Eyelid Surgery: Cost, Photos, Rewiews, Q&A

Rejuvination of the eyelids often involves addressing both the upper eyelids as well as the brow. Some people have severe brow ptosis (droop) while others suffer more from excess upper eyelid skin and the brow is in relatively good position.

There are several options for brow and upper eyelid rejuvination. A lateral brow lift or temple lift is a relatively non-invasive technique that addresses the side of the brows and elevates the brow to its more natural position without creating a surprised look.

Other techniques include an endoscopic brow lift with or without the endotine system, a coronal brow lift which entails making an incsion across the entire scalp, a pretrichial lift, and a direct brow lift.

In my opinion, I would choose the least invasive option that will give you the best, most natural result with the least amount of down time and the best longevity. In my experience this has been a lateral brow lift with an upper blepharoplasty. (Todd C. Miller, MD, Newport Beach Facial Plastic Surgeon)

Both work – either together or separately

When face to face with people, the area we all notice first is the eyes. That is why the peri-orbital area is the one most commonly identified by patients as being of concern, and it is the most common area treated – either with Botox, fillers, or surgically.

Brows that are too low can make a person look tired or angry. Brows that angle downward from the middle of the forehead toward the side of the face can make a person look sad.

Brow lift – done either as and endoscopic or open approach – can significantly improve this, making one look as alert and happy as one feels.

Difference between brow lift and blepharoplasty for rejuvination of the eyelids

Eyelids that have excessive loose skin or “puffiness” can make also make a person look tired or sad. Blepharoplasty, with removal of excess skin (and sometimes fat) from the eyelid can correct this problem with almost invisible scarring.

Some individuals have both problems and woudl benefit from having both procedures done. In this case, caution must be taken that neither procedure is “overdone”, so the patient is not left unable to fully close the eyes, resulting in tearing and irritation.

If a combination procedure is done, the browlift is always done first; then the amount of skin that can be safely removed from the eyelids is determined with a pinch test. Both procedures are extremely high satisfaction with minimal down time and risks. (Robert Stroup, Jr., MD, FACS, Cleveland Plastic Surgeon)

Browlift Vs Blepharoplasty – Which is Best for Sagging Eyelids?

Difference between brow lift and blepharoplasty recovery after

If the upper eyelids are sagging, but not the brow, the excessive skin in the upper lids should be removed. This may be apparent at a very young age and may be hereditary. If the brow sags, then the brow should be lifted. This, however, comes with aging. As we age the brow sags, particularly the outer brow, and this sagging causes the upper eyelids to sag as well. There are occasions when one needs both a brow lift and an upper lid lift (blepharoplasty). You can look in the mirror and lift the outer third of your brow and see if that is the appearance that you want and if it also lifts the upper lids sufficiently. Seek someone experience in this field and discuss the alternatives with him/her. (E. Ronald Finger, MD, Savannah Plastic Surgeon)

Browlift or blepharoplasty

Difference between brow lift and blepharoplasty surgery

Difference between brow lift and blepharoplasty: which is best? a temple lift can be used alone to lift the outer lid a full brow can lift and correct frown lines or you can use botox there if the brow position is above the bone, eyelids alone can be done many patients need both (Jed H. Horowitz, MD, FACS, Orange County Plastic Surgeon)

Browlifts and upper eyelid blepharoplasties do different things. It is a mistake to try to do a really big browlift to make the upper eyelids look good, or a really big upper eyelid surgery when the brows have become heavier.

It is usually better to have each procedure performed conservatively, and avoid an exaggerated look or an upper eyelid that appears still heavy once the brows come down again, which they almost always do due to the powerful closing muscles of the eye acting over time.

When the upper eyelids are performed with a fat conserving technique, the upper eyelids can look natural, youthful and unoperated. You can try this yourself in the mirror and raise up the brows until the upper eyelids look good.

Usually you will see a very exaggerated appearing brow contour before the upper eyelids look good. Therefore, the browlift is not the answer for both the upper eyelids and the brow, since they are really two different areas.

The main focus for browlifts in our practice is the lateral brow, the outer portion of the brow, affecting skin that lies outside of where an upper lid blepharoplasty reaches. We do not routinely raise the central brow much because this can give a startled appearance.

The types of browlift – endo vs. coronal vs. pretrichial vs. minimally invasive lateral vs. Endotine will have profoundly different effects on the appearance and the hairline.

Basically, any brow procedure that originates above the hairline will raise the hairline. It is best to have a candid discussion with a number of board certified surgeons before choosing your procedure.

The effects on creating areas of baldness or loss of sensation also need to be considered. For most of our patients conderned with not having a raised high forehead when their procedure is done, we perform lateral browlifts, minimally invasive.

This technique actually restores an aging hairline by lowering it slightly. It also preserves the all important deep branch of the supraorbital nerve, the branch that is cut during a coronal lift that gives sensation to the top of the head. Endotine techniques are promising but many patients complain of pain or sensitivity with the hooks underneath the brows. For a complete discussion of browlift techniques, you may want to preview my chapter in the “Mathes” Plastic Surgery textbook on my website “drbrent.com” under Articles. (Brent Moelleken, MD, Beverly Hills Plastic Surgeon)

Brow Lift vs Upper Blepharoplasty

An upper blepharoplasty and a brow lift achieve slightly different things.Sometimes they are used in combination. An upper blepharoplasty removes the excess skin and typically a small fat pad that makes your upper eyelid look heavy and gives you a tired look.

A brow lift can lift a little of this excess skin, but the goal of a brow lift is to put the brow back into a more appropriate position if it has dropped. Your brow should be positioned at about the orbital rim (the bone you feel just below your brow). If it has fallen below that, we typically perform a brow lift to raise the brow.

Many times the excess skin of the upper eyelid should be removed as well as the medial fat pad for maximal results. You should see a board certified plastic surgeon in consultation to determine which of these procedures is best for your face. (Christopher T. Maloney Jr., MD, Tucson Plastic Surgeon)

Browlift and upper blepharoplaty are on the same team

When excessive heaviness develops in the upper eyelids, it is important to do a careful physical exam in order to determine the cause of the heaviness and to recommend the proper operation. If you place two fingers above the brow and lift it in a subtle manner and this correct the problem, then a browlift will probably be at least part of your solution.

If you need a browlift and try to solve this problem with upper eyelid surgery alone, it is likely that one of two undesirable consequences will occur. One possibility is that your will see little benefit after upper eyelid surgery, since the brow will come down further and obscure any benefits of the blepharoplasty.

Another more serious possibility is that the surgeon will try to compensate for the brow issue by aggressively removing an excessive amount of upper eyelid skin. This makes it impossible to subsequently do the proper operation (a browlift) because the excess skin removal from the previous operation will preven eyelid closure when the brow is brought to its proper position Browlifts have gotten a bad name in some quarters due to the tendency of certain surgeons to overdo the operation, which produces a startled or surprised look. If the brow is simply brought to a proper but not over corrected position there can be a wonderful restoration of a relaxed and alert appearance to the eyes.

There will also be a softening of the horizontal forehead creases that have developed in a person who is constantly raising her brows to open up the eyes. I wish we could rename the operation a brow stabilization, as this is what really occurs.

If the brow is in a good position and there is heaviness that is confined just to the upper eyelid, then an upper blepharoplasty procedure will be all that is necessary.

Often the best result will occur with a combination of procedures: a browlift to restore the brow to its proper but not over corrected position and an upper blepharoplasty to address true excess eyelid skin and any herniation of the upper eyelid fat. (John Q. Cook, MD, Chicago Plastic Surgeon)

Brow Lift vs Blepharoplasty

The eyebrow typically should live at or above the bony rim above the eye. If it is not in that position, one can gently lift it up manually and if that addresses the excess skin of the upper lid and is found to be more appealing a brow lift is indicated.

If the brow is above the rim and there is excess skin, then the excess skin of the upper lid should be removed, a blepharoplasty. Sometimes people may need both.

An interesting exercise to pursue is to go through a magazine like ELLE looking only at people’s eyes folding over the corner of the page for those you find attractive.

Then go through the magazine a second time to see if you find high brows or low brows attractive and then your plastic surgeon can work with you based on what you like. (Roger J. Friedman, MD, Bethesda Plastic Surgeon)

Browlift and blepharoplasty are complimentary procedures for eyelid area improvement

Patients can benefit from both a browlift as well as an upper blepharoplasty depending upon their invidividual anatomy and cosmetic needs. The browlift addresses the position of the eyebrows and only indirectly improves the upper eyelid position.

Typically a browlift is done to improve the hooding of skin that hangs over the corners of the upper eyelids or the heavy brows themselves that can hang below the bony prominece on top of the eyelids. Upper blepharoplasty, on the other hand, removes the skin that hangs over the eyelid and often encroaches upon the eyelashes. Only conservative amounts should be removed here or difficulties with eyelid closure can result and dry eyes can be the consequence.

In summary, you can think of the browlift as raising the curtain over the movie screen and where the upper blepharoplasty is like making the screen bigger so that you can see more of the movie. Both procedures are often done simultaneously although some surgeons prefer to do them separately. (Scott Trimas, MD, Jacksonville Facial Plastic Surgeon)

It really depends on your individual anatomy. Most of my patients who see me for eyelid or brow rejuvenation do so because they feel they have a very “tired” appearance.

When I evaluate a patient for eyelid rejuvenation, I’m first looking at the position and shape of the eyebrow, then the quality and amount of eyelid skin, and finally the presence or absence of fat around the eyes.

This will dictate what operation will give the patient the most natural result. In general, I like the brows on women to arc as they move from the center of the face to the side of the face, and this is widely considered the aesthetic ideal (in men, it’s a bit different – we want the brow to be a bit flatter).

Also, the position of the brow should be slightly higher in women than in men, sitting above the bony rim of the orbit. If your brow already is at the proper height and shape, then I’ll evaluate the eyelids themselves.

This evaluation will allow me to recommend either a browlift (and there are several different types of browlifts which can be performed based on what will give you the best result), a blepharoplasty, or both.

But the key is to give each patient the right operation or operations in order to best attain a natural, refreshed look. (Shahram Salemy, MD, FACS, Seattle Plastic Surgeon)

For the majority of patients a blepharoplasty is better.

In most patients there is a slight drop of the brow but the majority of the cause of the sagging is because of the upper eyelids.

Subtle elevations in the brow can be achieved with Botox/Dysport but the excess upper eyelid skin can only be corrected with an upper blephroplasty. (Leila Kasrai, MD, FRCSC, Toronto Plastic Surgeon)

Browlift versus blepharoplasty

The brow and upper eyelid are intimately associated with one another and changes to one, in turn affect the other. Evaluation should start with the brow. For a woman, the brow should have a pleasing arch with the highest point lying vertically above the outer corner (lateral limbus) of the iris, which is the colored portion of your globe (eyeball). It should lie just above the superior orbital rim (the bone above your globe). If your brow is low or flat, then you would likely benefit from a browlift.

Next, look at the eyelid. If you have extra skin that hoods over your lid platform or rests on your lashes and your brow is low, use your hand to raise the brow to a natural position (its temping to raise it too high, so be conservative).

If this results in resolution of your lid hooding, then you only need a browlift. If there is still extra hooding, you need both browlift and upper lid blepharoplasty. This is obviously simplified, but should give you an idea of what you need. (Sirius K. Yoo, MD, San Diego Facial Plastic Surgeon)

If indeed it is only the eyelids that are sagging, then…

It depends upon the level of the eyebrows in relation to the eyelids. If it is only the eyelids that are sagging, then an upper blepharoplasty is the appropriate procedure for correction. The surgeon will determine the distance between the eyebrows to the eyelashes, and if that distance is adequate, just an upper blepharoplasty is performed.

If the distance is short between the eyelids and eyebrows,and the eyebrows are quite low, consideration should be given to a forehead lift or a browlift. A brow-lift is an operation that is used for someone who has very low set eyebrows. The procedure softens frown lines( corrugator, procerus and frontalis muscles) and horizontal lines of the forehead and can be done through an endoscopic approach or through the coronal approach. (William Portuese, MD, Seattle Facial Plastic Surgeon)

It depends on whether you think you’re brows have dropped over time

For too long, a high-positioned or high-arching brow was seen as a sign of youth. That notion is clearly challenged by the many young, attractive models in magazines who have low brows. My advice is the following:

1. If you do believe your brows have lowered over time or flattened, a brow lift may be the best procedure. Also, a browlift allows the forehead and glabellar muscles to be weakened (like a longer lasting Botox treatment) to relax the “eleven” and forehead lines.
2. If you like the position of your brows and believe they have always been about the same, then an upper blepharoplasty may be best for you.
3. If you have very heavy upper eyelid skin, then a combination of both may be necessary but with great restraint and in the hands of a specialist. (Anand D. Patel, MD, Brookfield Facial Plastic Surgeon)

Blepharoplasty and Browlift treat different problems, but many patients need both procedures

It’s not unusual for patients to require both procedures. Ideally, the eyebrow should be above the bony rim at the top of the eye socket, with a slight arch for women.

When a plastic surgeon examines a patient with brow ptosis, he should elevate the eyebrow to this ideal location and then determine if there is still excess skin of the upper eyelid.

In addition he should determine whether the upper eyelid drooping is due to an abnormality in the eyelid muscles or due to excess skin alone. I often see patients, for Botox therapy, with forehead wrinkles.

They need to be made aware of the fact that their forehead wrinkles may be due to the brow ptosis and excess upper eyelid skin. The patient will raise their eyebrows in order to see better, which causes them to have forehead wrinkles.

If patients are not made aware of this before you treat them with Botox, they will be very upset when the forehead is now smooth, but their eyelids look worse. (Joseph M. Perlman, MD, Houston Plastic Surgeon)

Browlift versus Blepharoplasty

Both a browlift and a blepharoplasty improve the facial appearance around the eyes – but in different ways. A browlift will reduce the sagginess of the eyebrows and lift the thicker skin over the eye socket off of the eyelids. A blepharoplasty will reduced the excess saggy thin upper eyelid skin that hangs over the upper lid crease.

What you need will depend on what you have – droopy brows, or droopy lids, or both. You plastic surgeon can tell you what is recommended for your condition. (Randy J. Buckspan, MD, Austin Plastic Surgeon)