modification of the corrugator and procerus muscles.

Currently, we have so many safe and effective options for brow and eyelid rejuvenation. In the right patient and in the right hands, each has a role and each may be considered the best option.

These recent advances were made possible through the efforts of all four core specialties of plastic surgery, facial plastic surgery, oculoplastic surgery, and dermatology. The willingness to share and to learn from each other has benefited us as physicians, and most of all, our patients benefit most from this shared information. Each of the authors in this volume is recognized as a contributor in his own field and we are indebted to them for sharing their expertise with the rest of us.

This volume, reviewing the current state of the art, belongs in the library of each of us who are involved in periorbital rejuvenation.