Which option would produce best results: eyebrow lift OR hairline lowering plus upper blepharoplasty?

When I don't manually lift my eyebrows, I have a large forehead that is quite masculine (going farther back at the sides) and very low, straight brows and hooded lids. When I manually lift, my forehead appears smaller and I don't have such hooded lids (but still a bit). I am now wondering whether a subcutaneous brow lift would be better or an upper blepharoplasty plus a hairline lowering/rounding.

Doctor Answers 10

Which option would produce best results: eyebrow lift OR hairline lowering plus upper blepharoplasty?

Hello Realisticperfectionist,

As you can see with the other answers, there are several ways to treat the eyebrows.  You will find out in medicine when there is more than one option that there isn't one perfect option.  If you feel like you have a large forehead, then there is really only one treatment that can do that which is the pretrichial (just in front of the hairline) incision.  In my experience that incision heals quite nicely when done properly.  This would both raise your brow and lower your forehead, which is what you indicated you wanted.  An upper blepharoplasty won't improve the position of your brows.  If you also have excess skin or fat in this area, then an upper blepharoplasty can be of assistance.  

The best option is really to have a consultation.  This way your anatomy can be evaluated, your goals discussed, and a proper surgical plan created.  

I hope this helps and good luck.  

The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 28 reviews

Irregular Trichophytic Forehead Lift with hairline lowering.

Irregular Trichophytic Forehead Lift with hairline lowering is a procedure we developed 35 years ago for patients like you. It "kills several birds with one stone". The brows are raised, the hairline is lowered and hair grows thru the scar so it is not noticeable. See a surgeon who does this technique and can show you photos of the resultant hairline without a scar.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Browlift options

The issues you mention in your question are common when deciding what type of brow rejuvenation procedure is best for you.  I would recommend a consultation with a board certified facial plastic surgeon with experience in browlift procedures to help you determine what is the best treatment for you.  Be sure to show the surgeon the issues that most concern you and what is the best treatment.  Be sure to review before and after photos during your consultation.  Hope this helps answer your questions.

Bradford S. Patt, MD
Houston Facial Plastic Surgeon
4.0 out of 5 stars 4 reviews

Which option would produce best results: eyebrow lift OR hairline lowering plus upper blepharoplasty?

Fullness of the upper lids can be cosmetically improved with a number of surgical options depending on individual anatomy, the cause of the fullness, and desired outcome: an artistically performed conservative upper lid blepharoplasty, a repositioning of the brow if it is low, or often a combination of both.

There are multiple options which can produce an improved natural appearance that are available for a patient with your anatomy: Upper lid blepharoplasty alone, endoscopic brow lift, limited lateral brow lift, forehead lift, neuromodulators like Botox or Dysport, hyaluronic fillers of the forehead above the brow, or a combination of procedures. A browlift and a blepharoplasty (upper) are not mutually exclusive procedures and in certain cases they can be done in conjunction. There is no one best option. It depends on your desired outcome and understanding of the pros and cons of the various procedures.

It is important to realize that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do without seeing  photos and more importantly without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person. Facial rejuvenation needs to be individualized. What would be an ideal approach for one patient is not necessarily the same for someone else. Based on the examination and discussion at the consultation, you should have a better understanding of the various options that can achieve the best cosmetic result for you.

Robert Singer, MD FACS 

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Brows and forehead

A trichophytic hairline lowering forehead/browlift should solve your concerns. Concomitant upper blepharoplasties might be added. Avoid the endoscopic approach unless the height of your hairline needs to be higher. 

Sheldon S. Kabaker, MD FACS
San Francisco Facial Plastic Surgeon
4.4 out of 5 stars 35 reviews

Browlift vs eyelid lift and hair lowering

Hi there,

From your description, I think it could be that lifting your brows would help open your eyes and address your hooding. If the browlift is done enfoscopically you have small scars and the height of your hairline does not change.

Hairline lowering can be combined with a browlift, but by itself it will not address brow position. 

An exam in person would better allow to differentiate hooded eyelids from excessive eyelids skin versus low brows, but I suspect in your case the brows are causing the hooding.

Hope this helps!

Good luck 

Myriam Loyo, MD
Portland Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

The so-called hairline lowering forehead lift is the old fashion coronal forehead lift with lipstick.

Compared to the small incision, endoscopic forehead lift which heals very quickly, and does not interfere with forehead and scalp sensation, the open forehead lift, takes weeks and weeks of recovery, and results in permanent scalp numbness.  Shifting the incision to the hairline does remove non hair baring forehead skin moving the hair line down.  However even when the incision is carefully beveled so hair grows through the incision to help hide it, the incision is very obvious.  This hairline scar compressed the frontal hairline and is unnatural no matter that a persuasive surgeon might try to convince you otherwise.  As a perfectionist, you may be very upset by this permanent change to a very visible part of the face.  You have not provided useful photographs of your eye area so it is speculative to say what type of blepharoplasty candidate you would be.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Eyebrow lift versus upper blepharoplasty

A full set of facial photographs are required to make a decision about two independent surgical procedures. A brow lift procedure can accomplish lifting low eyebrows, addressing asymmetry of the eyebrows, elevating or lowering the hairline, and softening the wrinkles caused from the frontalis and corrugator muscles.  The goal of the upper blepharoplasty procedure is to remove the excess  skin in the upper eyelids creating the tired look. For many before and after examples of both procedures, please see the link and the video below 

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Forehead lift vs upper blepharoplasty

Dear realistic:

Thanks for your question. It's difficult to give you an exact recommendation without an examination, but from what you describe, I would likely recommend a forehead lift. If there is still some extra upper eyelid skin remaining with full forehead (brow) elevation, that could be removed at the same time. I perform either or both surgeries under local anesthesia with some oral sedation and my patients do quite well with this format, avoiding the risks (and costs) of general anesthesia. The advantages of the forehead lift are many--not just elevation of the brows and enhancement of their arched configuration, but also, elimination of the inter-brow furrows ( the "11's"), a "clearing" of the upper lid area "crowding" in most cases, and, with the incision at the hairline, as you identified, a "lowering" of the hairline, and a lessening of the forehead height. I place my hairline incisions centrally in a "zig-zag" pattern, and the resultant scar then is generally not that noticeable (with proper technique, hair follicles usually grow through the scar). Consult with a board-certified plastic surgeon who does a lot of facial cosmetic surgery to discuss your options. Good luck with your facial rejuvenation.

James H. Scheu, MD, FACS
Saint Louis Plastic Surgeon
4.4 out of 5 stars 24 reviews

Brow and eyelid procedure


Whenever I consult on a patient with droopy eyelids, the first thing I look at are the brows.  Blepharoplasty performed on a person with droopy brows will result in an "angry" appearance.  Because the skin from the lid is removed during the eyelid procedure, it becomes difficult to go back and elevate the brows.  The eyes may not be able to close.  For this reason, it is suggested to perform the brow lift first.  There will probably be less eyelid skin to remove since much of it is pulled upwards along with the brow.  For those with high foreheads, a direct lift or a lift originating at the hairline is a better option than an endoscopic lift.  The latter elevates the brow but without skin removal.  Cheers and good luck!

Hugo Higa, MD
Honolulu Oculoplastic Surgeon
5.0 out of 5 stars 1 review

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.