What's the Scarring Like from an Eye Lift with a Brow Line Incision?

Blepharoplasty (eyelid lift) incisions heal very nicely and are well hidden in the eyelid crease. Hairline browlift incisions, if performed properly, also heal very nicely and are camouflaged by the hair. It is uncommon to perform an eyelid tuck through a brow incision however.Stephen Weber MD, FACS

I guess I'm a little confused of what has really been suggested. Upper eyelid lift (blepharoplasty) results in a thin scar in the upper eyelid crease. This heals exceptionally well and very difficult to see, if at all. Then there are browlifts, which actually raise the eyebrow. This helps to open up the eye area. there are several different ways this is done. One way is to remove skin from right above the eyebrow. While it sounds like such an "easy" thing to do, I would not recommend it in anyone your age. The scar can definitely be slightly visible and is nearly impossible to make better. Before you do anything make sure you know exactly what is going to be done.

The terminology that you [or maybe your surgeon] are using can lead to a bit of confusion. If it is truly an eyelid surgery that is being proposed, than I cannot think of an instance where the incision should be made in the browline.

If it is a brow ptosis [droop] that he's recommending, then again, the brow line incision is not a favorable location due to the fact that it is a highly visible area. There are many different brow incisions that can be utilized depending on age, sex, hairline, brow hair, etc.

Consult an experienced Oculoplastics or Facial Plastic surgeon for a second opinion.

Upper blepharoplasty incisions are made in the crease. If one needs the brow elevated then you can kill 2 birds with 1 stone by doing a mini browlift at the hairline or in the hair. See an experienced surgeon for the best evaluation.

An incision along the brow can be used if a browlift is advocated. In my practice, this is rarely a good choice because of the potential for the resulting scar being noticeable.

I would say that I would not advocate this approach for a 27 year old patient. Please keep in mind that this is my personal opinion; your surgeon may have an excellent experience that he can demonstrate to you with his technique.

Definitely, you should have full understanding of the pros and cons of the surgery and the expected outcome including the scar line. You should also know about alternative treatment approaches.

They are three basic things that can give "droopy upper eyelids":  1) ptosis, which is true droopy upper eyelids from relaxation of the muscle that lifts the eyelid;  2) excess upper eyelid skin;  3) droopy eyebrow.  "Eyelid lift" is incorrectly used to describe procedure to correct any of the above three problems.  Raising the brows/forehead, as your surgeon suggests, will not correct eyelid ptosis.  The incision for eyelid ptosis is either in the eyelid crease or behind the eyelid.  For brow/forehead lifts, the incision is usually somewhere above the brows or along/behind the forehead line.  See an oculoplastic specialist.

Typically the incision for an upper blepharoplasty is made in the upper eyelid crease. There was a recent article published in one of our journals where a surgeon described a technique for upper blepharoplasty in elderly asian patients that used an incision just underneath the eyebrow and reported some very good results. Given that you live in Seoul you may very well be asian, in which case this may be a reasonable option for you.