The upper eyelid, the outer half of the brow, and the forehead all relax and descend with age. How do you know if you need an operation on the upper lid (blepharoplasty) or an operation on the brow (lateral brow lift) or BOTH? If you lift up the outer half of your brow with your finger, you will see that the amount of excess upper eyelid skin is reduced, indicating that there is a relationship between the brow position and the amount of excess upper eyelid skin. The surgeon must determine whether the main problem is the lid or the brow or both, and recommend a procedure accordingly.
The upper eyelid tends to accumulate excess before there is much sagging of the brow. Younger patients, therefore, are more likely candidates for isolated upper blepharoplasty. The older patients, or patients who have already had upper blepharoplasty, are more likely candidates for a lateral brow lift. Finally, it is not unusual to perform both procedures together.
If the outer half of the brow is in a good position (approximately the same height as the inner corner of the brow), then upper blepharoplasty is indicated. If the outer half of the brow sags lower than the inner corner, then a lateral browlift is indicated. If there is still excess upper lid skin when the brow is raised to the ideal position, then both procedures are performed concomitantly.
Upper blepharoplasty is a plastic surgical procedure that removes excess skin and sometimes muscle and fat, from the upper eyelid. While some people have excess upper lid skin in their 20’s or 30’s, almost everyone accumulates excess upper lid skin eventually.
Upper blepharoplasty may be the simplest and best procedure in all of the plastic surgery. The incision is usually totally hidden and the patients almost universally like having the overhanding skin removed.
Most browlifts these days are lateral browlifts; that is, the outer half of the brow is lifted and the inner half of the brow is left alone or is treated with Botox. There are a number of different incisions and approaches to lifting the brow but the incisions are usually at the hairline or behind the hairline depending on the type of skin, density of hair, patient preference, etc.
We have learned that brow shape maybe even more important than brow height. In other words, it the shape is ideal, with the outer corner at approximately the same height as the inner corner, it is almost always attractive, regardless of height. On the other hand, a high brow with an aging, undesirable shape, is never attractive!
Combination of upper blepharoplasty and browlift
The two procedures are often performed together. This requires good judgment on the part of the surgeon so that too much skin is not removed from the upper eyelid, because the browlift will decrease the amount of excess lid skin. This combined procedure, however, can be transformational for the patient without looking like surgery was performed.
Consult a Plastic Surgeon
A board-certified plastic surgeon can tell whether you need a brow lift, an upper blepharoplasty, or any other plastic surgical procedure.
Dr. Charles Thorne is an internationally renowned plastic surgeon with extensive experience in performing brow lift, blepharoplasty, and other cosmetic procedures. Book a virtual consultation with Dr. Thorne to address your concerns.