I would not offer you surgery

Manish H. Shah, MD answers: Am I a good candidate for a brow lift and upper blepharoplasty surgery?

I have just turned 35 and noticed that my eyes are starting to look old. My eyebrows have dropped slightly and my upper eyelids always look tired and little puffy no matter how much I sleep. I have also noticed that my eyes no longer look as open and have the nice almond shape they had when I was in my 20's. So I would like to know if a brow lift combined with a blepharoplasty would be the right procedures to fix the problems I just mentioned or would just a brow lift by it self be sufficient?


Manish H. Shah, MD
6 months ago

 Looking at your face (what you included of it) I can only assess you to be a youthful looking male.  You have a sharp supratarsal fold with relatively normal positioning of your brow relative to your superior orbital rim.  Your skin looks healthy in the picture.  All of these are limited assessments but they point to you being probably better for minimally invasive procedures like Botox or injectible filler.  

Surgery in the periorbital area carries significant risk so the need for the enhancement needs to be obvious.  I agree with those who mention BDD, which stands for Body Dysmorphic Disorder.  You need to look at your issues with your eye/brow critically and determine how important to you is the need to change and how bothered would you be if you didn't change anything.  Talking things over with friends and family sometimes helps, but by no means should anyone else be the validator of your own personal feelings.  

As physicians, we all try to keep our patients safe, even from themselves sometimes.  It sounds paternalistic, but in reality we all took the oath to "Do no harm."  

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