Brow Lift vs. Eyelid Surgery: Which is the Right Procedure for You?

    

Brow Lift vs. Eyelid Surgery Which is the Right Procedure for You

The eyes are thought to be the first facial feature one sees when assessing beauty. They are the key attribute that helps promote facial harmony and balances the upper face with the lower face. The eyes often convey the initial sense of emotion and can instantly change the world’s perception of you. 

The eyebrows play a fundamental role to help shape your eyes. We use our eyebrows to express a number of emotions: raising them when we are surprised, contracting them when we feel anger, or lifting one up when questioning a thought. 

Both eyelid surgery (also known as blepharoplasty) and brow lift surgery are very popular requests for facial rejuvenation. They are excellent surgical procedures that help restore the upper one-third of the face to look refreshed and well-rested. In order to understand which procedure is right for you, you must understand and recognize components of facial aging. This article will discuss what you need to know about aging as it relates to the eyelids and eyebrows, as well as help you find the right procedure.  

Beauty Is In the Eye of the Beholder

Beauty and youthfulness are ever-changing concepts that play a role in the public perception of an individual. In relation to the eyelids and eyebrows, the idea of beauty varies based on culture, race, ethnicity, and time. Eyelids that were the beauty standard 70 years ago are rarely found now. For example, Marilyn Monroe touted “bedroom eyes” that showed more of the eyelid in a closed position rather than open. They were considered sexy during her time and often sought after in the 1950s. 

Although trends are changing on a regular basis, there are certain eyelid features that have withstood the test of time in terms of a youthful appearance: 

  • A sharp upper eyelid crease
  • Little to no excess skin in the upper or lower eyelid
  • No bagginess or puffiness in the lower eyelid 
  • The quality of the skin is firm and free of any crepiness  

As we get older, the upper eyelid skin can start to feel heavy. There is loss of volume and wrinkling of the skin. Sometimes the excess skin can be so severe that it obstructs our vision, preventing us from completing normal, everyday tasks like reading, driving, or exercising. 

Having bags under the eyes expresses a “tired” or “sad” emotion that may not reflect how you really feel. It can be very stressful to hear colleagues or coworkers ask you every day, “Have you had enough sleep?” or “Is everything OK at home?” This can take a psychological toll that may affect other parts of your life. 

Put Down the Tweezers and Give Those Brows a Break

Historically, the concept of brow aging has revolved around the brow sagging as we grow older. According to beauty standards, the medial (inside) edge of the eyebrow should line up to the spot where the nose begins, and then the brow should extend to the lateral (outside) edge of the eye. 

Additionally, the ideal shape of the eyebrow for women and men is different. For women, the highest peak of the brow should line up where the iris meets the white portion of the eye (sclera). The eyebrow should also be above the brow bone. For men, the brow is classically located just at the horizontal level of the brow bone and is typically straight rather than arched. 

As you know, styles do change and the “classic” rules are broken with evolving culture. A decade ago, pencil-thin eyebrows were trending with beauty models and celebrities. Women would use many different methods of tweezing, wax strips, and threading to obtain the sharp, thin eyebrow look. It was a sign of beauty to have the eyebrows raised well over the eyebrow bone. 

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However, in this current era we see supermodels and social influencers flaunting their thick, horizontal eyebrows. In my opinion, it is false to assume that every woman with low-set eyebrows would look better with them elevated. The eyebrow should match the face, personality, and your personal preference, which you can discuss with your facial plastic surgeon during your consultation. 

Brow aging is a dynamic process that varies based on gender, race, ethnicity and other individual factors. Volume loss also plays a considerable role in the upper face, causing the descent of the brow. As we grow older, our fat pads in the temporal region (our temples) start to atrophy. The hollowing effect immediately exposes our lateral arch bone which creates a “skeletonizing” look. 

Additionally, our thick eyebrow skin starts to thin and becomes less pliable. As the eyebrow changes from being high and tight over the brow bone to more elastic, the skin starts to droop. This creates shadows over the transition point of the upper eyelid and the eyebrow—a sign of aging

As the eyebrow ages, the creases in the surrounding skin are accentuated. Horizontal wrinkles can be seen because of the underlying muscle which we call “crow’s feet.” Forehead wrinkles form above the eyebrow to compensate for the drooping eyebrow and try to hold it up. Forehead furrows and frown lines start to appear near the central portion of the eyebrows as well. 

 

Keep Your Eye on the Ball During Surgery Consultation

The complaints I hear the most from a patient for eyelid or brow lift surgery consultation are “I have puffy eyes” or “I look tired and angry.” The proper evaluation should be a holistic one, taking into consideration the patient’s age, gender, personality, weight, and occupation.  

When I evaluate the upper one-third of the face, I begin from the top down. I look at features such as the hairline, characteristics of the skin, and the amount of skin redundancy. This will all play a role in which procedure and technique I will use. 

I have noticed most patients draw attention to their eyelids first. The excess skin in the upper eyelid bothers them the most. But a lot of the time, patients do not even notice that they are contracting their forehead muscles at rest and unknowingly lifting their brows to compensate for the extra skin redundancy in their upper eyelids. 

Oftentimes, I will stabilize the brow in its natural resting position and ask the patient to close and open their eyes to identify the precise eyebrow position. If I find that the eyebrow is no longer in a youthful position, I will often recommend that the patient consider a brow lift. Next, I look at the amount of skin redundancy of the upper eyelid by doing a pinch test. Often there still is excess skin, in which case an eyebrow lift would complement the eyelid procedure

I always let patients know if they are a candidate for a brow lift procedure to address droopy eyebrows, because many patients are not aware of this option or how it can benefit them. In fact, some patients end up getting overly aggressive upper eyelid surgery performed elsewhere by other surgeons without ever being counseled on the brow lift procedure. If this happens, the patient may not be able to have a brow lift in the future to achieve that youthful and rested appearance they were seeking. 

Finally, I assess at the lower eyelid. I evaluate the puffiness around the eyes. I perform a “snap test” in which I pull the lower eyelid down and monitor the time it takes for the lid to “snap back” to its normal position. I evaluate the skin quality of the lower eyelid and how elastic it is. If any of these features bother the patient, I recommend a lower eyelid surgery. 

Performing isolated upper or lower eyelid surgery is rare. When one portion of the eyelid is rejuvenated, attention will be drawn to the other. Therefore, most patients undergoing eyelid surgery prefer to have both the upper eyelid and under-eye area treated at the same time.  

Which Is the Right Procedure For You?

The right procedure depends entirely on your individual features. One thing is for certain: the eyebrows and eyelids need to be evaluated together. 

If elevating the brow reduces the hooding of the eyelid to your satisfaction, a brow lift might be the right procedure for you. However, if you still have extra skin hanging from your eyelid despite lifting the brow, you are a good candidate for upper eyelid surgery. If you have lower eyelid bags or drooping or sagging skin, lower eyelid surgery will restore your youthful appearance. 

There is no cookie-cutter answer to choosing the right procedure. Your facial plastic surgeon must customize and tailor a plan that is the perfect fit for you!

If you are interested in pursuing eyelid surgery or brow lift surgery in Melbourne, Florida or want to know if you are a good candidate for both, please schedule your consultation with Clevens Face and Body Specialists to learn more about these procedures and find out if they can benefit you.

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