I'm a 21 year old female. Lateral Brow Lift and/or Upper Blephroplasty? (photo)

 All my life I've been conscious about my 'wrinkly' eyelids to the appearance of extra creases and apparently low set eyebrows. This gives me an overall sad/sulky appearance and people often comment on my eyes being half open. I'm not sure if it's ptosis or eyes half opening because of the weight of the eyelids

Doctor Answers 10

I'm a 21 year old female. Lateral Brow Lift and/or Upper Blephroplasty?

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While a conservative upper blepharoplasty would help, the real culprit appears to be inadequate volume. It would take an exam to be sure, but for now you might want to look into something simple and nonsurgical like fillers or even fat grafting before going for the surgical fix.

Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

I would recommend a detailed consultation with an oculoplastic surgeon.

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Unfortunately you are in a part of California with pretty limited medical care options.  For this reason you will need to travel either to the Bay Area or Los Angeles to actual care for this.  It is improbably that health insurance will cover your concern.  I recommend setting two or more consultations for you have several options for different surgeons.  The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a regional directory that will help you find a well qualified surgeon (ASOPRS dot org).

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Upper Eyelid Wrinkle treatment

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The upper eyelids, eyebrows and forehead are one continuous unit. If the forehead and eyebrows sag, then the eyelids feel and look heavy. You can prove this to yourself by pushing the forehead and eyebrows downward and seeing what it does to your upper eyelids.
The subconscious part of your brain is constantly trying to make it easier for the upper eyelids to function without problem. If your brain detects the excess weight of eyebrows and forehead on your eyelids, it will stimulate the forehead muscles to lift the forehead and eyebrows upward to relieve this stress. As you age and the forehead and eyebrows sags, the stimulus to lift the forehead results in wrinkling. Early in the wrinkling process, Botox or other neuromodulators will relax the muscles and soften the forehead wrinkles. The converse of relaxing these muscles is the eyebrows will sag somewhat and the upper eyelids will look and feel heavy. As the true, natural sag of the forehead and brows becomes worse, Botox treatments become less effective and the eyelids become heavier. If you are at that point, then forehead lifting is your only choice.
A good way to determine how much compensation your forehead is doing to correct for forehead sagging is to stand in front of a mirror and close your eyes. With your eyes closed, the forehead muscles relax. Place your finger on one eyebrow and hold it in place, then open your eyes. Opening your eyes will cause the eyebrows to elevate to the compensated position. Release the finger and watch how high your eyebrow lifts. This difference between the fixed and released eyebrow is the amount of compensation you need to correct for with a forehead or brow lift.
If you have come to the conclusion that a brow lift is in your future, then you need to consider;
  1. the height of your forehead. Most brow lift procedures will raise your hairline. If you already have a high hairline you can have a lateral brow lift, pre-trichial brow lift or direct brow excision - all of these techniques will NOT raise your hairline.
  2. If you have thinning hair at the frontal hairline, you may avoid the coronal brow lift (most effective) and consider an endoscopic brow lift.
  3. If you only need to lift the outer third of your eyebrows then a lateral brow lift is all that is needed.
Types of Brow Lifts
  1. Coronal Brow lift - most effective, raises the entire forehead, elongates the forehead, can leave numbness and a scar. May contribute to some hair loss.
  2. Endoscopic Brow Lift - does many of the same things as a coronal brow lift, but less effective. scars anr less but the elongation of the forehead persists.
  3. Pre-Trichial Brow lift - very effective lifting of forehead and brows without elevating the hairline by placing the incision at the hairline. The scar may be obvious.
  4. Lateral Brow lift - will lift the lateral third of the eyebrow without elevating the hairline. Scars are well-tolerated.
  5. Direct Eye Brow excision - by removing skin at the top of the eyebrow the eyebrows are lifted but with a scar that may be visible. Simple procedure, quick recovery.
If you do not need a brow lift, then the wrinkles of your upper eyelids can be treated with a blepharoplasty, which is the direct removal of skin, fat and muscle from the upper eyelid.

For more information on brow lifts and/or blepharoplasties, please read my book " A More Beautiful You - Reverse aging through skin care, plastic surgery and lifestyle solutions".

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 reviews


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This is a rather common Hispanic look. I see it often in Miami, and not everyone is bothered by it. Part of it IS some upper eyelid ptosis, part of it IS some lateral brow downturn. The upper lid skin, has not in my experience, been a prominent part of their concerns, A full discussion of your options and examination by an experienced surgeon should better help define things for you.

I'm a 21 year old female. Lateral Brow Lift and/or Upper Blephroplasty? (photo)

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I recommend you get carefully evaluated by an experienced oculoplastic surgeon. Your problem may not only be your eyelids or brows. I see evidence of a possible marginal ptosis (droopiness) of your upper eyelids. This may not be straightforward and requires specialized care. 

Maan Kattash, MD, FRCS, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 22 reviews

I'm a 21 year old female. Lateral Brow Lift and/or Upper Blephroplasty?

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Hello and thank you for your question.

You know, it is relatively unusual for such a young person to need eyelid surgery.
In order to get some sort of accurate opinion and plan, I believe you need to sit down with a Board Certified Plastic surgeon(referred to as 'Board Certified Plastic Surgeon' in the US, and 'Plastic Surgeon' here in Australia).
That's because there are surgical and non-surgical options. And this is a perfect example of where you need to sit face-to-face with someone appropriately qualified to make the assessment and recommend options. Your face is different from any other patient we may see, and to recommend options appropriate for you specifically, we would need to  see you.

I wish you well. 

Lateral Brow Lift &/or Upper Blepharoplasty

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Stand in front of a mirror and lift your brows. In this way you can determine if you like the result and if there is still excess upper eyelid skin to remove. On the basis of the pictures submitted I suspect that it will be necessary to remove excess skin from the medial upper lids.Of course consultation with an experienced surgeon will be helpful.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Improve eyes

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I think you should see an oculoplastic surgeon, not for the brows or a blepharoplasty. There appears to be an element of ptosis that might be corrected to give your eyes a better appearance.

Sheldon S. Kabaker, MD FACS
San Francisco Facial Plastic Surgeon

Filler injection for upper eyelid wrinkles in young person

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Looking at the photos, you have hollow upper eyelids/brows and the best treatment for would be volume augmentation of the upper eyelids/brows with filler or fat injection. The "wrinkles" are from the deflated balloon effect (when air out of balloon goes out, the balloon collapses with wrinkles).  See the link provided.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Minibrow lift for sad eyes.

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Minibrow lift for sad eyes will raise your brows and make less skin in your lid. See an experienced surgeon for this. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

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.