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When it comes to facial rejuvenation, no two patients – and no two surgical recommendations – are exactly the same. In this edition, I will address a very common concern: how to refresh aging eyes while choosing the right surgical approach.
A patient writes: “Dr. Wolf, I’m concerned that I’m looking older, and my eyes appear puffy with extra skin over my upper lids. I have consulted with two surgeons who have given me different recommendations. One suggests that I should have my lower lids done along with a brow lift, while the other recommends an upper lid blepharoplasty and lower lids but no brow lift. What is your recommendation?”
In all my years of expertise in facial plastic surgery, my approach with clients has been to break down the options, discusses the key factors in choosing the right procedure, and provide them with valuable insight into achieving natural, youthful-looking results.
If you’ve ever wondered whether a brow lift, blepharoplasty – or a combination of both – is the best approach for you, this is a must-read. Let’s dive in.
When deciding between upper and lower blepharoplasty versus a forehead lift, the key factor is determining the root cause of your concern. If the primary issue is excess skin in the upper lids and puffiness in the lower lids, then upper and lower blepharoplasty would be the most direct and effective solution. This procedure removes excess skin and fat, creating a more refreshed, open appearance without altering the position of the eyebrows.
On the other hand, if the heaviness around the eyes is due to brow descent, where the eyebrows have lowered over time and caused the upper eyelids to appear hooded, a forehead lift can help reposition the brows to a more youthful height. However, since you have concerns about a high hairline, this procedure would need to be carefully planned. A traditional endoscopic forehead lift could elevate the hairline, while a modified approach, such as a hairline-lowering or trichophytic brow lift, may help prevent that issue.
Ultimately, the best choice depends on facial anatomy and aesthetic goals. If the primary concern is excess eyelid skin, blepharoplasty alone may be sufficient. If the brows have descended significantly, a forehead lift may be beneficial, but techniques that preserve the hairline can be explored.
A detailed evaluation would help determine the best approach. because of your concern, it is important to choose a board certified facial plastic surgeon, or a board certified plastic surgeon who specializes in facial surgery, so that you don’t end up with a great looking eye operation – but look older because your forehead now is enlarged. When choosing, be sure you see before and after pictures and discuss your concerns with your surgeon.
Dr. Carlos Wolf is a partner at Miami Plastic Surgery and is board certified. Email your questions to cwolf@miamiplasticsurgery.com or call 305-595-2969. You can also follow him on Instagram @CarlosWolfMD or visit www.miamiplasticsurgery.com.
