Best approach to improve low brow and droopy eyelids? (Photo)

I am in my mid 40s. I have always had a heavy brow and droopy eyelids even as a child. To compensate for my stern/tired look, I often smile or raise my brows. The asymmetry of my eyes and brows really bothers me. I have a lot of extra skin on my lids but I am afraid removing it would further lower my brow. Any advice is welcome. I don't necessarily want to look younger but I would like to look prettier and pleasant so people don't think I am mad. Thank you for any advice!

Doctor Answers 15

Combo brow lift and blepharoplasty

Hi.  You've been trying to compensate using your forehead muscles ("frontalis"), which elevates the brows, but causes more forehead wrinkling.  In addition, you have some excess skin on the upper eyelids.

The best bet to fix this would be the combination of a forehead lift (and there are a few different types to discuss) and an upper blepharoplasty.  The eyelid lift alone would be unlike to fix your situation completely.

Best to have an in-person consult with a board-certified plastic surgeon to discuss the details.

Thanks!

Brow lift blepharoplasty

A pretrichial brow lift to remove excess forehead skin and an upper lid blepharoplasty to remove upper eyelid skin would do the trick.  

Dermatochalasis and heavy brow

You have some excess skin of the upper lids.  Patients who have this often use their brow to try and elevate the lids.  When you remove the skin, the brow may relax, and might appear lower.  You also have a very heavy brow fat pad.  Even if your brow is not too low, a small elevation of the temporal brow and fat pad can help to open up the appearance of the eyes. 

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 25 reviews

The Minimally Invasive Ten Minute Eyelift Can Help To Improve Droopy Upper Lids & Upper Eyelid Hooding

I can thoroughly sympathize with you, since I, too, have had a heavy brow and droopy eyelids since childhood. When discussing the Ten Minute Eyelift with potential patients, I actually include my own before and after photos of the procedure that I performed on myself a number of years ago.

In The Ten Minute Eyelift, which actually does take only five minutes per eyelid to complete, basically consists of numbing the lids with local anesthesia and then performing a light electrodessication or electrocautery along the hidden, inner recesses of the folded eyelids. Treatment in this fashion leads to immediate heat-related collagen shrinkage of the excess lid skin resulting in greater exposure of the true upper lids.  Once healed, the treated skin converts to a thin, linear scar that remains hidden within the folds of the lids.

As part of my general discussion of this approach, I close my own lids to expose the faint, barely visible scars that remained  after my own self-treatment. Unlike following traditional more aggressive blepharoplasty surgery, The Ten Minute Eyelift engenders only minimal downtime (I boarded a ten hour transatlantic flight) only about five hours after performing the procedure on myself. 

For more details on the procedure, check out the archives of Realself.com.

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.8 out of 5 stars 24 reviews

Brow lift and blepharoplasty

Hello Ekkdev,

You would be an excellent candidate for both a brow lift and a blepharoplasty.  The female brow should rest just above the bony rim above your eye and peak around the corner of the eye.  In your case in the first picture I see two things.  The first is your left eyebrow is lower than your right and second your brows are more horizontal and than arching.  There are multiple ways to perform a brow lift and the best option for you can be discussed during your consultation with a surgeon.  In the middle picture when you really elevate your brow your eyes improve.  However, you would not want a brow lift to raise your eyebrows that much (giving the surprised look all of the time).  Therefore, a blepharoplasty would be helpful to remove the extra skin that is currently sitting on top of your eyelids. 

Although you didn't mention it, you may also consider a lower eyelid blepharoplasty at the same time to help with some of the fullness there. 

I hope this helps and good luck. 

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 25 reviews

Excess skin

Your eyebrows are assymetric and that could be corrected but I think doing an upper lid bleph is all you need.One could adjust the height of your eyebrows to make them more symmetric.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.8 out of 5 stars 56 reviews

Just have a blepharoplasty performed

If your blepharoplasty is performed correctly, there is no chance of your eyebrows being pulled down. By removing the loose skin, your eyes will be more open and the eyebrows will appear higher. For such a minimal brow ptosis you should not take the risk of brow elevation surgery. There will be a high risk of over correction, giving an artificial appearance. Make a consultation with an oculoplastic surgeon who performs many eyelid and brow procedures. Good luck. 

I have always had a heavy brow and droopy eyelids

Your intuition about this upper lid area is correct. Based on your photos I would recommend both a lateral brow lift and an upper lid blepharoplasty. The lateral brow and the heavier skin immediately beneath the lateral brow should be elevated off the upper eyelid to improve the "sub-brow hooding" and to prevent recruiting thicker sub-brow skin into the upper eyelid itself. Seek a Plastic Surgeon with an extensive experience in this area. Best of luck!

Brow lift and upper eye lid surgery

A brow lift can accomplish raising the eyebrows, making them more symmetrical, and softening the frontalis and corrugator muscles which cause wrinkles on the forehead. An upper blepharoplasty can accomplish removal of the hooded extra skin on the upper lids. Both procedures can be performed together or separately, depending upon the patient's desires. Both procedures are performed under a brief general anesthetic as an outpatient surgical procedure. For many examples of both procedures, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Careful!!!

your question is one I get asked every day.  Summarized, do I need a browlift or can I get by with just having my upper eyelids done (upper lids are a lot simpler, with less complications and faster recovery than upper lid lift and brow lift.)...   It does look like you have a slightly downturned look to your brows, but they also look as though they are above the orbital rim ( the bony upper part of the eye socket)  You have a lot of heaviness out to the sides, so removing skin from your eyelids and doing a LATERAL brow lift (ie only lifting the outside part ) would , I believe give you a brighter , happier look and yet avoid that "surprised" look

Michael Olding, MD
Washington DC Plastic Surgeon
4.7 out of 5 stars 6 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.