One Doctor Says Browlift, the Other Says Upper Bleph? What to Do?

How can I determine which I need?? I have seen two excellent facial plastic surgeons and I've heard two different stories. One is saying I need a browlift and an upper bleph would cause my brow to drop. The other doctor is saying I need the upper bleph and I would look "done" with the browlift. I tend to like the browlift guy better and can see how raising my lateral brow would look pretty good if he doesn't go crazy. How can I tell what I need? Thank you all!!!

Doctor Answers 27

Browlift or upper bleph

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A common mistake in periorbital aesthetic surgery is assuming one operation can solve the entire problem. Often it is by a combination of a browlift and upper bleph that the optimal result can be achieved. An experienced surgeon should be able to not over-elevate your brows giving you a permanent "surprised" look. Get a third opinion! Good luck!

Long Beach Plastic Surgeon

Brow vs upper bleph

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one of the eternally asked questions in plastic surgery. none of us will be able to help much without photos. even then it can be a touch and feel thing. one of those times when you have to go with your sense of the surgeon. the bleph is more conservative and you could do the forehead years later if needed.

Sherwood Baxt, MD
Paramus Plastic Surgeon

Browpexy or lateral lift through the blepharoplasty incision

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It is hard to believe that an upper blepharoplasty would make your brow drop if performed correctly, but you would need to be evaluated pre-operatively.  Do you like the appearance of your eyebrows when you get  a lateral brow-lift type effect from Botox?  One procedure that I have been doing pretty regularly is to do an upper blepharoplasty to address the excess upper lid skin and fat pads and then through that same incision secure the brow at a higher position laterally, either with a permanent suture, bone tunnel or trans-blepharoplasty endotine device.  It is called a trans-bleph browpexy or browlift.  It has great results and is not any more invasive than the bleph alone.  Many surgeons believe that an endoscopic browlift does last a long time and I tend to agree, but the trans-bleph browlift does a great job of preventing the brow from falling futher.  Hope that helps.

Jason D. Bloom, MD
Philadelphia Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Browlift vs blepharoplasty

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These are two totally different operations.  The browlift is more invasive and aims to elevate the brow especially laterally.  This can take up some of the lateral hooding of the eyelid and make it look better.  The blepharoplasty only addresses the extra skin and sometimes fat of the upper lid.  Properly done, it should not pull the brow down.  Ask each doctor to show you many photos including someone a little like you and then look at the results and see which more attracts you.

Brow lift vs. upper blepharoplasty - a very common dilema

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This is a very common dilemma among patients and surgeons alike.  The link below goes over some ways to determine which is the better choice for you.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Browlift or Upper Eyelift

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You can get an idea of the effect that a browlift would have by putting your index finger above the mid portion of the eyebrow, and your thumb at the lateral (outside) part of the eyebrow. Lift to position the brow where you would like it to be. Notice whether that's aesthetically pleasing or whether there still appears to be excess skin. Many times a well done browlift creates the best look. Sometimes severe 'hooding' of the upper eyelid will benefit from both the browlift and the blepharoplasty.

Ask the board certified plastic surgeon a lot of questions and discuss exactly what you're hoping to accomplish. Make sure to see many of their before and after pictures and then choose the surgeon you feel most comfortable with understanding your goals.

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 97 reviews

Browlift vs upper blepharoplasty

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Both a browlift and an upper blepharoplasty can improve the appearance of the upper 1/3 of the face.  If the primary problem is excess skin between the eyelashes and the eyebrow, then the blepharoplasty should suffice.  On the other hand, if the brow is sagging and/or there is a lot of loose skin/wrinkles over the forehead, then a browlift would be the better choice.  In some cases, a patient would have the best improvement by having both procedures performed.  Unfortunately, without your photos it is difficult to say which option may be best in our case. It may be worthwhile to get a thrid opinion.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.7 out of 5 stars 63 reviews

Blepharoplasty or browlift

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The blepharoplasty versus brow lift operations is a very controversial topic, even in the field of facial plastic surgery.  There is no one absolute solution to this problem.  The best advice that I give patients is that it is important to look at the distance between the eyelashes to the eyebrows.  If the distance is quite short and the eyebrows are truly low, it is best to have a brow lift procedure.  If the brows are in excellent position already and the eyelids have lateral hooding, it is important to just perform an upper blepharoplasty.  It is true that when performing an upper blepharoplasty the eyebrows tend to drop 1-2 mm from the procedure depending upon how much fat is removed from the eyelids.  It is also important not to overdo the brows with the brow lift procedure so that the brows look natural. 

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Perhaps you need both a brow and an eyelid lift

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In my practice I usually have to point out to my patients the need for a browlift when the initial consultation is for blepharoplasty. Tell tale signs of a decending brow are the horizonal line at the lateral corner of the brow which then tail downward as the actual eyebrow ends. In addition there is often a small crease or hood of skin at the corner of the eye which signifies a truly decended brow versus excess eyelid skin. In my opinion an conservative forehead lift can really accentuate the results of a good eyelid lift without giving patient that surprised or "done" appearance.  A good non-surgical trial would be to see if you like the way a Botox or Dysport can elevate the lateral brow with a small amount of a filler like Restylane or Perlane used to correct the volume loss here. If so you probably are a candidate for both. Good luck!

Giancarlo Zuliani, MD
Rochester Facial Plastic Surgeon
5.0 out of 5 stars 71 reviews

Brow lift or Upper Lid Blepharoplasty?

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The answer lies in your mirror. When you elevate your brow, does it look better? If so and if your brow is below the underlying bony rim, then you do need a brow lift to look your best. However, you may also need an upper lid blepharoplasty. Often the two procedures are done together. The trick is to find a surgeon that is conservative so that either procedure is not over-done. Viewing your photos, it appears that your brow could be improved with a lift, and the excess skin in your upper lids isn't severe, so the blepharoplasty would be a simple removal of a small amount of skin. Another option is to have the brow lift done and see how the lids look. They will be better and maybe acceptable. If not, you can do the lids at a later date under local anesthesia. Recovery time would be minimal.

Hope this helps you, and good luck.

E. Ronald Finger, MD, FACS

Savannah, GA  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.