Management of the brow remains a challenging, important, and gratifying area in the care of facial paralysis patients. Aged facial paralysis patients generally require surgical management of brow ptosis. Young facial paralysis patients occasionally require surgical management of brow ptosis. Indications for surgical management, treatment options, and surgical approach are discussed. Consideration of factors such as age, forehead furrows, skin type, duration of paralysis, and degree of visual impairment are discussed in the context of treatment planning.