I'm considering a brow lift after a blepharoplasty last year (done too conservatively) failed to address the hooding I have. A new surgeon said that it seems all I need is removal of some remaining excess skin and of fat deposit on the upper eyelids and that should open up the eye sufficiently. He calls it transblepharoplasty/browplasty but I'm not sure if this combined procedure will lift the brow at all. Will this involve using a fixation device to make sure the brow is lifted?
Will a Transblepharoplasty Sufficiently Lift the Brow? (photo)
Doctor Answers (13)
Will a Transblepharoplasty Sufficiently Lift the Brow?
The upper eyelid skin removal will be less invasive and give you a nice improvement. That type of internal brow pexy may only give a mm or two of lift and it tends to be less durable. Find a plastic surgeon with ELITE credentials who performs hundreds of facial procedures and brow lifts each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA
Brow lift options
I agree that you still have some degree of upper lid hooding, but there is also mild brow ptosis, especially in the lateral brow area. I would favor an endoscopic brow lift, and possibly a very limited upper eyelid revision to address only excess skin and /or fat pseudohernias. There is a risk of dry eye problems with overaggressive treatment, so you may want to wait about 3 months after brow lifting to determine how to proceed with revision upper blepharoplasty. Good luck!
Brow lift after an upper blepharoplasty
A brow lift can be performed via many types of approaches or incisions, and commonly combined with eyelid surgery or facelift. A brow lift through an upper eyelid incision alone is generally reserved for minor droopy or sagging eyebrow tissue. Most patients, however, who are considering a brow or forehead lift benefit from an endoscopic or limited incision forehead lift where small incisions are hidden in the hair of the scalp to rejuvenate the forehead. A more significant and natural lift is generally achieved with a scalp approach as compared to an upper eyelid approach.
Only after a comprehensive evaluation can a plastic surgeon help determine appropriate options for you. Best of luck.
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Transblepharoplasty Brow Lift
The brows can be elevated using an incision in the upper eyelid but I recommend a more reliable traditional incision in the scalp or at the hairline.
Trans blepharoplasty brow lift
In general, the trans Blepaharoplasty brow lift is not very effective and may give you a very subtle ANC minimal brow lift that may not last very long. In looking at your photo, you definitely have a lot of excess skin in the upper eyelids and you would benefit from an upper Blepharoplasty but, in my opinion, you don't need a brow lift at this time. A brow lift is likely to give you that "surprised" look. A skillfully performed upper Blepharoplasty will give you an excellent result.
Irregular Trichophytic forehead lift is what would be best.
Irregular Trichophytic forehead lift is what would be best. Your brow is raised with a hairline incision and hair grows thru the scar and in front of it. Doing your lids will not get your brows to the best position.
Brow lift and upper eyelid blepharoplasty
It does appear that you have excess skin of the upper eyelids and low brow position. I would recommend a more formal lateral brow lift with excision of excess skin and fat of the upper eyelids.
Browlifting can be done in a variety of ways depending on the patient's age, skin thickness, and hairline.
In my opinion, the trans-blepharoplasty brow"lifts" help stablize and at best give a modest amount amount of lift. I offer this approach mainly in patients with very limited need, in males that need stabilization rather than aggressive lift, and in patients that really do need a lift but do not want the added incision [mainly to prevent additional descent after skin is removed from the eyelid]
From your photo [if this is in fact your postop photo after the first blepharoplasty], it would seem to me that you would do well with a blepharoplasty with some additional skin removal, but would do even better with a combination browlift [either endoscopic or hairline depending on your skin thickness] AND blepharoplasty.
Of course an in person analysis will help finalize your plan.
Will a Transblepharoplasty Sufficiently Lift the Brow?
The brow/upper lid is a very complex and dynamic anatomic area. It is unfortunately impossible to give specific advice without examining your brow and eyes. Based on your video, you still have significant excess skin in your upper eyelids and drooping of the brows. Typically, patients require both an upper eyelid lift and browlift (of some variety) to improve these concerns. I've found the transbleph browlift to be best at raising the outer portion of the eyebrow but not changing the inner portion to a significant degree. I hope this information is helpful.
Eyelid Eyebrow Surgery In Combination
Roxanna3100 There are numerous procedures to fix and/ or lift the eyebrow. While your picture does show dermatochalasis ( excess skin), it also reveals a degree of brow ptosis. A full examination is warranted to determine the extent the eyebrow impinges on the eyelid. A suture transblepharoplasty / browplasty will help to fix the eyebrow in place but more than likely will not elevate the eyebrow long term. I would be happy to evaluate your eyebrow and eyelid position to give my opinion on the best course of action.