Blepharoplasty vs Brow Lift – Which is Best for Sagging Eyelids?

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As we get older, the forehead and eye area are the first places where we begin to notice wrinkles, fine lines and sagging skin, all of which contributes to a tired and aged appearance. Sagging of the eyelids, in particular, is a common occurrence for many, not only making people look older than their years but in some cases, also interfering with their vision.

If you are becoming increasingly unhappy with the appearance of your upper face and eye areas, it may be time to consider cosmetic surgery.

Continue reading as we discuss the types of patients that would benefit from blepharoplasty or brow lift procedures, and how to decide which treatment is the right one for you.

Upper lid Blepharoplasty

A blepharoplasty procedure is performed for a variety of reasons, most commonly in patients who complain of a “tired” appearance brought about by heavy, sagging eyelids and under-eye bags. As such, for patients with sagging eyelids, blepharoplasty is often the most suitable treatment option.

Blepharoplasty may also be performed to enhance the symmetry of the eyelids, or to improve vision, particularly in patients where the visual field may be obstructed due to saggy upper eyelid hooding.

The procedure involves removing excess skin, muscle or fat from the upper eyelid space (upper lid blepharoplasty), the aim is the reduce excess tissue and remodel underlying bulges caused by fat in order to achieve a fresher, more youthful appearance.

When not to have a blepharoplasty

If your goal is simply to remove fine lines and wrinkles around the corners of the eyes, there are other treatment options that would be more appropriate and are less invasive.

In many cases, the appearance of sagging of the upper eyelid is due to a combination of not only inherent excess skin, but also descent of the eyebrow, compacting the upper lid space. In these situations, a brow lift may be better that a blepharoplasty. In some scenarios, both blepharoplasty and brow elevation are required for optimal results.

If you have previously had an upper blepharoplasty but are starting to notice droopiness of the eyelids again, you may be considering undergoing another procedure. However, if there is no longer much eyelid skin left to remove, a brow lift may be advised as an alternative. With that being said, most patients are delighted with the outcome and do not feel the need to come in for another procedure, as results are long-lasting.

Brow Lift

With brow lift surgery, the aim is to elevate and reposition the brows to achieve a younger, more natural appearance, which is in line with the rest of the face. Brow lifts are suitable for those who have low, “hooded” brows or who have noticed a sagging of the brow area (brow ptosis) as they age.

When the position of the brow is low, a person may have to constantly raise their eyebrows, which often causes fine lines and wrinkles on the forehead. Sagging or low brows can also give the face an angry, sad or tired look, which affects the way patients are perceived by others. Some patients also complain that they can no longer see the make-up that is applied to their eyelids.

A brow lift can refresh the appearance of the eye area, without having to undergo eyelid surgery. Many patients do, however, choose to undergo a combined blepharoplasty and brow lift procedure, leaving them with an all-round rejuvenated appearance.

There are several different approaches to performing brow lift surgery, which include:

  • Endoscopic brow lift, using keyhole incisions above the brow-line.
  • Internal browpexy, performed at the same time as blepharoplasty through the same incision.
  • Direct Brow lift, usually used for very low brows and requiring an incision above the brow hairline.
  • Temporal brow lifting, using incisions behind the hairline, which can also be used to lift the outer part of the brow.

When not to have a brow lift

If your brow position naturally sits higher, then undergoing a brow lift is not typically recommended, as it can leave you with a shocked or surprised appearance, which is clearly not ideal.

Moreover, if you are opposed to somewhat invasive procedures, a non-surgical treatment option to raise the brows, such as using injectables, might be preferable. However, they will not provide the same long-lasting results as surgical methods.

Blepharoplasty or brow lift, which is right for me?

Every patient is different and will have their own desired outcome, so the answer really depends upon what you wish to achieve. For sagging eyelids specifically, blepharoplasty is the recommended procedure, but many patients opt for combination procedures in order to achieve a fresher, more youthful appearance overall.

Brow lifts are recommended for patients who have low or sagging brows, helping to reduce the signs of ageing and to no longer look as worn out, angry or unhappy.

Regardless of which treatment you are thinking of having, it is vital to seek advice from a professional surgeon, who will be able to assess your individual needs and give you a realistic idea of what can be achieved. As with many cosmetic procedures, there may typically be more than one solution that is right for you.

Oculoplastic surgeons, such as Daniel Ezra, understand each procedure in detail and have expert knowledge of facial anatomy and eyelid function, thus helping you come to the best decision.

Given the current global crisis, now is a better time than ever to start thinking through any forthcoming surgical decisions. With plenty of time on your hands, you can carry out a significant amount of research, ensuring you find the right person for the procedure in the future.

To discuss your needs, contact us today by telephone or fill out the form to book a consultation. We are also able to facilitate virtual consultations during the Coronavirus crisis.