I want to get an upper eyelid surgery. Should I do an internal browpexy as well? (Photo)

The upper eyelid muscle (obicularis oculi) and the brow muscle (frontalis) oppose each other but are attached at the level of the brow. The obicularis pulls the brow down. The frontalis lifts it.Your best option is an endoscopic browlift because of the minimal scars and it separates the 2 muscles so the eyelid muscle does not pull down the brow. The key is to separate the depressor action of the upper eyelid from the elevator action of the brow. The endoscopic browlift does not cut skin, it lets the muscles act naturally.The link below and the video have more info. 

Brow pexy is not a good solution for lifting your brow which is low due to poor nerve function. Based on this, you will always have a difference in position and animation of the two brows, but a better way to correct the asymmetry is by performing an endoscopic brow lift. In this way your eyebrow will be lifted to a more favorable position, and the result is more long lasting. This can easily be combined with an upper blepharoplasty to address the excess skin on your upper eyelids.

I routinely offer internal brow pexy with upper lid blepharoplasty. You would do well with this procedure but more information is needed about the nerve injury and it’s consequences. Best wishes.

Unfortunately, the only way to really answer your question is with an in person exam. Browpexy done through the upper lid incision is a very reasonable procedure in many people, especially if you do not need significant elevation of the brow or simply stabilization of the brow or have a high forehead making a brow lift from an incision within the hairline difficult. It does work well. I have had one myself and do it not infrequently for the right patient. It ads very little to the blepharoplasty or recovery from it.