Unhappy with upper eyelid surgery, 9 months post-op. Do I need a brow lift or another eye lift? (Photo)

Eyelid surgery, particularly upper eyelid surgery, seems deceptively simple and seemingly straightforward but there are nuances that require attention and precision. Despite well executed eyelid surgery, revisional eyelid surgery is necessary in a percentage of eyelid procedures, particularly to remove more skin; this is preferable to removing too much skin and having dry eye concerns. Anatomically in evaluating the eyelids, there are the lower and upper eyelids but also the brow and midface as well as peri-orbital volume considerations and skin quality. From your pictures, there needs to be more skin removed from the upper eyelid. I would consider a temporal brow lift also, as there appears to be hooding of the lateral brow. This will open up the eye. Lastly, peri-orbital laser skin resurfacing and possibly fillers would improve the fine lines and provide volume concerns. These can be done serially or combined, as desired to provide an optimum result. Good results can be achieved however with less procedures depending on the goals and expectations of the patient.  

It is best to get in person consultation. What exactly is bothering you?  Is it the tired appearance? Is it the loose appearing skin?I see two main problems: ptosis (droopy upper eyelids) and hollowness (which gives the deflated balloon appearance with loose skin/tissue).  You would likely benefit from ptosis surgery and filling of the upper eyelids with fat or filler.  See an oculoplastic specialist.

You do have some extra skin still present.  Your brow looks to be at a good height, but you don't have much of an arch.  A temporal browlift, where just the outer part of the brow is lifted may help with this extra skin.  When you see your surgeon, they can elevate the brow temporally and you can decide if you like that.   You also have a ptosis , worse on the right.  When extra skin is removed you may want to fix that too. See an oculoplastic surgeon for this.     

Revision upper blepharoplasty is what you need since your brow position looks good. Of course an exam would be best. Choose an experienced surgeon who does good natural work and not because he has membership in a certain group. 

I think you would do well to have revisional eyelid surgery.  Sometimes bargain price surgery is not always the bargin it appears to be.  I would recommend an aesthetic oculoplastic surgeon when you are ready.  The American Society for Opthalmic Plastic and Reconstructive Surgery maintains a regional directory that can help you find a well qualified surgeon (ASOPRS dot org).

Your brows cannot be evaluated properly based on the limited photos. Would need to see the whole forehead. Theoretically speaking lateral hooding can be improved with a lateral brow lift or temple lift. As to the lids themselves you do have residual excess skin and pending a hands-on exam to determine lid movement and eye closure you may need a revision surgery. It is always best to reconsult with your original PS. Good luck.

By looking at your pics, you have what I call "lateral Hooding" due to excess skin mainly. Your brows are in a correct position. I would advice for a revision but keep in mind that the incision may have to be carried out more laterally to take care of the "lateral roll" of skin. 

You do have excessive skin in the upper eyelids which can be removed easily. This might be done under local anesthesia but still requires some mild healing time. At 9 months this is probably the final result. You do not need a brow lift. Two words of caution however: In an effort to create a perfectly flat upper eyelid itI routinely recommend massage as well as head elevation. Taking Arnica Montana, bromelain, and other nutrients will also help. It will take time but I suspect that the results will be worth it. As a side note is better to prevent swelling with elevation, ice packs, salt restriction, etc. than to have to treat it. You should always massage toward the incision line. is very easy to remove too much skin thereby causing an exposure problem. Better to be conservative. Secondly, variations in peri-orbital anatomy including the depths of the eye socket etc. will lead to variations in result even using the same surgery. Therefore do not expect to see your eyelids looking like your favorite movie star's eyelids.

Photographs demonstrate hooded excess skin on the upper eyelids. The brows are in excellent position eyebrow lift is not needed. An additional cleanup of extra skin should be probably all that is necessary, but a examination is  needed to confirm. For many examples, please see the link below

The best way to get an idea of what is the best result you can achieve at this point, would be a thorough examination, to look at your facial structure, skin and texture and laxity, fine lines, and brow and eyelid position. It could be that a combination of treatments which may include skin care, resurfacing, a type of brow lift or eyelid,a filler (fat or injectable), botox, or a pinch of skin removal may be indicated. I would consult with an experienced eyelid specialist with an office visit for your next step. Goo luck.