48, female, medium skin tone - Upper blepharoplasty or brow lift? (Photos)

In my opinion, from the photos you would see benefits from both and I would recommend a combination approach. A brow lift would reposition the brows in a higher position and will create an eye opening effect. However, alone, this will not have an effect on your upper eyelids. An upper blepharoplasty will address hooding to the eyelids.

You are a great candidate for upper blepharoplasty surgery. Blepharoplasty makes eyes look younger and rejuvenated by removing excess skin, fat, and muscle to help patients look more vibrant. It also reduces the appearance of loose skin in and around the eyelids and can also improve the appearance of bags under the eyes. In your case, you will definitely look at least 10 years younger. I highly recommend this procedure for you.

Thank you for your inquiry! By your photos, it looks like you would be a great candidate for another upper bleph procedure to remove additional excess skin to your eyelids. I recommend scheduling a consult appointment with a board certified plastic surgeon like myself so we can assess your eyes, listen to your goals, and create a surgical plan that is best for you and your goals!

Your eyebrows are below the level of the orbital rim and they should be above the level of the orbital rim in females. You would benefit from a brow lift. This will lower the hairline and decrease the vertical height of the forehead. The brow lift can also be extended down to the ear and do a lateral eyelid lift as well.

Best Wishes,

Gary Horndeski, M.D.

Thanks for your question. The answer is probably both. I think most patients who need blepharoplasty would probably benefit from at least a temporal browlift. That said, I do think you would have an nice result from blepharoplasty alone. I probably wouldn't recommend just a browlift, however.

Dr. B

It is nice to hear that you recognize that a browlift may be indicated and achieve the desired aesthetic change you seek.

Do you like the way you look when you elevate your brow? Do a quick check with your fingers or a Q-tip or two. If you like the position of your eyebrows and feel that the heaviness in your upper eyes is satisfactorily relieved by this, then you could consider a browlift alone. If there's still some residual heaviness to your eyelids with your brow elevated, then both procedures are likely indicated.

Keep in mind that if you are thinking of both, you should do the browlift, at least. If you start with an upper bleph, you may be prohibited from doing a browlift for years as the slack taken out from the upper bleph followed by a browlift could leave you with an open eye (i.e., lagophathalmos). Furthermore, if your brow is ptotic, an upper bleph alone could pull it down further.

The one lesson I've learned in 20 years of Realself is that photos and brief patient narrative cannot replace the two-way communication and physical examination with patient participation before a mirror. As a result, answers on Realself, based on limited information and understanding, may be at variance with truth. Upper bleph, levator advancement, and temporal browlift results can all be simulated in the office for you yourself to answer the question (and get your questions answered) better than any doctor can.

The photos suggest that you would benefit most aesthetically from both an upper eyelid blepharoplasty and an endoscopic forehead lift. Although I do not think that a browlift alone will be satisfactory, an upper eyelid blepharoplasty in isolation would offer an acceptable result. This is all predicated on excellent surgical results by an experienced facial plastic sugeon. Good luck i your journey!

I would suggest the eyelid surgery just based only on your two photos and not exam. Your brows naturally sit low on your forehead and if raised, your looks will be significantly changed. Not everyone likes that look they never had. The blepharoplasty will look very natural once healed.

Thank you for your question and photo. You appear to have mild asymmetry and some upper eyelid heaviness, which is quite common. An upper blepharoplasty could be a great option to address excess skin and improve definition in the upper eyelids.
If brow descent is contributing to the heaviness—especially on one side—a brow lift (or a combination of both procedures) may offer a more balanced and youthful result. A detailed in-person consultation will help determine the root cause and best approach for your anatomy and goals.