Blepharoplasty or forehead lift? (Photo)

Question

I’m 57 and my right eye has always been smaller than my left. It’s becoming more pronounced as I get older. Recently had dysport, which I’ve only had twice before and it’s dropped my brow on my right eye even more. Do I need a forehead lift or a Blepharoplasty?

Andrew Miller, MD · Answer

In your photo, it looks like you are lifting up the eyebrow over your right eye, but on the other side, your brow appears to be below the bone. That means that you will probably do well with a browlift, but you would need a full exam to make sure. Be sure to see a facial specialist for consultation.

Jason Emer, MD · Answer

Hello and thank you for your question. A formal evaluation would be needed to determine the best treatment. There are both surgical and non-surgical options to correct excess upper eyelid skin, depending on the situation.

For less significant upper eyelid skin excess or more mild improvement, there are nonsurgical treatments: Radiofrequency (Thermage or Venus Legacy/Viva), injectable fillers, and a Botox brow lift can help contour the eyebrows and lift the eyelid skin.

Surgery (browlift and/or upper blepharoplasty) is a great option for more significant improvement- for example if the hooded eyelids have more excess skin present.

Dr. Donald Groves is an expert facial plastic surgeon that I work with, who specializes in these types of procedures. It is important that if you are considering surgery that you go to someone who is well trained and very experienced with these delicate operations to get the best results. I suggest getting a consultation with an experienced cosmetic dermatologist and facial sculpting expert, or an aesthetic facial plastic surgeon like Dr. Groves; we are both located right here in Los Angeles.

Best, 
Dr. Emer

Gurkan Kayabasoglu, MD · Answer

You definitely need to have a brow lift surgery. Eyelid surgery will make the current situation worse. Please avoid it.

Please contact us for more detailed information and consultation.

+90 541 244 56 54

Michael A. Persky, MD · Answer

Hello there Melissa,
Let the Dysport wear off over the next few months and consult with a blepharoplasty expert.  I would likely perform a skin only upper blepharoplasty under local anesthesia in our office.  It is quick, easy, long lasting, and very effective.  Feel free to contact me with any further concerns or questions. Make sure to choose your bleph surgeon very carefully.  Good luck and be well.
Michael Persky, MD
Encino, CA

Cameron Nabavi, MD, FACS · Answer

This is a tough question to answer. Ideal world I would say consider both brow and lid surgery. The main issue seems to be brow asymmetry leading to lid asymmetry. Raising the eyebrow can help improve the asymmetry but it’s hard to completely remove that asymmetry. Eyelid surgery can help give the illusion of asymmetry but taking a little more skin on the heavier right side than the left. I’d say the realistic goal is to better symmetry but it will be hard to get perfect symmetry.

William Portuese, MD · Answer

A blepharoplasty is performed when they're significant excess skin and fat deposits in the inner corners of the eyelids creating the hooded look. A brow lift is performed when there's low set eyebrows. You should let your Dysport wear off before making any surgical decisions. For many examples of both procedures, please see our photo gallery below.

Blepharoplasty or forehead lift? (Photo)

Answers (6)

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