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Ask the doctors: Eyebrows or Eyes

Article-Ask the doctors: Eyebrows or Eyes

How do I know whether I should get an eyelid tuck or a browlift?

Dr. Niamtu:

> This is confusing to the layperson, but should be crystal clear to the surgeon. When considering upper face rejuvenation, a contemporary surgeon will always evaluate the brow first.

Normally, the eyebrow of a young female is above the bone of the upper eyelid. If the brow and forehead is significantly descended, the result is excess eyelid skin. By elevating the brow and forehead, the brow is elevated to a more youthful position.

In addition, the forehead wrinkles and frown lines are generally improved with a browlift procedure.

On the other hand, performing an eyelid tuck (blepharoplasty) does not reposition the eyebrows or address forehead wrinkles. In blepharoplasty surgery, excess skin muscle and fat are removed or recontoured to recreate a more youthful look.

With blepharoplasty surgery, the brow position remains unchanged, so the main indicator in choosing which surgery is appropriate is determined by the patient's desire to have elevated brows.

If the patient looks in the mirror and the brows are manually elevated, and he or she believes the cosmetic result is beneficial, then a browlift may be more appropriate. This is especially true for patients who had higher brows when they were younger.

If the manually elevated brow looks excessive or "overdone," then the patient would not want a browlift and would be a better candidate for only blepharoplasty.

The important thing to remember is that doing eyelid surgery only does not help the brow. Some patients have a "sad puppy" look, because the lateral forehead droops and causes "hooding," and only a brow lift will improve that.

Some patients with excessive tissues may require a brow lift and blepharoplasty for optimum rejuvenation. Some patients (especially younger ones) may opt for blepharoplasty surgery but may desire a browlift later in life.

One caution is that if a patient has multiple blepharoplasty surgeries with skin taken away from the lids, he or she may never be able to have a browlift in the future, as there would be too little skin left to close the eyes.

The best thing is to seek a surgeon with experience in both procedures and mutually decide which procedure is best for you.

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