The eyes are the most expressive unit of the face and the key element for a good result in facial aesthetic surgery. Multiple physical characteristics must be carefully evaluated and the appropriate surgical approach individualized for each patient., Blepharoplasty alone cannot improve the appearance of the eyes or relieve the tired appearance if brow ptosis is present. This is the reason that the authors do a brow lift or forehead rhytidectomy in 75% of their patients with aging of the eyebrow/eyelid complex. The authors can reposition the brow, decrease infrabrow hooding, and increase the vertical dimension of the orbital aperture (Fig. 15)., In the authors’ hands, the ITH incision provides the most consistent, reliable approach to reverse the physical signs of the aging forehead and upper eyelid.¹⁷ If upper lid blepharoplasty is necessary in the forehead rhytidectomy, the authors prefer to excise the excess upper eyelid skin in a separate procedure approximately 2 months after the brow lift. A more exact correction can be achieved (Fig. 16).