Blepharoplasty or Brow Lift for Female Patient in Early 20s? (photo)

I am concerned with the upper lid heaviness/overall unrefined look to my eyes...they have looked this way for as long as i can remember. I cannot wear makeup without it smearing and looking 'sloppy' and feel like my eyes make me look more masculine, especially when smiling. I have been on a few consultations and have been told multiple times that an upper blepharoplasty is what I should look into and once that a browlift would address my concerns. Which procedure would benefit me more?

Doctor Answers (22)

Eyelid or Brow procedure? (photos)

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Interesting opinions by some other responders.  The question that must be answered before considering any procedure is, "What anatomic feature is causing the appearance of heaviness that I do not like?". When the responsible feature is known, then it becomes clear where to address surgical treatment efforts, or non-surgical possibilities.  

Brow shaping and upper blepharoplasty may help, and I would open the upper eyelid slightly by levator advancement because of your low marginal reflex distance.  Would consider lateral canthopexy as well to slightly raise lower lid margin.  Would defer brow or forehead procedure unless eyelid procedure incompletely successful.

Of course, this is only a guess based upon submitted photos.  Personal evaluation must precede formulation of surgical plans.

San Diego Plastic Surgeon
5.0 out of 5 stars 39 reviews

Blepharoplasty or Brow Lift

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Your brows are relatively well positioned in the photographs.  A browlift may look strange on someone your age.  I would recommend a very conservative blepharoplasty.  Removing too much skin would pull the heavy skin from your brow down onto your lid, negating the effect of the surgery.  I would remove a small amount of muscle and fat as well.  Botox done properly could be used to lift your lateral brow a little, but only lasts for months and needs to be repeated.  You might try that before surgery.

Possible upper eyelid blepharoplasty

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In my opinion, your eyebrows are very important in defining your facial expression and character. I feel a browlift would make you look surprised. From my perspective, I would perform an upper eyelid blepharoplasty to reduce the “hooded area” of the upper eyelids.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.5 out of 5 stars 40 reviews

Brow lift vs upper blepharoplasty

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      Because of your age , I would opt for being more conservative and do an upper blepharoplasty. With time, you probably would also benefit from a brow/coronoplasty which I do endoscopically.

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.5 out of 5 stars 24 reviews

Blepharoplasty or Brow Lift for Female Patient in Early 20s

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Based on your photographs, you appear to be a candidate for an upper blepharoplasty. To confirm, consult with 3 - 4 experienced and expert board certified plastic surgeons.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 20 reviews

Blepharoplasty Versus Brow lift in Young Patients

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It appears that you have a familial type problem that I see in my office relatively frequently. Although you have features that could be improved by both an upper blepharoplasty (eyelid) and brow lift, I would recommend just doing an upper eyelid procedure at this time to remove the heaviness and skin redundancy (skin rests on your lashes in some of the photos) and at the same time shorten your muscle (levator muscle) so that it opens a bit more. The brow lift can be saved for years later.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 59 reviews

Deflated sagging brows

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Your eyebrow is DEFLATED, meaning it is relatively hollow.  Do NOT do brow lift.  Although conservative upper blepharoplasty can help with the appearance of the upper eyelid, a better option might be filler/fat injection into your eyebrows.  See an oculoplastic or facial plastic surgeon for proper evaluation and treatment options.

Mehryar (Ray) Taban, MD, FACS
Los Angeles Oculoplastic Surgeon
4.5 out of 5 stars 13 reviews

Blepharoplasty or browlift?

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  I think you will get different opinions on this question and none of them are wrong.  But personally, I'd advocate upper blepharoplasty instead of browlift since it is a less invasive procedure.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.5 out of 5 stars 51 reviews

Browlift with or without upper lid skin resection?

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Thanks for the pictures.  Your photos suggest that a browlift would be my first recommendation to elevate the lateral brow position.  This will make the lateral upper lids appear less heavy and correct the concerns for a masculine appearance.  For optimal support of future skin aging, the upper lid blepharoplasty should also be considered to anchor the upper lid folds in a more open position as well.  So, I would recommend you consider both procedures for best balance.

Randy Wong, MD
Honolulu Plastic Surgeon
5.0 out of 5 stars 19 reviews

Browlift vs eyelidplasty for upper lid heaviness

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Generally, a browlift is used for rejuvenation of the upper face. During the process of aging, the position of the eyebrow often droops over time.  However, even some young people show an eyebrow that is lower than the classic aesthetic ideal but this does not make them look old.  In someone so young, it is unlikely that brow position is the cause of upper lid heaviness.  Skin redundancy intrinsic to the upper lid occasionally occurs in people in their 20's due to a genetic propensity to laxity.  In these circumstances, an upper lid blepharoplasy is the best surgical procedure for addressing skin laxity and hooding in the upper lid.  Occasionally, in younger patients a neurotoxin njection (Botox) done by an experienced injector can subtly raise the brow and clean up the upper eyelid. Before making any decision, it is important to have a consultation by a board certified plastic surgeon who is experienced with both surgical procedures and the injection treatment to determine what treatment will best meet your aesthetic goals.

Lawrence Bass, MD
New York Plastic Surgeon
5.0 out of 5 stars 8 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.