Brow lift or blepharoplasty - which procedure would be best for me? 38 y/o (photo)

You would benefit from a browlift. Physical examination can determine whether you will need an upper blepharoplasty.

Best Wishes,

Gary Horndeski, M.D.

Hello and thank you for your question. A formal evaluation would be needed to determine the best treatment- it is very difficult to see the details present from the single picture you provided. There are both surgical and non-surgical options to correct this, depending on your exact situation.

For less significant issues, there are nonsurgical treatments: To give the eyebrows a nice lift, we use injectable fillers to improve the eyebrow, upper eye, forehead and temple. A filler is placed on the bone and in the fat pads of these areas to contour and lift without it looking overdone. We use cannulas to limit pain and swelling.

Surgery (browlift and/or upper blepharoplasty) is a great option for more significant improvement- for example if there is more substantial eyebrow drooping. I suggest getting a consultation with an experienced cosmetic dermatologist and facial sculpting expert, or an aesthetic facial plastic surgeon like Dr. Donald Groves; we are both located right here in Los Angeles.

Best,
Dr. Emer

That question is best answered by looking at past photos of yourself. If you have always had pretty heavy eyes, you don't want to get too aggressive because will may look significantly different. If you feel that your brow has come down over the years then a browlift can help. But if not, just do the upper lid blepharoplasty. Be sure you are seeing a facial specialist for consultation.

Unfortunately, the photo you have provided is not adequate for us to give an opinion. A decision for brow lift is often a personal one depending on your aesthetic ideal.

BROWLIFT OR BLEPHAROPLASTY OR BOTH? I would need to see a set of photos with your eyes and a relaxed position to answer this question. Based on my 50 years experience, usually only a brow lift is needed and rarely both. See a very experienced surgeon and do not get a lateral brow lift.

Great question and something that I discuss with patients almost every day. It's something that must be based on the individual patients anatomy and personal desires / expectations. In some cases I strong advise for both as they address slightly different aspects of this region (upper periocular), in other cases I give them the choice based on what they feel will give them the results they want, and sometimes I advise for just one of the procedures. In your case, the blepharoplasty will provide the most significant enhancement, especially when coupled with a brow fat pad pexy (suspension). A surgeon can show you the approximate result of this by using a qtip to roll up some of the extra skin and holding up the brow fat pad to the orbital rim. A lateral brow lift can also be considered and this will elevate the brow to reveal more upper lid, but it may not be as much in you case as you imagine. .. at least not without over arching the brows. This is something that needs to be assessed by lifting the lateral brow in the correct direction. By using 1 finger and lift the lateral brow UP and OUT (approx 45 degrees) you can get an idea of what this procedure might be able to do for you. In the end, such decisions are best made with an in-person consultation to replicate the possibilities and help the surgeon and patient make a decision together. In cases where my patients fly in from other states, we sometimes leave the decision for the day of or day before surgery when they actually come in to the office. Hope that helps!Good luck!

Additional facial photographs are required to make a determination about how best to proceed. The one photograph is too limited. You do not appear to have low set eyebrows, so probably just an upper blepharoplasty could address the excess skin on your upper lids touching your eyelashes. This procedure can be performed under local anesthesia and outpatient procedure.