Do I need upper Bleph or Brow lift? (photo)

Based on your photos, I think that mainly your brow has descended into your eyelid area and is creating that hooded/droopy appearance which a brow lift would address. You might also have some excess eyelid skin that a blepharoplasty might address, but this requires measurements taken at an in person consultation. I would suggest getting evaluated by an oculoplastic surgeon who had optimal understanding of the eyelid/eyebrow anatomy, and will guide you to choosing the surgery that will give you the best results without wasting your money.

Although I do not have the benefit of a physical examination, so I can understand where your brow sits in relation to the bony orbit of your eye, it appears that your brow has a good position, and also an excellent shape. Therefore the simplest solution for you to rejuvenate your periocular area, would be to have a skin only upper blepharoplasty, performed under local anesthesia only. This would involve only removal of some skin of your upper eyelid, preserving all of the volume to maintain your rejuvenated look. At some point in the future, if your brow does descend, a brow lift could be performed, which can also be performed under local anesthesia only. Have a detailed consultation with your plastic surgeon about these options.

Thank you for your inquiry! By your photos, it looks like you would be a great candidate for an upper bleph procedure as that procedure will remove excess skin to your your upper eyelids therefore making you look more refreshed and rejuvenate your eyes. I recommend scheduling a consult appointment with a board certified plastic surgeon like myself so we can assess your eyes, listen to your goals, and create a surgical plan that is best for you and your goals!