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

Roxanna3100 There are numerous procedures to fix and/ or lift the eyebrow.  While your picture does show dermatochalasis ( excess skin), it also reveals a  degree of brow ptosis.  A full examination is warranted to determine the extent the eyebrow impinges on the eyelid. A suture transblepharoplasty / browplasty will help to fix the eyebrow in place but more than likely will not elevate the eyebrow long term.  I would be happy to evaluate your eyebrow and eyelid position to give my opinion on the best course of  action.

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.

A brow lift can be performed via many types of approaches or incisions, and commonly combined with eyelid surgery or facelift. A brow lift through an upper eyelid incision alone is generally reserved for minor droopy or sagging eyebrow tissue. Most patients, however, who are considering a brow or forehead lift benefit from an endoscopic or limited incision forehead lift where small incisions are hidden in the hair of the scalp to rejuvenate the forehead. A more significant and natural lift is generally achieved with a scalp approach as compared to an upper eyelid approach.

Only after a comprehensive evaluation can a plastic surgeon help determine appropriate options for you. Best of luck.

Dr. Chaboki

 

 There is a  significant  amount of hooding still present on the upper eyelids  which was  not addressed from the previous blepharoplasty.   A revision blepharoplasty with removal of fat and excess skin should be  all that is required. The photograph shows a mild amount of brow ptosis which can be addressed with either endoscopic or open techniques behind the hairline in the scalp.

It does appear that you have excess skin of the upper eyelids and low brow position. I would recommend a more formal lateral brow lift with excision of excess skin and fat of the upper eyelids.  

 From the photo provided, the eyebrows are extremely low and would not be significantly raised with anything but a true Browlift.  This should be done the same time as the upper Blepharoplasty.