The top photo was taken in 2009. The middle photo was taken this year and I had noticed my double eyelids have fallen. But daily, my eyelid heights are inconsistent. My eyes may look like the photo in 2009 on one day and on another day, my eyes may look like the middle photo. I went to a plastic surgeon to discuss blepharoplasty. He didn't recommend this because of the scarring. I agreed. Instead, he recommended an endoscopic brow lift. He laid me down and said this is what a brow lift will do.
35 Year Old Asian Female. Should I Get a Brow Lift or Wait Until I'm Older? (photo)
Doctor Answers 20
I dont think you need a brow lift. You will benefit from a upper eyelid blepharoplasty for the double eyelid
Brow lift or blepharoplasty
A brow lift is only performed for patients who have brow ptosis this is where the distance is quite short between the eyebrows and the eyelashes. The brow lift can be performed through either endoscopic techniques or coronal. Multiple incisions need to be made on the forehead to be able to lift the eyebrows. Surgical adjustments of the eyebrow muscle, the corrugator, frontalis, and procerus muscles are also usually performed depending on the patient’s needs and desires. It is important to not have a “surprised” or “over lifted” look with brow lift results.
A brow lift can do what you want changed. The eyelids themselves might also be worked on. Get a few in person opnions. Perhaps nothing should be done,
If your eyelid heights are inconsistent, you are possibly referring to the changes you have with various expressions. Botox therapy could keep the area consistent.
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Browlift or blepharoplsty?
I think that your brows in the bottom picture are too high. You might get a good idea of what a browlift would achieve by trying either Botox or Dysport. If you choose to have eyelid surgery you should pick a surgeon who is good at performing eyelid surgeon in Asians. There are some specific differences which need to be discussed beforehand or you might end up with Caucasian looking eyelids (which is fine if that's what you want). Ask to see photos.
I feel that a brow lift is the wrong procedure. You will end up with a surprised look to try and raise the eyelid skin. The eyelid lift will work very well and the incision is minimal. Video will examples of patients having a brow lift.
35 Year Old Asian Female. Should I Get a Brow Lift or Wait Until I'm Older?
It does appear that you have fullness of the upper eyelids, however there are three possible (best) treatment options that will require an in person evaluation of the eyebrow position in order to ascertain which is appropriate in your particular case.
With you seated, the eyebrows must be placed in the proper aesthetic position, on each side, and the following evaluation performed. Based on what is found, the best-option treatment would be as follows.
1. The eyebrows are raised to their proper aesthetic position and the amount of upper eyelid fullness remains unchanged. This means that your eyebrows are not low and therefore do not contribute to the upper eyelid fullness. In this case, an Upper Eyelid Surgery is the suggested treatment to remove the excess skin and fat of the upper eyelids.
2. The eyebrows raised into the proper position and all the upper eyelid fullness is gone. In this scenario, all the upper eyelid fullness is due to low eyebrows and the suggested treatment is a Brow Lift to raise them into the proper aesthetic position. In this case, an Upper Eyelid Surgery is contraindicated as removing any upper eyelid skin would cause the eyebrows to drop further.
3. The eyebrows are raised into the proper aesthetic position and some, but not all, of the upper eyelid fullness disappears. In this mixed scenario, you would several options. First, the amount of excess upper eyelid skin remaining, when the brows are raised in the evaluation, could be removed with an Upper Eyelid Surgery...not more or you'd risk dropping the eyebrows. You could elect to raise the eyebrows with a Brow Lift alone that would place the eyebrows into the proper aesthetic position but would leave some excess fullness in the upper eyelids. Lastly, you could decide to treat both issues with a Brow Lift to raise the eyebrows and an Upper Eyelid Surgery to remove the remaining amount of upper eyelid fullness.
In women, upper eyelid fullness must always be evaluated in person, in this manner in order to determine the correct treatment. Hope this helps.
Blepharoplasty and browlift
If I understand correctly the top photo is how you used to look. The middle is the current look and the lower is you lying down. Contrary to what you seem to have been to told the look of you lying face up does not simulate a browlift. The extra component of gravity pulling the orbital contents back into the head is quite different from the effect of a browlift. I suspect what you are seeing standing upright is a combination of corrugator muscle pulling the inner eyebrow down and outward protrusion of the fat around the eye. That fat protrusion is also visible in the lower eyelid in the middle photo. It is not visible in the lower photo because you are lying on your back and pulls the fat back into the orbit. At this point in the aging process the difference you are looking for is only a couple of millimeters. Chasing those millimeters can be surprisingly elusive and lead to a lot of future problems if you are not careful. Therefore I think your safest bet is botox to the corrugator muscles learn to live with the small improvement you get from it. And wait till the before vs. after surgery look will be sufficiently different to justify the surgery.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
Like most surgeons here, I don't feel that you have a droopy brow to need a browlift. If you compare your brows from 2009 to the lying down photo in 2012, you'll notice that your brows are positioned higher in the lying down photo, than the photo from 2009, and in my opinoin, does not look natural for you.
Your surgeon is addressing the eyelid issue with a brow surgery. Asian blepharoplasty can be an intimidating surgery for some surgeons. You should seek one out with experience in this surgery.
Brow Lift or Blepharoplasty
You appear to be a good candidate for an upper lid blepharoplasty. Many time this is done in conjunction with a Brow Lift depending on the actual brow ptosis. In your photos it is difficult to determine your brow ptosis. I personally perform a lot of Asian Blepharoplasty and scars are not an issue. I would suggest you see a good board certified surgeon and look at the before and after photographs of his asian blepharoplaty patients. I am always happy to provide other patients who would love to discuss their experience and show their results. This is especially true of my asian patients they are very sweet and always happy to speak with other patients. Best regards!
Hello, I would recommend a blepharoplasty in your case. I do not feel that a brow lift is necessary to get the correction that you are looking for. You do not have enough brow ptosis at this time, maybe into your 50's you may want to consider it, not now. I would advise you to schedule a consultation with a Board Certified Facial Plastic Surgeon. Ask to see before and after photos of other Asian eyelid surgeries that the surgeon has performed. Good luck to you.
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.