Brow Lift and Lower Bleph with TCA? (Photo)

Question

I had an endoscopic brow lift to correct asymmetry as well as a low bleph in May. I can't tell a difference. I went back to my triple board certified dr, and he gave me another TCA peel to lighten my under eyes in Oct, but now I look worse than before. Will a lateral brow lift help the still sagging brow? And what do I need to lighten my undereye? Would a skin pinch or revision help the still visible hollows? 52 yr old female

Nelson Lee Novick, MD · Answer

A couple of microdroplets of Botox to the tail of the eyebrows along with a mid-viscosity HA filler in the same area can be used to create a more feminine "fox eyebrow lift", I.e. the desirable upward and outward flare to outer tail of the eyebrows. 
At least from the photos, it would appear that there is volume deficit in the upper, outer mid-cheek region, and since the upper cheeks serve as a major support for the under-eyes, the use of robust HA volumizing filler injected properly can not only create a more feminine OGee Curve to the cheeks, but would help to diminish the appearance of the bags under the eyes and smooth the transition between the upper cheeks and the under-eyes. 
As for the increase in pigmentation under the eyes that you have noticed, this may actually be post-inflammatory hyperpigmentation related to the recent TCA peel. A series of in-office superficial peels, using, for example, high concentrations of glycolic or salicylic acid combined with the at-home use of prescription topical pigment-reducing topicals would likely promote fading. 
Hope this helps and best of luck.

Gary M. Horndeski, MD · Answer

You would benefit from a brow lift since your eyebrows are still below the level of the orbital rim.  I would do this first.

Best Wishes,

Gary Horndeski, M.D.

Pawel Szychta, MD, PhD, DSc · Answer

A lateral brow lift may help with the sagging brow if the endoscopic lift was insufficient. For under-eye concerns, treatments like fillers, fat grafting, or a skin pinch can address hollows, while lasers or microneedling may improve discoloration. Consult a different board-certified surgeon for a second opinion and tailored advice.

Brow Lift and Lower Bleph with TCA? (Photo)

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Brow Lift and Lower Bleph with TCA? (Photo)

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Everything you need to know about Brow Lift

Our mission is to create a world where every investment in modern beauty is Worth It.