Which Procedure Should Be Done First?

I'm thinking of a brow lift to correct a slightly drooping brow and to eliminate the resulting asymmetry. The overall lift to the entire forehead is desirable also. I also need to correct a ptosis on the other eye. Which procedure should be done first if I need to do them separately due to cost? Seems to me that the brow lift offers a little more range of correction than does the ptosis repair, since the eyelid position with the pupil and iris should match that of the other eye.

Doctor Answers 14

Brow lift and ptosis

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  If it is possible, I would say do them both together.  Yes, this MAY cost more than a brow lift alone but would still cost less than doing the procedures separately.  To say nothing about having two separate recoveries, with possible time missed from work.  Find a surgeon who can do the ptosis repair (oculo-facial plastic surgeon) who can also do the brow lift procedure.  Good luck.

Saint Petersburg Oculoplastic Surgeon
4.9 out of 5 stars 137 reviews

Browlift and Ptsosis Repair

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Usually I would perform the browlift first, the only downside is that this may make the ptosis more evident.  Then, several months later, the ptosis repair can be done, with perhaps at that time any removal of upper eyelid excess skin (blepharoplasty) if indicated and desired.

Jeffrey Epstein, MD, FACS
Miami Facial Plastic Surgeon
4.7 out of 5 stars 143 reviews

Browlift and ptosis repair

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I woudl probably do the brow list first to set teh eybrows in the proper position. If you have really bad ptosis wher you need a suspension, This has to be set to the eyebrow and positioning the eyebrow first is probably best.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

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Browlift or ptosis repair first

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It is not that important that either one of the procedures be done first, but to space them at least two to three months a part to allow maximum healing. This way you know where the final level of the brows and eyelids will be after undergoing the second procedure. If you have a facial plastic surgeon and oculoplastic surgeon, they could be done on the same day if the surgeons are working together.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 155 reviews

Correct Brow Position Before Eyelid Ptosis

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In general the brow lift should be done first if you truly need both. Once the brow position is stable then have another assesment with your plastic surgeon regarding the Ptosis. Keep in mind the symmetry of the eyebrows is often due to asymmetry of forehead muscle tone and is not always correctable. You can find out more about browlift by following the link below.

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
4.9 out of 5 stars 113 reviews

Brow Lift and Eyelid Ptosis Repair

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First of all, it is unlikely you will "eliminate" asymmetry of your brows with surgery - improve yes, eliminate no.  If you have true ptosis , not simply excess skin of the eyelid, my ophthalmic plastic surgeon would do the ptosis repair at the same time I did the browlift. If there is excess skin of the upper eyelid, I would do the blepharoplasty at a later date.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 42 reviews

Brow Lift or Upper Eyelid Surgery Sequence

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Generally, brow lift surgery and blepharoplasty are performed at the same time. If performed separately, most plastic surgeons would recommend performing the forehead lift surgery first, then followed by upper blepharoplasty.

Ptosis repair of the upper eyelid is different than standard blepharoplasty for facial aging. Once upper eyelid ptosis repair is performed, the eyebrow may descend a bit since the forehead was elevated trying to keep the eyes open. In addition once one upper eyelid ptosis is repaired, the other upper eyelid position may change a bit. As a result, plastic surgeons would recommend ptosis repair prior to a forehead lift.

Lastly, many procedures may be performed simultaneously. After a comprehensive evaluation by a plastic surgeon can he/she help determine appropriate options for you.

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

Done first

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As other experts have stated the forehead first than the eyelids is a better plan. Discuss in detail with your chosen surgeon.

Ptosis repair and browlift

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Droopy upper eyelids may be caused by an excess of skin, or may be due to a functional defect in the muscle that controls lid position, or both. Prior to undergoing any surgery, a complete ocular examination of the brow and upper eyelids in order to establish the cause of the drooping eyelids is indicated. Performing a brow lift will tend to reposition the drooping brow and eliminate some of the excess lid skin but will not correct any muscle problems. An oculoplastic surgeon or ophthalmologist may be consulted if necessary.

Olivia Hutchinson, MD
New York Plastic Surgeon

Timing of Procedures

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Ptosis repair is definitely more complex and has a much higher revision rate than an average upper lid procedure. In terms of timing of procedures, it is important to know how  a brow lift will affect the position and function of the upper eyelids prior to addressing the upper lids.  In my hands, a brow lift is always performed first.   

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 103 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.