If you could choose one, would you do upper blepharoplasty or lateral temporal browplasty? (Photos)

Question

If you could only have one, would you do upper blepharoplasty or lateral temporal browplasty? Could the other be done at a later date?

Andrew Miller, MD · Answer

Based on your photos, your brows are in a reasonable position, so you would benefit from upper lid surgery by itself. If the brows start to droop in the future, then a browlift would be performed. Be sure to see a facial specialist for consultation.

Sudeep Roy, MD · Answer

Based on your photo, I think you could benefit from both an upper blepharoplasty and brow repositioning, although if I had to choose only one, I would probably lean toward the upper blepharoplasty. You do have some brow asymmetry, with greater brow ptosis on the right contributing to the heavier appearance of that upper eyelid.

An upper blepharoplasty would more directly address the excess skin and improve upper eyelid definition on both sides. A temporal browlift could further improve the lateral hooding and asymmetry, particularly on the right, but I would consider that complementary rather than necessarily a substitute for the blepharoplasty. An in-person examination with the forehead completely relaxed is important to determine how much of the heaviness is coming from the brow versus the eyelid itself.

And yes, either procedure can be performed at a later date. However, if you choose to have the upper blepharoplasty first, it should be performed conservatively, particularly when some of the apparent excess skin is related to brow ptosis. Removing too much upper eyelid skin can make a future browlift more difficult as the risk of not being able to close your eye may be increased.

Jeffrey M. Darrow, MD · Answer

Thank you for your photos.  The correct position for the brow is to be at, or above, the bony orbital rim of the eye socket. Your brow appears to be above your orbital rim and elevating it further with a temporal brow lift would not provide an aesthetic improvement.  An upper blepharoplasty, with only skin removed, would help to freshen and rejuvenate your upper eyelids while retaining all the youthful volume in your upper eyelid. This is commonly done with only local anesthesia, plus/minus some sedation, involves a single suture for each eyelid and has a rapid recovery.  Best wishes.

If you could choose one, would you do upper blepharoplasty or lateral temporal browplasty? (Photos)

Answers (3)

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