23 Asian female with hooded eyes. Would you recommend me a Botox brow lift first before I have a surgical lift? (Photo)

Based on your photos, Botox is unlikely to give you the degree of lift and upper eyelid definition that you are looking for.  An incisional upper blepharoplasty with supratarsal fixation will create the most attractive result.  Excess skin and fat can be removed from the upper eyelid, and sutures used to create a more crisp upper lid crease.  

Hello, Thank you for your question. Botox may assist is providing the brow with a slight lift. A blepharoplasty may be worth considering. I recommend you book a consultation with a board certified Plastic Surgeon who specializes in Asian Blepharoplasty, to ensure you're a good candidate for this procedure.Take care. 

There are ways to improve this like botox brow lifting and Thermage to the lids themselves, but nothing gives a lift or crease like a surgery and this is very specialized.  Please see an expert.  Best, Dr. Emer.

Thank you for the question.Typically in cases like this, I would recommend a upper blepharoplasty.Your brow placement appears satisfactory in my opinion.We can still maintain the Asian feature with the blepharoplasty if you wish.

Botox is a great way to get a little brow lift and in most situations will give about a 2mm lift. It is not likely going to give you the result that you are specifically looking for however, and I would recommend instead that you consider a Blephoroplasty. It is important to chose a surgeon with expertise with Asian eyes to give you the most natural results. 

I always recommend a less invasive procedure prior to surgery if there is a potential benefit. I your case from the limited photography, I would suggest the Botox treatment first by a qualified physician. If this does not achieve the desired result,'then you can consider surgical correction. 

The size of the 'orbits/eye sockets' are an important feature to consider. In your case, they are not large so that the primary focus can be on the fullness of the upper eyelid tissues; to create the natural Asian 'makeup platform'. Browlift will not help 'heavy tissue' lift up, in your case. 

As an Asian female, I understand your concerns. Botox would not achieve the appearance of "a double lid."  An upper blehpharoplasty would be the surgery to remove a fat pad that Asians commonly have that cause the "no lid" appearance and almond shaped eyes. The result tends to also create a more "awake" look. I would suggest finding a plastic surgeon that has experience with the procedure and ideally has many examples of Asian patients. Warmly, Jennifer Murphy, MD