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Aesthetic concerns about upper eyelid and brow position are very common in ophthalmic practice. Management of brow descent and devolumization requires an approach customized to each patient taking into consideration preoperative examination and patient desires. This article will review several minimally invasive techniques that can be used to address the needs of patients with mild-to-moderate brow ptosis.Recent publications describe and analyse efficacy of several variations of browpexy techniques.Browpexy techniques provide a minimally invasive way to provide stabilization and modest elevation of the lateral brow. They can enhance outcomes of upper eyelid surgery in patients with both functional and cosmetic brow ptosis, who desire to avoid the cost and morbidity of more formal brow lifting techniques.

PURPOSE OF REVIEW The purpose of this review is to describe the results from published clinical studies evaluating the efficacy of two types of dacryocystorhinostomy, namely external and endonasal. RECENT FINDINGS Many studies report high success rates with either procedure in alleviating the consequences of nasolacrimal duct obstruction. However, only a few studies have compared the two approaches in a prospective, randomized fashion. SUMMARY Both types of procedure achieve excellent outcomes, and there is no definitive evidence from published, large-scale studies that one approach is superior to the other.

PURPOSE OF REVIEW Chemodenervation has evolved greatly over the past 30 years since botulinum toxin was first introduced as a therapeutic injection for managing strabismus. RECENT FINDINGS Botulinum toxins are now accepted as a first-line treatment for patients suffering from spasms secondary to facial dystonias. These treatments are extremely effective and well tolerated by most patients. New agents including doxorubicin, Doxil, and ricin mab35 are being developed to create a longer-lasting treatment option for patients with facial dystonias. Recently the use of chemodenervation for managing facial wrinkles has expanded the use of these agents. The botulinum toxins have been found to be extremely efficacious in managing facial wrinkles, especially in the upper half of the face. The federal drug administration approved the use of Botox (Allergan, Irvine, CA) for glabellar furrows. Periocular crow's feet lines and horizontal forehead lines are also amenable to treatment with the botulinum toxins. Further uses including chemical browlift, as well as lower face and neck line treatments have also been described. SUMMARY The use of the botulinum toxins has revolutionized the treatment of a broad array of diseases from benign essential blepharospasm to facial wrinkles.