Is It Too Risky Having a Brow Lift and a Blepharoplasty on Top and Bottom Eyelids Performed at the Same Time?

Can you safely have all three together?  From a systemic health stand point-sure.  But why get something you don't need?  From your photo it very much appears that a forehead lift may be all that you need.  It you actually need anything in the form of an upper blepharoplasty, would be extremely subtle and it might be best to first heal from the forehead lift before proceeding with an upper blepharoplasty.  For the lower eyelid, the probablity of a transcutaneous lower blepharoplasty harming your lower eyelid position is at least 50% which is quite high.  Transconjunctival lower blepharoplasty is inappropriate for you because you have no herniated orbital fat.  At most you might need a lower eyelid skin pinch or possibly a chemical peel.  Be careful out there and good luck.

        The brow lift can be performed first.  Then leave it to the discretion of the surgeon whether to do the upper blepharoplasty at the same time if necessary.   Skin pinch blepharoplasty for the lower eyelid may be the best option, but I am not sure you need it.  The wrinkling present is inferior and lateral to the lid and may be better served by other modalities.  Kenneth Hughes, MD Los Angeles, CA

Your concern is valid but should be easily addressed by an experienced qualified surgeon. The excess skin above the eye is due to a combination of forehead drooping and excess eyelid skin. The combination can be 80:20, 50:50, 20:80 etc. Your surgeon should be able to discern that at the time of physical examination before surgery and then know how much skin to remove from the upper eyelids at the time of browlift surgery. You can see this for yourself but pushing the forehead up with your fingers until the eyebrows are at or just above the upper eye socket bone rim. The amount of excess upper eyelid skin is then evident.

Most surgeons take the extra precaution of doing the browlift in sequence before the eyelid surgery but I have seen good surgeons do it in the opposite order without a problem. The vast majority worldwide are done together in the same surgery and not staged but there is nothing wrong with staging it if that is what you want.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship in order to know if this assessment is valid.

It depends on your preferences and those of your surgeon.  Make sure that you are seeing an experienced board certified plastic surgeon.  Most surgeons should be able to do all 3 procedures together without any compromise of the final outcome.  It should be done top-down, however (i.e. brow lift first, then upper lids).

Best,

With an experienced surgeon, it is unlikely that you should need separate surgeries to achieve symmetry.

Most often than not [95% plus] no further surgery is necessary when these three procedures are done together. And in the other 5% of cases, one revision would solve the problem.

So what you are suggesting is doing surgery three times for what can be achieved in one surgery 95% of the time, and two surgeries 5% of the time.

Overkill, in my opinion.

No it is not too risky for an experienced PS. The brow lift will lessen the need for more skin removal of the upper lid. The brow lift does not effect the lower lid procedure. Best wishes. DR. ES

If you have an Irregular Trichophytic Forehead lift as we described 35 years age you will NOT need your upper lids done! Tha lower lids can be done at the same time or separated. Choose a very experienced surgeon. 

Your question is a very personal one. The main concerns are amount of downtime, number of anesthetics required and overall cost. Separating the procedures will increase all three. There is a risk of asymmetry with each procedure whether done together or separately. I do not think that performing the procedures separately significantly reduces that risk while, on the other hand, it does significantly increase the emotional and financial toll on the patient. For these reasons, most patients will choose a combined procedure. However, the best option is the one that appeals most to you and your plastic surgeon should respect that. I hope this information is helpful.Stephen Weber MD, FACS

All three procedures can be safely performed at the same time with a very good result. There is nothing wrong with breaking up the procedures, but it is not necessarily a guarantee for better symmetry. It is often very easy to have a procedure under local anesthetic if needed to correct any small asymmetries that may occur after swelling resolves.

 


There are multiple procedures that can be performed to rejuvenating the eyes.  To address the upper eyes a browlift or upper blepharoplasty can be performed.  These can be performed simultaneously, although frequently they are completed at separate times to give you the best result.  The browlift results often can relax a bit around 6 months after surgery and this is a good time to perform the blepharoplasty.  The lower eyelid surgery can be performed simultaneously with either the browlift or upper blepharoplasty.  This two step approach can be a better approach for you with  only two recovery periods instead of three.