Brow lift or eyelid surgery? (Photo)

Question

I would like to have visible eyelid space for makeup. My eyes are very hooded. When I lift my eyebrows my eyelids look great, but otherwise they're very hooded. Would you recommend a brow lift or eyelid surgery and why?

Jason Emer, MD · Answer

Hello and thank you for your question. A formal evaluation would be needed to determine the best treatment. There are both surgical and non-surgical options to correct this, depending on your exact situation.

For less significant issues, there are nonsurgical treatments: To give the eyebrows a nice lift, we use injectable fillers to improve the eyebrow, upper eye, forehead and temple. A filler is placed on the bone and in the fat pads of these areas to contour and lift without it looking overdone. We use cannulas to limit pain and swelling.

Surgery (browlift and/or upper blepharoplasty) is a great option for more significant improvement- for example if there is more substantial eyebrow drooping. I suggest getting a consultation with an experienced cosmetic dermatologist and facial sculpting expert, or an aesthetic facial plastic surgeon like Dr. Donald Groves; we are both located right here in Los Angeles.

Best, 
Dr. Emer

Ricardo L. Rodriguez, MD · Answer

hello,

Thank you for your question. You are correct that a Brow Lift is the best course of action to not only lift your brow, but to reduce hooding in the upper eyelids.  Based on your photos this would be a great procedure for you!

I also want to note that if you do the Brow Lift, you likely will not need any upper blepharoplasty work.
In my practice 90% of the patients who have the endoscopic Brow Lift, do not need any removal of skin from the upper eyes.  And to emphasize, I *always* do the brow lift first!

I have seen patients who have had upper blepharoplasty done by other surgeons, whereas what they needed was a  browlift to restore the position of the brow.  The problem these patients encounter is that it is sometimes not possible to do a Brow Lift *after* a blepharoplasty, because the patient will risk the eyelids not being able to shut completely.

You will love the Brow Lift procedure--make sure it is the type done with an endoscope.
Hope thise helps.

Ricardo L Rodriguez MD 
Board Certified Plastic Surgeon
Baltimore, Maryland

Jacob Tower, MD · Answer

Hello, hope you are well. This is a very common question. A brow lift can be performed to change the shape and position of the eyebrow, with one of the benefits being improvement in eyelid hooding. You have bilateral brow ptosis and could certainly consider a brow lift to elevate the brows which would reduce eyelid hooding to some extent. I would propose a pretrichial/trichophytic approach to lower the hairline at the same time (forehead reduction). Upper blepharoplasty could be considered subsequent to the brow lift procedure depending on your satisfaction with the results as it pertains to the eyelid hooding. It can also be considered as a standalone procedure if you decide you're not interested in a brow lift. Hope this helps!
Best,Dr. Tower

Gary M. Horndeski, MD · Answer

I would recommend a browlift.  This will lower the hairline and will lift your eyebrows.

Best Wishes,

Gary Horndeski, M.D.

Nelson Lee Novick, MD · Answer

Before jumping in the expense, downtime and risks of invasive surgery, you might wish to explore the use of Botox and HA filler for a "fox eyelift," i.e creating a very feminine, upward and outward flare of the outer third of eyebrow, as well as some secondary decreased upper lid hooding. Combining a few properly placed microdroplets of Botox with the use of an appropriate HA filler properly injected can be used to achieve this improvement. Treatment, in experienced hands, should take no more than twenty minutes or so to complete. The results of the filler can typically be seen immediately and those from Botox usually take one to seven days to see. You would be wise to make certain to consult an experienced, board certified cosmetic dermatologist. Best of luck.

William Portuese, MD · Answer

The position of your eyebrows is acceptable, therefore, a brow lift is not necessary, otherwise you'll look too surprised permanently. An upper blepharoplasty procedure can accomplish increasing your upper lid fold if you want to put more eye shadow make-up on.

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