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Upper Blepharoplasty After Botox Brow Lifts?

Hi! I am 31 year old female and my upper eyelids have been getting lower. I could see the eyelids in pictures taken about 7 years ago but not anymore. I have been getting Botox for about 3 years now and don't know if this has weakened my forehead muscle causing them to droop more or if it is just my genetics.

My Dr who does my Botox is one of the best around but my brows only responded to a Botox brow lift slightly. Should I go for a tissue sparring upper Blepharoplasty (just skin no fat or muscle)?

Asked 30 months ago by samnic1 in uk

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Be careful with blepharoplasty without brow support such as lateral hood lift

With your concerns I would definitely recommend some sort of lateral brow suspension to avoid worsening brow ptosis. My prefered technique is the lateral hood lift which also cleans up the bulky skin to the side of your eye. Wiht this technique you will need a much more conservative upper blepharoplasty. I hope this helps! All the best! Rian A. Maercks M.D.

Doctor's Website

Rian Maercks, MD

Miami Plastic Surgeon

Yes, you can have a blepharoplasty after Botox

The effects of Botox typically last 2-3 months for the initial treatment, and may last up to 6 months or so after 3 years of consistent treatment. You should wait at least 4-6 months after your last Botox treatment before you consult with a plastic surgeon who can help you to decide whether upper eyelid surgery is right for you.. While the Botox could always have a role, I suspect your issues do have a genetic component. It does seem in looking at your photo, that... more

Michael Vincent, MD

Rockville Plastic Surgeon

ASAPS ASPS

Upper blepharoplasty creates deeper fold on eyelid compared to tissue sparing blepharoplasty

The Botox can certainly weaken muscle if it has been consistently performed over the last three years. This combined with the aging process will have brows descend downward, giving the eyelids the appearance of being saggy. A skin-only blepharoplasty would be an acceptable alternative for your upper lids based on the picture that was presented. It all depends on how deep of an upper lid crease you would like to have. Removing fat and muscle tends to deepen the fold on the upper lid.... more

Doctor's Website

William Portuese, MD

Seattle Facial Plastic Surgeon

Upper blepharoplasty

Hi! 1) You will do well with an upper blepharoplasty. But you have a lot of hooding, and some muscle needs to be removed as well as skin. 2) You do not need a brow lift.

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

You might look better letting your Botox wear off

Dear Samnic1 In your photo, your forehead appears over BOTOX'd. There are no lines and yet your upper eyelid folds hang into the eyelid space. A true forehead lift with BOTOX is possible (look at lidlift.com microdroplet BOTOX) but one really needs to understand anatomy to get this effect. On the other hand, upper blepharoplasty will be a disaster for you. The issue is that you already hold your eyebrow so low (as noted, this may be an over BOTOX issue). When the eyelid fold skin is... more

Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon

Botox Browlift can only do so much

Botox can provide a nice, non-surgical, elevation to the brows. However, this treatment can only do so much. For those who have too much excess skin, Botox may not be enough. In my experience, patient who have skin resting on their eyelashes may require a more aggressive treatment -- an upper lid blepharoplasty.