Bilateral Temporal Brow Lift vs. Upper Lid Blepharoplasty? (photo)

Question

I have excess skin under my brows and have been to two doctors for consultation. One is recommending a Bilateral Temporal Brow Lift and the other recommends an Upper Lid Blepharoplasty. Can someone tell me the pros and cons of each proceedure and how to decide what one is most appropriate for me. I am a 72 year old female and I'm considering having something done because I find that I lift my brows a lot when reading.

Gregory T. Lynam, MD · Answer

Not trying to add a layer of confusion but I bet a brow lift and upper eyelid lift would be the right combo for you. You have too much laxity of the brows and also excess upper eyelid skin so one isolated brow or lid procedure is not going to work. Take your time and find the right doctor who explains this to you, good luck!

John Mesa, MD · Answer

Patients with excess of skin underneath the eyebrows and on
the upper lids may require a endoscopic brow-lift (small incision brow-lift),
upper lid blepharoplasty or both. Patients with this these kinds of physical
findings should undergo consultation with a board certified plastic surgeon
specialized in brow-lift and facial cosmetic surgery. In our practice we
performed these procedures under local anesthesia with minimal discomfort or
pain, which means faster recovery, increased safety and decreased cost.

Robert Glasgold, MD, FACS · Answer

This is commonly a very confusing issue for patients as every recommendation is clouded by our own aesthetic preferences.  I put a lot of emphasis on creating a natural and rejuvenated appearance.  A very easy way to help determine what you want is by looking at photos of yourself when you were younger.  This will tell you what your "youthful eyes" looked like; that is usually what we should try to recreate.  I think your brow position is fine, my feeling is that raising you eyebrows further is going to give you an unnatural and surprised look.  Your photos demonstrate that their is significant excess skin at the outer portion of the upper lid and significant volume loss in the inner portion of the lid.  It is this combination that gives the appearance of your eyes turning down, because our attention is drawn to the shadow under your brow running from high (inner) to low (outer).  In a younger appearing eye this shadow line should run more parallel to the brow above and the eyelid below.  Browlifting will not correct this problem.  My recommended approach for your eyes is an upper blepharoplasty to remove the skin redundancy and a fat transfer (primarily to the inner half of the lid) to address the sunken appearance of the upper lid.  The fat is suctioned out of the belly or thigh and injected into the area.  If this sounds confusing, photos which we have on our website gallery under "upper blepharoplasty" can help demonstrate this.

Toby Mayer, MD · Answer

Well I had the argument 35 years ago and it seems a lot of surgeons still do not get this. 1..gravity works vertically so the brow lift you need isNOT temporal but rather an Irregular Trichophytic  Forehead Lift which we developed for patients like you so your hairline is not raised and you do NOT see a scar. 2. You could hide a "nest of robins" in your upper lid sulcus so a blepharoplasty is NOT needed.

Mark Berkowitz, MD · Answer

Path42  Hello Neighbor.  Thank you for your picture. A complete consultation is necessary to determine your best course of action.  You have three age  related changes occurring to your eyelid area:Eyebrow Ptosis or droopDermatochalasis or excess skin with hallowing of eyelidEyelid Ptosis or droopYour plan can address one, two , or all three parts.  Each one of these can improved with  a variety of procedures.  It will get to complicated to discuss on line . Luckily , I am in your backyard.  I have performed 1000s of these procedures and would be honored to discuss your concerns. Please call Laney  and set up a no obligation appointment 5862547692.

John J. Martin, Jr., MD · Answer

You have a very low brow, especially on the left, which is why you see all of the redundant skin there.  If you do just a blepahroplasty, the brow will fall even further and will end up in your lid crease.  You should do some sort of a temporal browlift.  You also have a ptosis where the lid itself is low.  This can be fixed at the same time as an upper eyelid bleph.  You have some hollowing of the upper eyelids as well.  If this doesn't bother you and you have always had this, just know that it will not change with upper eyelid surgery unless you also add some fat or filler to the area.

Mehryar (Ray) Taban, MD, FACS · Answer

I can see three common problem in your upper eyelid area:  1)  ptosis, which is droopy upper eyelids,  2) loose upper lid skin,  3)  droopy lateral brows.  Each requires a different procedure, each with their own benefit.  Ptosis surgery will open the eyes more.  Upper blepharoplasty removes excess loose skin from the upper lids.  Brow lift will lift the saggy lateral brows.  All can be performed at the same time. See an oculoplastic surgeon.

Michael A. Carron, MD · Answer

Hi, your question is a good one.  Overall, the entire forehead and brow region in addition to the upper eyelid function basically as a unit.  From what I can tell in the photograph, the brows are ptotic (dropped) and asymmetric.  The forehead has laxity and wrinkling as well.  The upper lids appear to have redundant skin as well.  Sometimes, the excess skin of the eyelids is actually skin from just below the eyebrows and is not necessarily eyelid skin per se.  There may or may not be element of redundant fat in the upper lids (I cannot tell from the picture).  There are several options for a browlift, endoscopic or a hairline appraoch.  Skin thickness, laxity and the actual hairline location are taken into consideration.  From what I can tell, would address the entire forehead unit (entire brow as well).  There is a high probability the upper lids would benefit as well.

Darryl J. Blinski, MD · Answer

Maybe BOTH! Best to seek additional IN PERSON evaluations to determine best course for you. Good Luck.///

Terrence Murphy, MD · Answer

Consultation with experienced board certified surgeons is important. Ask them to evaluate the hollow appearance of your upper orbit. Adding fat may help. Your brow height in general seems fine. Ask if they can release the frown muscle which is furrowing your brow. A definite plan is bet made in person.

Bilateral Temporal Brow Lift vs. Upper Lid Blepharoplasty? (photo)

Answers (16)

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