Browlift versus Eyelid lift: Which one do I need?
“I look tired but I’m not!” is a common refrain heard in many facial plastic surgery offices. Often, the driving force for patients to present for consultation is that the outside appearance doesn’t match the vital, energetic person they feel they are inside. The upper face can be a good starting point in this case. The eyes truly are the windows to the soul, but as we age, they can be crowded out by excess skin or drooping of the brows and can lose their bright appearance. Many times, patients may even hone in on that area and point to the excess skin themselves. Sometimes, however, the reason there is excess skin is that the brows have drooped so low they are allowing the upper eyelid skin to bunch up and even crowd the eyelashes.
Determining whether you are a candidate for an eyelid lift alone, a brow lift or a combination of the two is a job for a facial plastic surgeon, but understanding why they may recommend one or the other is critical for you as the patient. Ideally, in women, we would like the brow to start in a gentle curve above the top of the nose and rise above the bone of the orbit until it peaks at the outer edge of the eyelid, then it should gently curve out and slightly downward. Preferably the entire course should be at or slightly above the bone of the orbit and the two sides should be relatively symmetric. Minor asymmetries are common. Many people with a “tired” appearance will have gotten used to holding their brows up to compensate for any drooping, so you may not immediately realize if this is a problem. Stand in front of the mirror and close your eyes. Take a deep breath in and out and purposely relax your brows and forehead. Open your eyes slowly taking care not to raise the forehead and look at your eyelids and brow position. If it appears your brows have actually dropped lower than you thought they were, you likely inadvertently hold them up all the time and a browlift may be needed. To imitate the effect of a brow lift, you can even take your fingers and place them between your eyebrows and hairline and watch in the mirror as you gently lift a little to see the brow position change and the excess skin reduce on the eyelids. If raising the brows gently like this improves the skin excess at the eyelids and is a favorable change in your appearance, a brow lift may be the right option! If there is still excess skin on the eyelids even after doing that, your surgeon may recommend a combination of the two for best results.
If your baseline brow position is mostly above the orbit, or in the case of a male patient, at or even minimally below the orbit, a brow lift may only make you look unnervingly different, not better. If the issue is skin excess in the upper lids alone, without any need for change in brow position, an upper eyelid lift is a relatively simple and low-downtime, cost effective way to improve the brightness of your eyes. In some cases, this can even be performed under local anesthetic alone given the ideal patient and setting.
Rejuvenating the upper face can be quite an “eye-opening” experience for most patients ☺ The satisfaction rates are high, and the downtime can be as little as 5-6 days to 10 days depending on the amount of surgery that is needed. Results usually last many years and don’t often need to be “tucked up” in the way that some other plastic surgery procedures require. As always, a consultation with a board-certified facial plastic surgeon can help outline what options exist for you and what recommendations would be best. Although some patients are fearful of the sound of a “brow lift” as more invasive or complicated, in truth, the procedure is not particularly high-risk or painful. Ultimately, addressing only the “easy” area and not the actual need, can reduce your happiness with your procedure and leave you still feeling like you look tired when you’re not. Feel free to ask any and all questions and even to seek multiple opinions if needed. There is no one right answer and each surgeon’s aesthetic and style is different. Finally, get ready to sit back and enjoy your new, bright and refreshed appearance-you’ve earned it!
