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Upper Blepharoplasty or Brow Lift for Heavy Eyelids?

I am 30 with heavy eyelids. There is no fat, just excess skin. I am wondering whether I am a candidate for an upper Blepharoplasty or a Brow Lift.

I feel like there is a lot of space between my brows and eyes and a brow lift might look strange. I've seen a few doctors and received a host of responses - some say my eyes would be easy to do, some thought it was hard, and one said to leave them alone because I might look bug-eyed? Thoughts?

Asked 28 months ago by lapcas in Los angeles, CA
Sort 20 expert answers by:
+2

Upper bleph vs browlift - I'd vote for neither

At 30, you are young for either procedure, plus your unique anatomy which sets you up to have eyelid closure problems if either procedure is overdone even to the slightest degree. You certainly don't need a browlift and quite honestly, the upper lid bleph would need to be so conservative that you would hardly look any different. My vote would be to do nothing for now and save your money and avoid the risk for very little potential gain.
Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
+2

Blepharoplasty or Brow Lift

Although photographs alone can be deceiving, it appears that in this particular photo your brow is nicely positioned and conservative resection of upper lid skin will likely give you a very pleasing result with minimal discomfort or downtime. I would agree that you do not want your brows positioned any further apart than they currently are.
Philip S. Schoenfeld, MD
Chevy Chase Facial Plastic Surgeon
+1

High brows look old, don't do it!

Just a tiny little skin trim will give you a cleaner upper lid, hard to say from photos but sometimes actually filling (with restylane) corrects subtle deflation that may be the actual problem.
Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon
+1

Blepharoplasty, Eyelid Surgery, Beverly Hills Blepharoplasty, Beverly Hills Brow Lift

   Fullness of the upper eyelids come from two places. • One is the position of the eyebrows. If the eyebrows are low, in position, this adds fullness to the upper eyelids. • The other factor is true excess upper eyelid fat and skin which honestly, is a bit rare at 31 years old. Now   In women, the proper aesthetic shape of the eyebrows and eyes must be determined in person by the plastic and cosmetic surgeon in order to determine which of the... more
Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
+1

Blepharoplasty or brow lift for heavy eyelids

According to the pictures, there is no need to do a browlift. The distance between eyelashes to the brows is acceptable. The upper eyelids are full, and there is some orbital fat in both the middle and medial compartments of the upper lid, which can be slightly teased out and removed. There is a small amount of excess skin on the upper lids that can be also removed. A conservative blepharoplasty would be the best so as not to make the eyelids look bug-eyed.
William Portuese, MD
Seattle Facial Plastic Surgeon
+1

No brow lift when brows in good position.

Hi. 1)  You do not need a brow lift, because your brows are where they should be.  A brow lift will give you a startled look. 2)  You look like a good candidate for a simple upper blepharoplasty.
George J. Beraka, MD
Manhattan Plastic Surgeon
+1

Upper Blepharoplasty Less Invasive Than Browlift

You have extra skin in in your upper eyelids. The brow is not that low. Given mild proptosis (bulging of the eyeballs) you should get checked by an internist for any possible thyroid problems and also see an ophthalmologist. Once you ar cleared by them you should have a very good result from upper eyelid Blepharoplasty Regards
Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
+1

Blepharoplasty vs Brow Lift

As others have mentioned, you do have a prominent eye with some lid retraction. Your brows appear to be in pretty good position and you will likely be a candidate for conservative excision of upper eyelid skin, blepharoplasty. I believe this would give the result you are looking for without the surprised look! Good luck.
Farbod Esmailian, MD
Orange County Plastic Surgeon
+1

Treatment for heavy eyelids

Your photo provides a limited view of your face, but I will assume that your left eye and brow are similar to your right. The most striking thing I see is that you have what we call a "prominent eye." Your upper lid sits above the colored part of your eye. "Typical" lid position has the upper lid covering the upper several millimeters of iris. While this may just be how you look, it is important to make sure that you are in good health. There are several medical... more
Elizabeth Lee, MD
Bay Area Plastic Surgeon
+1

Blepharoplasty vs Brow Lift

Hi Lapcas, Stay away from a brow lift. If you have normal thyroid hormone levels, then based on an examination you would likely be a candidate for very conservative excess skin (only) removal of your upper eyelids to correct your "heavy" lids without creating a "bug eyed" look. It sounds as if you are doing your "homework" in getting many opinions as you do want to choose your surgeon most carefully. Good luck and be well. Dr. P Encino,California... more
Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon
+1

Consider a conservative blepharoplasty or no procedure at all

Your eyebrows appear to be in good position. An easy way to tell is to close your eyes, relax your forehed and brows and feel where the tail of your eyebrow is located relative to the rim of your eyesocket. Ideally, you want the tail to sit above the rim (at the rim for men). You also do not appear to have much eyelid skin and your eyes appear to protrude a bit. That may be a funtion of the picture so you would need an in person consult first. Good luck!
Min S. Ahn, MD
Westborough Facial Plastic Surgeon
+1

Avoid blepharoplasty or browlift here.

The most obvious feature in this photograph is the degree of upper eyelid retraction. Normally, the margin of the upper eyelid should lie a few millimeters below the upper edge of the iris, whereas in your case the lid margin lies just at that iris margin (the limbus). A blepharoplasty or even a browlift might actually worsen eyelid closure and appearance in patients like this. For patients presenting with such an appearance, I would recommend thyroid function tests and an ophthalmology... more
David C. Pearson, MD
Jacksonville Facial Plastic Surgeon
+1

Brow position and upper blepharoplasty

Your brow position appears to be adequate. Ideally, there should be an arc from the most medial part of the brow extending laterally an placing the tail of the eyebrow slightly above the medial brow. You have that shape as well as the tail of the brow ending above the orbital rim (edge of the upper eye socket bone). Your main problem appears to be the excess upper lid skin almost touching your lashes. An upper blepharoplasty would most probably be all you need.
Ricardo Izquierdo, MD
Chicago Plastic Surgeon
+1

Upper Blepharoplasty or Brow Lift for heavy eyelids

Dear Lapcas, I am having a great deal of problem recommending a cosmetic procedure based on a single photograph in which only your right eye is shown. Based on what I see, you have a moderate degree of proptosis (your eye ball sticks out past the rim of the socket). The upper lid BARELY reaches the iris while the lower lid does not, leaving some (white) scleral show. The amount of "excess" upper lid skin, if any, is minimal. I would be very reluctant to do an upper lid procedure in... more
Peter A. Aldea, MD
Memphis Plastic Surgeon
+1

Leave brows alone

I think your brow location and shape is very good, I would not change this. The photo does not show a lot of excess skin of the upper lid but this could be assessed with an examination to see what it looks like in person. An upper lid blepharoplasty might be able to allow a little more show of the eye lid above the lashes when your eye is open. This would be a subtle improvement but your examining surgeon would have to give you an idea on how much it might change. Best Wishes Dr. Peterson more
Marcus L. Peterson, MD
Saint George Plastic Surgeon
+1

I wouldn't do either; Consider Botox

I agree that you have well positioned brows with a slight lateral arch. I also agree that you have minimal skin excess in the setting of having prominent eyes. I think in 5-10 years, you may make a more convincing case for surgery. However, at this time, I would be hard pressed to suggest a surgical procedure when other options exist. For a patient of your age with your physical findings, I would suggest a slight lateral chemical brow lift using Botox.
Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
+1

Upper eyelid surgery or browlift

I think your brows are fine. Browlifts are overdone in my opinion. Looking at your eyes, you may have a touch of upper lid retraction which means that your upper lid margin hangs out at the top of the cornea or above it. Normally it should be a touch below. This may be an early sign of Graves' disease. I recommend that you consult with an Ophthalmic Plastic Surgeon to sort it all out. Not knowing anything else about you, I would do a blepharoplasty alone or with an upper lid retraction... more
Peter T. Truong, MD
Fresno Oculoplastic Surgeon
+1

Customization

You certainly have mild "problems." Your surgeon needs to diagnose why you look the way you do and decide with you what you want to look like in the end. Then it is a simple matter of exploring the options that will get you close to want you want and see if any of these seem reasonable. Your "treatment" must be customized to your anatomy and your desires, not the other way around. One option is always to do nothing.
Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
+1

Upper eyelids

You dont have much upper lid visibility. A carefully (conservatively) done upper lid procedure would give you a nice "crease" that is desirable. As far as the eyebrows, you could have lateral (outer) brow lift done.....not the center and inner part of the brow. That is how you avoid the surprised look. Elevating the outer (lateral) part of the brow usually gives a nice open, interested, alert look. Get several opinioms
Andrew Pichler, MD
Sacramento Facial Plastic Surgeon
+1

Upper Blepharoplasty and/or Brow Lift for Heavy Eyelids

You will receive many responses on this forum as well. Determining between upper blepharoplasty and / or brow lift to rejuvenate the periorbital area can only be determined after a comprehensive examination in-person. Based on the single photograph, I agree that one has to be cautious about removing skin with an upper blepharoplasty, especially given your young age. Your right eye does appear to be protruding, and removing skin makes it appear more protruding or bug-eyed. You lack a... more
Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
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