Dear Linda
I hope that you are seeing an ophthalmologist who is fellowship trained in eyelid plastic surgery. This individuals will have been elected to the American Society of Ophthalmic Plastic and Reconstructive Surgery. Your doctor may truly believe that you need all of these things. However, it may be that they are looking to add cosmetic procedures that you will be financially responsible because insurance reimbursement for function blepharoplasty is now so low that it is almost not worth a surgeon's time to perform this procedure.
Levator advancement is a type of ptosis surgery. The tendon of the upper eyelid is shortened and then fixed to the upper eyelid platform to strengthen the effect of the levator palpebra superioris muscle that raises the eyelid.
I strongly don't advise a direct brow lift. This is a very unaesthetic procedure that places an ugly scar above each eyebrow. Also generally the sculpting of fat in the upper eyelid needs to be very conservatively and most eyelid surgeons would agree that this is part of the blepharoplasty even it it being done functionally.
I am going to encourage you to get other surgical opinions. I think that it is reasonable to to less but you may need the combination of procedures or it might be reasonable to only to some of the work. Take a look at the ASOPRS.org website. They have a directory of oculoplastic surgeons and this will help you find highly qualified surgeons in your area.
