Do I need blepharoplasty or brow lift before I make a mistake and regret? (photos)

I don't know if I need a blepharoplasty or a brow lift yet and I don't want to get one if it's not needed but I'm 38 and I think my eyes look puffy and horrible.Any advice would be appreciated before I have surgery I may not need.I 've had botox for 10 years now but only in last few years has my eyes gone a droopy look and skin pulls down in inner corner of one eye,I never had this before.How cab I fix this it seems forever to go away.Do I have eye ptosis now?

Doctor Answers 5

You upper eyelid ptosis repair.

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A brow lift makes no sense.  You are already doing the most maximal forehead lift yourself with your forehead muscles.  Blepharoplasty is a surgery that removed skin, muscle, and fat.  It does not fix upper eyelid ptosis.  So yes, letting a surgeon perform blepharoplasty or a forehead lift would be a huge mistake.  You need a careful assessment of the upper eyelids.  In my practice, I would perform an anterior levator aponeurosis resection ptosis surgery with removal of a tiny amount of skin and an anchor blepharoplasty procedure.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Do I need blepharoplasty or brow lift ?

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You may need either but it appears you have upper eyelid ptosis which causes your eyebrows to raise. See an oculoplastic specialist for evaluation. 

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Facial examination

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Its hard to say exactly what you need or what your concerns are based on your photos as you can read from the other comments, and I agree, the eyelids and brows are not badly positioned at all. 

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 104 reviews

Blepharoplasty or brow lift

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Your eyebrows are in an excellent position - so I wouldn't recommend brow lift. Your photos from the sides show a better lid margin position than the other oblique photos... I'd recommend an examination by an oculoplastic surgeon to determine the precise lid positions in primary gaze - this would clarify whether you need blepharoplasty or a more complex procedure - ptosis repair. If you do decide to have surgery, be sure to have your surgeon review risks, benefits and alternatives. You don't need to be in a hurry to have surgery. Best wishes!

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 12 reviews

Puffy eyes - what can I do?

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Thank you for your question and pictures.
The are many reasons for "puffy" such as genetics, ethnicity or even some medical conditions. I would want to make sure that all these things are kept in mind. Then, you need to have a review with your doctor about what you really want and have different posses (at rest, smiling, looking up and looking down) to really assess what you want and what can be done.
I recommend that you see experienced doctor and have a thorough consultation and assessment prior to proceeding with any treatments.
I hope that helps and best regards, Dr. Sapijaszko.

Mariusz Sapijaszko, MD, FRCPC
Edmonton Dermatologic Surgeon
5.0 out of 5 stars 13 reviews

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