What procedure(s) can be done to improve the appearance of my eyes/brows? I am 32 yrs old. (photos)

 my eyes have always looked this way. I feel like there is excess fat/skin beneath my brows and that brows are low and masculine-looking. People comment on how tired I look. I dislike the low position of my brow, but more so, I dislike how my brows protrude and seem to have excess fat/skin, impacting my profile. I can pull up a considerable amount of skin when pinching my eyebrow. I want a permanent fix, no Botox. All in all what can improve my eye area appearance? I want to know as much as possible before finding a surgeon. Thanks!

Doctor Answers 7

I would avoid surgeons with simple answers.

You have a pretty complicated periocular area.  First, the photos you have provided, while helpful, are simple no substitute for an actual personal consultation.  Perhaps the most important part of that consult should be carefully listening to how you understand your concerns.  You have a very long upper eyelid platform and I suspect that you have an early anterior levator dehiscence.  This is consistent with the relatively hollow upper eyelid sulcus and the eyelash ptosis visible in many of the photos.  If you have a brow lift.  This has the potential to raise the eyebrow unnaturally with further exposure of the upper eyelid sulcus and long upper eyelid platform.  Your brow is pinched.  Supporting the tendon in the upper eyelid usually allows the eyebrow to relax without resorting to Botox, which can be very good for this.  Without the benefit of a detailed consultation, my initial impression is that you would do exceptionally well with a microblepharoplasty that includes repairing the upper eyelid tendon, and making a hard upper eyelid crease to support the upper eyelid lashes.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Browlift for a Permanent Solution

Luckily you can have a permanent solution to your problem. You have low set horizontal shaped eyebrows. Low positioned eyebrows make a woman look more masculine.  Young people have more fatty tissue under the skin over the eyebrow bone. A bony look to the eyebrow area looks old. Because of this aging problem, I often put fat injections under the eyebrow area in old people to make them look younger. Sometimes the bone under the eyebrow is more prominent and this could be reduced by shaving down the underlying bone. This is a more tedious procedure but could be done at the same time as a eyebrow lift. An endoscopic brow lift (done through several small incisions within the scalp hair) can elevate your eyebrow to the perfect level for you without any visible scars. During this technique no hair is removed nor shaved and no scalp is removed. By pulling up your eyebrow more in the middle aspect during the brow lift will result in a better shaped arched eyebrow. Recovery from endoscopic brow lifts is very comfortable and short. I let my patients do any activities they desire post-op with the only limitation is to to not do a sport where they could get hit along the brow area the first couple weeks after surgery.  

The most important thing is to make sure you have your surgery by a board-certified plastic surgeon by the American Board of plastic surgery.

Jeanne A. Scanland, MD
Chattanooga Plastic Surgeon
5.0 out of 5 stars 9 reviews

Eyelids and brows

I agree that there is something going on with the asymmetry of the contours of your eyelids, and in one picture the left eye appears too open (retraction). But certainly many of us would recommend lifting the brows by many techniques available to make the eye and brow complex more aesthetic. My usual technique is endoscopic, but there are many successful surgical techniques for raising the brows that need to be discussed. A good examination by an eyelid specialist oculoplastic surgeon would help to sort out what is going on with both the brows and the eyelids.

Jeffrey Schiller, MD
Edison Oculoplastic Surgeon
5.0 out of 5 stars 11 reviews

You will need forehead lift

You will need to accept a scar just at your hairline to accomplish this goal.  A forehead lift will be required.   

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 23 reviews

Irregular Trichophytic Brow lift and contouring the orbital bone to correct masculine appearance.

Irregular Trichophytic Brow lift and contouring the orbital bone to correct masculine appearance. This is a procedure we developed 35 years ago and I have done more than a thousand. The hairline incision has hair grow THRU the scar so it is not seen. Your hairline can be lowered and your male looking brow bone shave while lifting your brow. An endoscopic forehead lift will RAISE your hairline. See several experienced brow lift surgeons familiar with this technique and look at their hairline scars!

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Upper Eyelids

There is a slight degree of variance between the left and right eyelids.  A blepharoplasty (eyelid lift surgery) could be a solution to create a more balanced and homogenous appearance of the lids overall.However pictures are never a replacement for an in-person consultation with a trained professional. Undergoing any surgical procedure requires careful attention to detail and consideration for different options.  Consider obtaining several opinions before moving forward with any given procedure.  And always trust your face to a board-certified facial plastic surgeon or a board-certified plastic surgeon with very extensive browlift and blepharoplasty experience.

William Numa, MD, FACS
Boston Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Eyebrow lift candidate

There are many factors to consider performing an eyebrow lift, which include the position of the eyebrows,  and the asymmetry of the eyebrows period photographs presented did not appear to be overly low set eyebrows. Eyelid surgery is performed and there is an adequate brow position and extra skin needs to be removed from the upper lids. In addition, the corrugator and frontalis muscles of the forehead  can be softened. The placement of the incision   will determine whether or not the hairline will be lowered or raised. For more information and many examples, please see the video and the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 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.