Brow, bleph or filler?

Question

I’m 44 and would like to rejuvenate my eyes. I have triple folds in both upper lids and my lateral brow seems like its falling BUT when I look at younger photos my upper eyes were very full. Could the folds be from medial volume loss vs laxity? I don’t want to remove or lift away tissue if its the fullness I need for a youthful, authentic appearance. My eyes look sleepy. Tried botox brow lifts but it looks unnatural.

Gary M. Horndeski, MD · Answer

I believe you would benefit from a browlift using a frontal hairline incision. This will lower the hairline, remove some forehead skin and pull up the medial brow. I would wait for the Botox to resolve before doing any surgery. At that time, you may or may not need a blepharoplasty.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

Based on these photos it appears that masterful micro fat injection to increase volume and correct sunken looking upper eyelids is the game changer. A consultation with a board certified plastic surgeon with experience in facial fat grafting is recommended. Good luck

William Portuese, MD · Answer

The height of your eyebrows is perfect, so you do not need a brow lift. To remove the extra folds of skin on your upper eyelids, consider an upper blepharoplasty, which can be performed under local anesthesia as an outpatient procedure. We do not recommend fillers around the eyes.

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