I Am Considering Either a Upper Bleph or a Brow Lift? (photo)

I have gone to a couple plastic surgeons and have gotten mixed answers. Are any of you close to Santa Cruz, CA? I do have a high forehead and have always had a lower brow position even when young. There is also swelling in my upperlids as well, perhaps from allergies but I am not sure. I took the pictures in bathroom lighting. Hope they work. Thanks for your help.

Doctor Answers 25

To decide between browlift and blepharoplasty, have your surgeon simulate both

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I find that browlifts tend to be done too often. When I got meetings and watch lectures on browlifts, they sometimes look to high to me. The eyelids look great, so that is where the surgeon and patient must be focusing their attention. A second indication for a browlift is called lateral hooding. Do the upper eyelid "hoods" go far beyond the corner of the eye? If so, a browlift may be necessary.

Another way to see what is best is bring in a photo from when you were in your 20's to see if your brows really fell.

New York Facial Plastic Surgeon
4.9 out of 5 stars 141 reviews

Upper bleph or brow lift: when to consider both

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As you might surmise from the number of answers to your question, it is more complicated to answer than it might seem. For one, when the upper eyelids are heavy, it is normal to compensate (unconsciously) by holding the eyebrows up with muscle activity. This means that the eyebrows may drop after the upper bleph, so it becomes a bit of a moving target. Situations like these often benefit from both the browlift and the bleph. A personal consultation is really the only way to analyze and make a plan, which would be based on both your goals and an asessment of factors affecting brow position.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

I Am Considering Either a Upper Bleph or a Brow Lift? (photo)

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Hello Melaniekay and thanks for your question.

Based on your photo, you dont need a brow lift. An upper blepharoplasty will do.

You medial brow is a bit low and the muscles that are responsible for that can be resected through the same upper eyelid incision. This procedure is called corrugator resection. If on dynamic examination the lateral ( outer) brow needs a lift, an internal brow stabilisation can be perfomed through the same incision.

Best wishes

I Am Considering Either a Upper Bleph or a Brow Lift?

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A lot will depend on what you want.  If you are happy with your brow position, then an upper blepharoplasty alone should give you significant improvement.  The good news is that you can always do a brow lift later if you don't want to do it at the same time.  Good luck.

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon

Brow vs Eyelid surgery

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According to your photos, you have a high hairline which is well camouflaged. The angles of your brows look good, and your medial brow is slightly low. The upper lid surgery with removal of the corrugater muscle will help here. This can be done with a single eyelid incision that is well camouflaged. All the best

Brow lift vs upper blepharoplasty

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Often the decision between (or both) a brow lift and upper blepharoplasty is partly an aesthetic preference. In your case, I would suggest upper blepharoplasty, no bow lift, but also a transconjunctival (fat removal/reposition only....no skin) lower blepharoplasty.

Andrew Pichler, MD
Sacramento Facial Plastic Surgeon

Browlift vs Blepharoplasty

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In your case, there may be no right or wrong answer, just a preference for one or another. Just as in painting and architecture, where different painters or architects may have different idea of aesthetics, design, or beauty, surgeons are the same in plastic surgery.

In medicine, and especially in plastic surgery, there is often more than one approach to a problem, and sometimes even difference in taste and preference that is individual or even regionally based. I would submit to you that the aesthetic preferences in Los Angeles area is different than in Seattle.

In my opinion, and thus in my practice, I evaluate a patient, and decide upon the different options that may improve a patients features. Then I discuss with the patient what their concerns or desires are, and then present the patient with the options available, and use them to narrow down my recommendation. I may recommend two different options to 2 patients with the same exact anatomic features.

Some surgeons have a different approach. I have heard some say, "This is my aesthetic sense, and this is what you NEED", and present a take it or leave it approach to the patient. Some patients may appreciate this approach because it takes the decision out of their hands.

Let's talk about your specifically. Your brow position seems to be in a proper position for a female, but does not have a high arch,  but isn't flat either. But I would bet, that this is your natural anatomy, even when you were in your late teens

In the office, I would manually lift your brow, to achieve more arched appearance and ask your opinion if it is aesthetically pleasing for you. If so, I would recommend a browlift, with a conservative blepharoplasty. If you did not like the higher arch appearance, I would recommend a more aggressive blepharoplasty.

Sorry for the long winded approach, but I felt it deserved a background explanation.

Good luck

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Hairline, brow position, upper eyelid relationships

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Thanks for your photos.  Based on your self analysis, you would be a great candidate for a MACS browlift to decrease your forehead height and elevate the brow positions.  Combined with careful upper lid skin resection and conservative fat reduction, I think you will have a very nice rejuvenation.  Be sure to discuss these options with your surgeon.

Blepharoplasty vs brow lift

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You might be a person who would benefit from both procedures which can be done at the same time. A conservative approach is to do a blepharoplasty and if the change does not reach your goal then consider a brow lift.. It is very important to have a consultation since your photos, which are good, cannot replace a consultation.

Ronald Iverson, MD
Pleasanton Plastic Surgeon

Upper blepharoplasty alone

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would give yo a nice result in my opinion. The brow position is more than adequate and doesn't need elevation with surgery. I would consider masking the asymmetry with titrated botox injections.

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.