Upper Blepharoplasty or Brow Lift for Heavy Eyelids?

I am 30 with heavy eyelids. There is no fat, just excess skin. I am wondering whether I am a candidate for an upper Blepharoplasty or a Brow Lift.

I feel like there is a lot of space between my brows and eyes and a brow lift might look strange. I've seen a few doctors and received a host of responses - some say my eyes would be easy to do, some thought it was hard, and one said to leave them alone because I might look bug-eyed? Thoughts?

Doctor Answers 22

Upper bleph vs browlift - I'd vote for neither

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At 30, you are young for either procedure, plus your unique anatomy which sets you up to have eyelid closure problems if either procedure is overdone even to the slightest degree. You certainly don't need a browlift and quite honestly, the upper lid bleph would need to be so conservative that you would hardly look any different. My vote would be to do nothing for now and save your money and avoid the risk for very little potential gain.

Blepharoplasty, Eyelid Surgery, Beverly Hills Blepharoplasty, Beverly Hills Brow Lift

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   Fullness of the upper eyelids come from two places.

• One is the position of the eyebrows. If the eyebrows are low, in position, this adds fullness to the upper eyelids.
• The other factor is true excess upper eyelid fat and skin which honestly, is a bit rare at 31 years old. Now

  In women, the proper aesthetic shape of the eyebrows and eyes must be determined in person by the plastic and cosmetic surgeon in order to determine which of the abovementioned two factors is causing the upper eyelid fullness in your particular case. I mention this in my new book on the aesthetics of beauty , "What's Your Number..the palmer code." the link to which is included at the bottom of this answer.

  The surgeon must, IMO, place your eyebrows in the proper aesthetic position and then with you opening and closing your eyes, assess the amount of upper eyelid fullness remaining. There are three possible outcomes all quite revealing:

• when the eyebrows are elevated to the proper position, all the upper eyelid fullness is gone. This means the fullness is due to low eyebrows and the solution is a Brow Lift, not an upper Blepharoplasty which if performed, in this scenario, would actually cause your eyebrows to become lower after the procedure. More on this later.

• when the eyebrows are elevated, some of the upper eyelid fullness remains. This indicates that a Browlift would remove some, but not all of the fullness, the remainer of which could be removed with an upper Blepharoplasty as a combined procedure.

• the eyebrow is already in the proper position and all of the fullness remains, indicating that an upper Blepharoplasty alone would remove this excess. This is the only scenario, of the three possible, where an upper Blepharoplasty alone is indicated.

  Until this simple, but crucial maneuver is performed on you in person...I don't see how an accurate answer can be provided. If an upper Blepharoplasty is done when the correct procedure should have been a Brow Lift, to raise the eyebrows, the Blepharoplasty can cause the position of the eyebrows to go even lower after the procedure.   Once this happens, the Brow Lift often can't be performed because there's simply not enough skin on the upper eyelid to allow the eyes to close properly after the eyebrows have been elevated. This can result in corneal exposure and complications.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Upper Blepharoplasty Less Invasive Than Browlift

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You have extra skin in in your upper eyelids. The brow is not that low. Given mild proptosis (bulging of the eyeballs) you should get checked by an internist for any possible thyroid problems and also see an ophthalmologist. Once you ar cleared by them you should have a very good result from upper eyelid Blepharoplasty


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

Blepharoplasty or Brow Lift

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Although photographs alone can be deceiving, it appears that in this particular photo your brow is nicely positioned and conservative resection of upper lid skin will likely give you a very pleasing result with minimal discomfort or downtime. I would agree that you do not want your brows positioned any further apart than they currently are.

Philip S. Schoenfeld, MD, FACS
Chevy Chase Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Upper Blepharoplasty, Not Brow Lift Is best For You

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Thank you for your question.

The high point of your eyebrow-the junction of the outer 1/3 with the inner 2/3 should be 1 centimeter above the bone of the eye socket. From your photo I believe your brow position is normal. A Brow Lift would make the Brow too high and might create the "Deer in Headlights" appearance.

Although you are young, you do have excess upper Eyelid skin which is encroaching on the eye lashes-a condition called Dermatochalasis. I see no reason to wait until you are older to have an Upper Eyelid Blepharoplasty.

High brows look old, don't do it!

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just a tiny little skin trim will give you a cleaner upper lid, hard to say from photos but sometimes actually filling
(with restylane) corrects subtle deflation that may be the actual problem.

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

Treatment for heavy eyelids

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Your photo provides a limited view of your face, but I will assume that your left eye and brow are similar to your right. The most striking thing I see is that you have what we call a "prominent eye." Your upper lid sits above the colored part of your eye. "Typical" lid position has the upper lid covering the upper several millimeters of iris. While this may just be how you look, it is important to make sure that you are in good health. There are several medical conditions that can cause an appearance like this. I would also want to make sure that you have no symptoms of dry eye. If your health is fine, then taking a small amount of skin from your upper lids would move your upper lid skin off your eyelashes. I think your eyebrow position is ok, although again this is a limited photograph and so I am not sure that a brow lift would be appropriate.

It is frustrating to get multiple different opinions from different specialists. Keep in mind that the most important thing you can do is make sure that you have no health issue contributing to the appearance of your eye. After a medical condition has been ruled out, find a surgeon who can address all the other opinions you have received and explain which procedure they feel is best and why.

Elizabeth Slass Lee, MD
Bay Area Plastic Surgeon
4.8 out of 5 stars 56 reviews

Consider a conservative blepharoplasty or no procedure at all

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Your eyebrows appear to be in good position. An easy way to tell is to close your eyes, relax your forehed and brows and feel where the tail of your eyebrow is located relative to the rim of your eyesocket. Ideally, you want the tail to sit above the rim (at the rim for men). You also do not appear to have much eyelid skin and your eyes appear to protrude a bit. That may be a funtion of the picture so you would need an in person consult first.

Good luck!

Min S. Ahn, MD, FACS
Westborough Facial Plastic Surgeon
4.6 out of 5 stars 35 reviews

Consider Botox Instead

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Thank you for your question. From your photograph, it appears that your brow position is somewhat flat and possibly a little on the low side, contributing to some mild upper lid hooding. Something easy you might consider would be a little botox to create a brow lift. Botox can lift the brow 1-2mm or so. If you like the effect, you can continue with it and it will help inform your decision for any future surgical considerations. You are young to be thinking about a brow lift and timing for surgery is a very personal decision. A surgeon who sees you in consultation will be better able to advise you after examining your eyelid laxity and true brow position.

Peyman Solieman, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 3 reviews

Blepharoplasty or brow lift for heavy eyelids

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According to the pictures, there is no need to do a browlift. The distance between eyelashes to the brows is acceptable. The upper eyelids are full, and there is some orbital fat in both the middle and medial compartments of the upper lid, which can be slightly teased out and removed. There is a small amount of excess skin on the upper lids that can be also removed. A conservative blepharoplasty would be the best so as not to make the eyelids look bug-eyed.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 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.