I am debating between a brow lift or upper eyelid surgery. Any suggestions? (photos)
Doctor Answers 13
Dry eyes and the surgeon I visited said that I should not do upper eyelid surgery. Would the brow lift be less taxing on my eyes
Hope this helps.
An oculoplastic surgeon is an ophthalmologist and an eyelid specialist, so they can treat dry eyes and perform eyelid surgery
I can certainly give you some guidance to this question. A little background - I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years and cosmetic eyelid surgery, brow lifting, face lifting, other procedures in this area, and procedures and solutions for facial aging are the core of my practice. This also includes non-surgical solutions like injectables, advanced methods of using blunt cannulas, laser devices, and thermal energy devices.
In your situation, having dry eyes is an important issue. However, will a brow lift make any impact on you, not so much in a dry eye perspective but from an aesthetic perspective. What you are clearly concerned about is some extra skin over your eyes, which is why you probably considered eyelid surgery. The reason why many surgeons are very concerned about dry eyes is because they don’t have an ophthalmology background. Eyelid surgery is typically the 3rd most popular cosmetic surgery, and if the surgeon doesn’t have an ophthalmology background, there are some issues with the management of dry eyes they can’t handle. Very often the surgeon who performs the procedure isn’t the doctor who manages dry eyes.
Myself, having an ophthalmology background, I am familiar with dry eyes - in oculoplastic surgery, we specialize in the lacrimal system which is the tear gland, and tear duct system. I’ve done blepharoplasty for many patients with severe dry eyes. It’s all about management because as I said years ago, and still remains to be true, is that eyelids that look good and function well.
From my experience, and from the aesthetic perspective, I would say a brow lift would not be a good idea. Looking at the photo, the position of your brows seems high enough. I Imagine how much higher the brow would be to get that skin to be more taut. I think if you were to undergo the brow lifting procedure, it wouldn’t look very natural and you may have constantly surprised look.
I think there are more than a few options for you, and it would benefit you to meet with a cosmetic oculofacial plastic surgeon because there are important issues with the health of the eyes, so someone with an ophthalmology background will be more comfortable in dealing with them. It may be that blepharoplasty or brow lift may not be optimal for you, so a proper examination by a specialist is best for your situation, with all do respect to the doctor you went to. Meet with a specialist and see if you can get some more clarity about the basis of any suggested procedure. It is so important to have good communication and really understand what the outcome will be, and what the impact would be on the health of your eyes. You really want to make this a smooth process as possible. I hope that was helpful, I wish you the best of luck and thank you for your question.
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If Reluctant About Surgery, Consider A Nonsurgical Browlift
So, especially if you are concerned about your dry eyes, and owing to the fact that you have already been advised not to undergo the surgery, this may be a very viable, quick (usually takes about ten minutes to perform) and relatively inexpensive approach to explore. This has been a first line approach with many of patients for well over a decade. In my Upper East Side Manhattan office, I typically use Juvederm Ultra Plus XC for brows. (In my Israel satellite facility, where a far greater number of regulatory agency approved volumizers are available, I typically opt for Princess Volume). Where appropriate, microdroplets of muscle relaxants, such as Botox, Dysport or Xeomin, appropriately placed may further help to lift the brow.
I am not a fan of supposed skin tightening devices, such as fraxel lasers, radiofrequency, and ultrasound machines that are frequently advertised for eyelid and brow tightening. In my experience, the results of these relatively expensive approaches tend to inconsistent, subtle, and variable and appear to be supported far more by device manufacturer marketing hype than hard science.For more information on the above, check out the archives of RealSelf.com.
Make sure you consult with a board certified aesthetic physician with experience and expertise in performing advanced nonsurgical facial rejuvenation techniques. And be sure to ask to see his/her before and after photos. Best of luck to you.
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Hi and thanks for posting your question!
Dry eyes are a relative contraindication for eyelid surgery. Oftentimes, your opthalmologist can quantify how significant your dry eyes are with a tear secretion test.
A brow lift procedure affects the upper eyelids without directly excising skin from the eyelids themselves-so if you have severe dry eyes, it may be a good option for achieving good results without doing upper eyelid surgery.
Best wishes in achieving your goals!
Eyebrow lift versus eyelid surgery
ENDOSCOPIC BROWLIFT WITH MID-FACE SUSPENSION
Your photograph shows brow asymmetry. Your right brow may be higher to compensate for right upper eyelid ptosis. A blepharoplasty alone would not correct this. I would recommend an evaluation by an oculoplastic surgeon ( fellowship-trained eyelid specialist that is board certified in ophthalmology). An oculoplastic surgeon will be able to evaluate your brow position, determine the amount of excess skin that is safe to remove, measure levator excursion ( strength of the muscle the opens the eyelid ) and evaluate your ocular surface for dryness. Hope this is helpful. Vikram D. Durairaj, MD FACSAustin, Tx
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon
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.