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Can Excess Skin Between Brows After Eyelid Surgery Be Resolved?

asked 3 years ago by Notperfect in Chicago, IL.
Latest answer by William Portuese, MD
Question viewed 1,887 times
Tags: between eyebrows, lower eyelids, upper eyelids, droopy, loose

I had upper and lower Eyelid surgery, Facelift and Botox on my forehead 3 weeks ago. I didn't want the Eyelid surgery but my doctor insisted. The eyelids are very droopy and there is a wide gap between my eyes, and sagging skin from the inner eye area and between my brows through upper bridge of my nose. I know I need to wait but what might my options be if this does not improve? I'm in my early 40's.

14 answers to Can Excess Skin Between Brows After Eyelid Surgery Be Resolved?

Difficult problem to address

If there is excess skin between the eyebrows this is a very difficult problem to address. A forehead lift can be performed usually only if there is preexisting low eyebrows. The thin skin closest to the nose on the eyelids is very difficult to remove without dragging the incision too close to the nose, which can create an obvious scar or webbing on the eyelid incision.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Botox and eyelid or eyebrow surgery

Botox injections may influence results in the immediate postoperative period after Blepharoplasty. It sounds as though a brow lift was indicated at the time of your eyelid surgery but this can only be determined after the influence of Botox has worn off and the postoperative swelling subsides from your blepharoplasty. I would recommend that you wait several months before initiating any therapy.

Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon

Brow Lift

If the distance between your eye appears to me worse now than when you were younger than there is an issue with the medial brows. Botoxing the corrugator muscles (between the brows) will allow the brows to move laterally if there is laxity in the tissue. This will give the appearance of wider eyes. I agree that once the Botox has worn off consider a brow lift without corrugator resection.

Christopher L. Hess, MD
Fairfax Plastic Surgeon

Botox may have influenced or affected surgical result

I would highly agree with my colleagues that you may benefit from a forehead lift but It would be wisest to wait for the Botox to wear off (3-5 months) prior to making any final decisions. Stick with your surgeon and give it some time.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Too early to tell if a forehead lift is needed

It is probably too early to tell if a forehead lift will be necessary. The relaxation of your forehead muscles by the botox has clouded the overall situation. As the botox wears off over the next 3 - 4 months you will need to be rechecked. If the condition is still present then a brow lift may be your next best option.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon

Generally not a good idea to have BOTOX and eyelid surgery at the same time.

Dear Notperfect You kind got the blue plate special here. It is quite possible that if you did not have both upper eyelid surgery and BOTOX at the same time you might be relatively satisfied with you results. It is very important to understand that when the upper eyelid fold is heavy, the brain sends a signal to the forehead to lift the eyebrows. 100 percent of the time, when upper blepharoplasty is performed there is less need for the forehead muscles to work. They relax and the... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

You may need a brow lift in the future.

Hi! The face heals quickly, and at 3 weeks, you should be looking better than what you describe. Of course, I can't see what you look like, but unfortunately you may well need a touch up. Don't do anything for 6 months. If you are not happy then, one of the various brow lifts may help.

George J. Beraka, MD
Manhattan Plastic Surgeon

Not perfect and not healed...yet

Dear Not, As you mention in your question, you have to wait. The Botox treatments throw in an extra variable to support that dictum. Now, you not only have swelling distorting things, you have the paralysis associated with the Botox treatments. This would explain the lateralization of your brows. You really need to be patient and continue close follow up with your surgeon. You won't have a realistic idea of your result until 6 months or so from now. Good luck!

Kenneth R. Francis, MD
Manhattan Plastic Surgeon

Swelling and Botox may be part of problem

The brows being far apart is likely due to the Botox. Also the slight drop in the medial brow from frontalis paralysis which can happen with Botox may also be contributing. Finally, you need to wait for the swelling to go down to see final result from upper lid blepharoplasty, especially if a significant medial fat pad was removed. So be patient, and stay in touch with your surgeon for reassurance.

W. Tracy Hankins, MD
Las Vegas Plastic Surgeon

Extra skin is due to a loss of volume with aging

This extra skin is a consequence of reductive type of surgeries. When you age, you lose volume and this contributes to the extra skin. Upper eyelifts / blepharoplasties take away skin and that usually leaves skin elsewhere. It won't end. A better way to rejuvenate the upper eyelids is to volumize the whole area. This will require fat grafting and on occassion facial implants. The extra skin between your eyebrows is a normal part of aging that can be accentuated with reductive type of... more

Philip Young, MD
Bellevue Facial Plastic Surgeon

Blepharoplasty, What if There is Excess Skin After Surgery?

Hi Not Perfect, You are correct, waiting may solve all of your concerns once you have fully healed. If not, there are methods to take care of the excess skin that is bothering you. The excess can be excised under local anesthesia in your surgeon's office, or you may choose to have fractionated CO2 laser of the upper eye lid with either Fraxel re:pair or Deep FX. Enjoy your new eye lids and be well. Dr. P

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

A photo would be invaluable in helping answer your question

Without a photo, all you will hear from us is to wait 3-6 months until full healing occurs before knowing if any revisions are needed or possible.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Too early to know.

You are still really early in your healing process. Although you may be unhappy now an nervous about it, you have to wait at least 3-6 months to have an idea of what if anything would need to be corrected.

Kari L. Colen, MD
New York Plastic Surgeon

Wait for 3 months after eyelid surgery first

3 weeks is a very early follow up. I would wait at least 3 months to start evaluating your results. Revision eye lid surgery is very technical and requires a plastic surgeon comfortable with this surgery. A picture will help to give a more sepcific plan.