The two procedures you should consider are upper blepharoplasty (that will take care of the extra skin on the upper eyelid) and a browlift (that will raise the outside of your brow and open the outside of your eye). Both can be done at the same time, but you need to understand the limitations of each. Get a few opinions for various surgeons. I would consult with either a plastic surgeon who is a member of ASAPS or a facial plastic surgeon who has done a fellowship in facial aesthetic surgery. Upper blepharoplasty is a simple surgery with a short recovery, but may not fully address what you are looking for. Good luck!
The aesthetic brow has a club end nasally with the arch between the outside of the iris of the eye and the lateral juncture of the upper and lower eyelids.The tail of the brow should be at the same level as the club. (parallel to the floor). Because the muscles that close the eyes are stronger than the elevator of the brow, we all get a narrower appearance through the eyes as we age. (especially when exposed to prolonged bright sunlight, wince when we read, or smile a lot!)While removing a pinch of skin above the eyelid cures most people, evaluating the brow position first is important. If the brow is depressed laterally as yours appears to be, elevating the brow first "sets" the brow aesthetically and makes sure that the correct amount of skin is removed from the eyelid. If you do the eyelids first, it may limit the amount of brow elevation that is possible in the future, if you ever decide that a browlift is necessary. (Because you may not have enough skin to close your eyelids if it has all been removed previously, to adequately elevate the brow).John Standefer MD
