Do I need eyelid surgery or a lateral brow lift? (Photo)

I am concerned about my heavy looking droopy upper eyelids the right lid is worse than the left. Would bleaplasty or a lateral brow lift give me the wider, more awake, bigger eyes I am looking to achieve ?

Doctor Answers 9

Brow lift vs eyelid surgery

Thanks for your question.  Fortunately you are starting from a great spot- very attractive features.  Your brows seem a little asymmetric- a normal feature of all people.  That said, proper examination of your brow requires evaluation in a raised, relaxed, and depressed position to really see the effect they have on your upper lids.  I would recommend an in-person evaluation by an experienced Board Certified Plastic Surgeon in order to get the best answer for your question.Best wishes,Dr. L

Eyelid vs brow lift surgery

You have beautiful natural eyes and lids.  You do not need surgery.  Save your money!!  If anything, a small amount of Botox can raise your minimally asymmetric eyebrow and nothing else.

You have bilateral upper eyelid ptosis that is worse on your left side.

There is also compensatory brow elevation.  In my opinion, a forehead lift will make you look freakish.  You have bilateral upper eyelid levator dehiscence ptosis.  Your anterior orbital fat is likely retracted into the orbit with the dehisence of the anterior levator aponeurosis, the tendon that inserts into the upper eyelid and raises the upper eyelid.  This is why your upper eyelid space is hollow and skeletonized.  Anterior levator ptosis surgery will correct and stabilize the upper eyelid margin.  An anchor blepharoplasty supports the upper eyelid margin.  You actually need very little skin removed from the upper eyelid.  This type of structured upper blepharoplasty with limited skin excision, I call structured microblepharoplasty.  

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Irregular Trichophytic Forehead Lift for droopy brows. For droopy Brose

Irregular Trichophytic Forehead Lift for droopy brows.  This is A procedure we developed 35 years ago for patients who have a high hairline and droopy brows.  And endoscopic forehead lift will raise your hairline. The ITFL will not only keep your hairline where it is but can lower it. A lateral brow lift will give you an evil look.  See a very experienced  brow lift surgeon who knows this technique and look at the results of the hairline and there should be no scar visible. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 32 reviews

Droopy lids

You definitely need an in person consultation to discuss the various issues and options. First of all I don't think you have ptosis. You have brow and lid crease asymmetry. We can treat the brow asymmetry with a temporal brow lift or Botox. That alone may fix the lid crease asymmetry. Or we can leave the brow alone and deal with the crease asymmetry (raise the right with a blepharoplasty or lower the left with filler injection). I recommend that you consider the reversible corrections first, i.e. injectables, rather than surgery.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon
4.9 out of 5 stars 31 reviews

Brow lift or upper blepharoplasty surgery

Dear jessicakitchin,
  • I would not recommend an upper bleph because it will likely make you look more hollow along the upper eye socket and thus making you look older
  • Botox around the eyes will help open the eyes as well
  • Alternatively, injecting volume under the brow (can be done with fillers in the office or with fat in the operating room) will lift the brow, taking the eyelid upwards with it
  • Your left eye looks like it might have mild ptosis (fancy medical term for drooping of the eyelid) and that would be a separate procedure to help open that eye
Best,Dr. Nima

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 68 reviews

Brow lift or eyelid surgery

  • Great question!  You have two issues; the lateral brow sagging and the differences between the two sides.  Surgeons want to know why there is a difference between the two sides.  The ultimate goal is to  elevate the sagging tissues, but more importantly to get both sides to look the same. In your case you have facial asymmetry with the left side bony structure being different than the right.  Second your brow on the left is more elevated.  Sometimes people subconsciously (not purposeful) lift the brow on the side where the thin little muscle that holds the eyelid up has stretched.  When the muscle (levator) stretches the eyelid sags, as a result you use your brow to lift the eyelid to the same level as the other side------- causing the difference.  I recommend an in person evaluation to determine the cause of your difference (asymmetry). If it turns out to be a sagging eyelid issue, you should have that repaired first to get both sides to look the same. You have nonsurgical options to help elevate the brows (fillers and neuroblockers) and surgical options (some form of a brow lift). I am unsure of what type of brow lift is best because that will depend on your exam findings and whether you need surgery for the eyelid.

George Orloff, MD, FACS
Burbank Plastic Surgeon
4.1 out of 5 stars 11 reviews

Asymmetric eyelid ptosis

Your left upper eyelid is more droopy (ptosis) causing the same side eyebrow to raise. You may benefit from left upper eyelid ptosis surgery. See an oculoplastic specialist for evaluation.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 58 reviews

Upper and lower eyelid blepharoplasty procedure

  The Photographs demonstrate adequate brow position, even though they are asymmetrical.  Performing a brow lift will  raise the brows too high, and look unnatural.  A conservative skin only upper blepharoplasty procedure can accomplish removing the excess skin on the upper lids to rejuvenate that area.  For more information  and many examples, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

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