45, 4 kids, over 100 pound weight loss - Upper bleph or brow lift? (Photos)

Question

I’ll be turning 45 this summer, I’ve also had four children and l lost over 100lbs two years ago. I have always had one “lazy” eyebrow bur it had become more pronounced and I’m self conscious of ir and the hallows of my eyelids themselves. Would a cosmetic procedure be appropriate right now?

Jeffrey M. Darrow, MD · Answer

Patients frequently complain about some asymmetry of their facial features.  No one has exact symmetry and everybody has a small amount of asymmetry. Your upper eyelids do not have any redundant skin that would be treated with an upper blepharoplasty. I believe the small amount of brow asymmetry that you have could be improved with a temporal, hairline brow lift. Your hairline is rather high, but a subcutaneous brow lift with an incision along your hairline should help to correct the small amount of a symmetry of your brows and make a nice improvement.

Pasha Mostofi, MD, DMD · Answer

Hi there. Congratulations on your weight loss, that is a huge accomplishment, and it’s very common for the face and eye area to change afterward. Looking at your photos, I do think you would likely benefit from a cosmetic procedure, but based on what I see, this appears to be more of an upper eyelid hollowing and mild brow asymmetry issue rather than a true heavy brow problem. Your brows are sitting fairly well overall, although one side is naturally a little lower, which many people have. The upper eyelids themselves look somewhat hollow and deflated after the weight loss, which can make the eyes appear more tired and accentuate asymmetry.
Because of that, I would be cautious about a traditional upper blepharoplasty alone. Removing too much skin or fullness in someone who already has hollow upper lids can sometimes make the eyes look more sunken. In your case, a conservative approach is important. Depending on your goals, options could include subtle upper blepharoplasty combined with volume restoration (such as fat transfer), or possibly a small temporal brow lift if the lower brow side bothers you most. Sometimes a little Botox brow balancing can even help preview what a lift might accomplish before surgery.
The good news is that you have nice eye shape and skin quality, so even small refinements could make a meaningful difference while still looking natural. An in-person exam would help determine how much of the asymmetry comes from the brow position versus the eyelid itself, but you are absolutely a reasonable candidate to explore treatment at this point. Hope this helps!

Vipul Gargya, MD · Answer

You would likely benefit most from a left brow lift to improve the asymmetry and help better match the right eyebrow. There are several different brow lift techniques available, and the best approach depends on your anatomy, hairline, degree of asymmetry, and aesthetic goals.
For the upper eyelid hollowness, I believe fat transfer to the upper eyelid hollows would provide the most natural improvement, especially after significant weight loss. Weight loss can often accentuate volume loss around the eyes, creating a more tired or hollow appearance. Carefully performed fat grafting can restore softer, more youthful contours while still looking very natural.
A formal in-person consultation would help determine the exact combination of procedures best suited for you.

Guray Yesiladali, MD, FEBOPRAS · Answer

From the photos, there does not appear to be significant excess skin or fat in the upper eyelids. A detailed examination is still necessary, but the concern may be related to ptosis caused by weakening or stretching of the eyelid muscles.
For the brows, an endoscopic brow lift may be beneficial.
A proper evaluation would clarify whether the eyelid position, brow position, or both should be addressed.
I wish you a clear plan and a result that helps your eyes look more balanced and naturally refreshed.
&mdash; Güray Yeşiladalı, MD

Zoran Potparic, MD · Answer

It appears that you have ptosis, droopy eyelids problem which needs to be corrected. Asymmetry of the eyebrows should be corrected with brow lift. Considering high forehead, my suggestion would be a hairline brow lift. Good luck.

Michael McCracken, MD · Answer

You could have a left brow lift to provide brow symmetry.  You have a very slight left upper lid ptosis that you might consider correcting.  DO NOT do an upper blepharoplasty - there is no skin or fat to remove.  In my opinion you would most benefit from adding volume to the upper lids via injection of filler or fat.

45, 4 kids, over 100 pound weight loss - Upper bleph or brow lift? (Photos)

Answers (6)

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