I would remain conservative at this point

I would be hard pressed to recommend surgery on the picture that you have shown.  While you do see a bit more puffiness and a tired look in the eyes, you may not be ready for surgery.  One thing that you could consider is the use of Botox.  Botox can sometimes give temporary brow elevation.  This may give you an indication as to whether brow elevation is what you need or not.  If it turns out that you don't like the change it will go away in a few months. 

Of course, these issues should always be discussed with your surgeon.  If the doctors avoids the questions or does not give adequate answers seek a second opinion.  Good luck with your situation.