Fullness of the upper lids can be cosmetically improved with a number of surgical options depending on individual anatomy, the cause of the fullness, and desired outcome: an artistically performed conservative upper lid blepharoplasty, a repositioning of the brow if it is low, or often a combination of both. There are multiple options which can produce an improved natural appearance that are available for a patient with your anatomy: Upper lid blepharoplasty alone, endoscopic brow lift, limited lateral brow lift, forehead lift, neuromodulators like Botox or Dysport, hyaluronic fillers of the forehead above the brow, or a combination of procedures. A browlift and a blepharoplasty (upper) are not mutually exclusive procedures and in certain cases they can be done in conjunction. There is no one best option. It depends on your desired outcome and understanding of the pros and cons of the various procedures. It is important to realize that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do based on limited 2 dimensional photos without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person. Facial rejuvenation needs to be individualized. What would be an ideal approach for one patient is not necessarily the same for someone else. Based on the examination and discussion at the consultation, you should have a better understanding of the various options that can achieve the best cosmetic result for you. Robert Singer, MD FACS La Jolla, California