Facial rejuvenation surgery such as a face lift or brow lift will address loose skin most effectively. Wrinkles or rhytids that form secondary to this skin excess will no doubt be taken up by excising this extra skin caused by gravity and aging, and tightening the remaining skin. Small creases in the skin, etched over the years, will need a form of skin resurfacing to fix effectively. This may be in the form of carbon dioxide laser, erbium laser, trichloroacetic acid (TCA) peel, phenol peel, Blue Peel ™. Either an endoscopic forehead or brow lift, or an open forehead or brow lift include the division and partial removal of the corrugators, depressor, and procerus muscles. Muscles that are responsible for the furrowing between the brows and just above them whilst frowning. Repositioning, or excising the forehead skin will address the forehead lines. So the short answer is that an open brow lift will address all of the above concerns, while the endoscopic brow lift may not address forehead lines as effectively. Any residual lines, crinkles, and creases will be handled effectively via skin resurfacing modalities.