Will a Transblepharoplasty Sufficiently Lift the Brow? (photo)

       The upper eyelid skin removal will be less invasive and give you a nice improvement.  That type of internal brow pexy may only give a mm or two of lift and it tends to be less durable.  Find a plastic surgeon with ELITE credentials who performs hundreds of facial procedures and brow lifts each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Thanks for your photo. I agree that you have some ptosis (drooping) of your lateral brow. A trans-blepharoplasty brow lift is performed through the upper eyelid incision that you would require to remove additional skin from your upper lid. This is appealing as it doesn't add any additional scar. The lift from this technique however is modest and may not be enough in your case. Consider a more traditional brow lift if you feel you need a bigger lift, Good luck!

Irregular Trichophytic forehead lift is what would be best. Your brow is raised with a hairline incision and hair grows thru the scar and in front of it. Doing your lids will not get your brows to the best position. 

Browlifting can be done in a variety of ways depending on the patient's age, skin thickness, and hairline.

In my opinion, the trans-blepharoplasty brow"lifts" help stablize and at best give a modest amount amount of lift. I offer this approach mainly in patients with very limited need, in males that need stabilization rather than aggressive lift, and in patients that really do need a lift but do not want the added incision [mainly to prevent additional descent after skin is removed from the eyelid]

From your photo [if this is in fact your postop photo after the first blepharoplasty], it would seem to me that you would do well with a blepharoplasty with some additional skin removal, but would do even better with a combination browlift [either endoscopic or hairline depending on your skin thickness] AND blepharoplasty.

Of course an in person analysis will help finalize your plan.

The brow/upper lid is a very complex and dynamic anatomic area. It is unfortunately impossible to give specific advice without examining your brow and eyes. Based on your video, you still have significant excess skin in your upper eyelids and drooping of the brows. Typically, patients require both an upper eyelid lift and browlift (of some variety) to improve these concerns. I've found the transbleph browlift to be best at raising the outer portion of the eyebrow but not changing the inner portion to a significant degree. I hope this information is helpful.