The eyes are great communicators — able to evoke a range of emotions in the blink of, well, an eye. But what if the expression you’re presenting is not one you’re actually feeling? With age comes the loss of elasticity, and this may result in droopy eyelids, a lowered brow, and, for some, the appearance of fatigue or sternness.
When age has taken its toll, a full eight hours of sleep isn’t enough, and/or you find your vision slightly strained, it may be time for surgical intervention. Blepharoplasty (a.k.a. eyelid surgery or eyelid lift) and browplasty (a.k.a. brow lift or forehead lift) are both common treatment options for aging and tired eyes, but what happens when you combine the forces of these two upper face rejuvenators? We spoke with Minnesota-based double board certified facial plastic and reconstructive surgeon Peter Hilger, MD, to learn more about these procedures and why they’re even better when paired together.
Blepharoplasty vs. Brow Lift
Both blepharoplasty and brow lift individually treat the upper third of the face to create a more taut, youthful appearance, but there’s more to these eye rejuvenation solutions than meets the eye. Here’s what you need to know:
Addressing the skin either above or below the lash lines, there are numerous types of blepharoplasty to treat an array of aesthetic and functional concerns (yes, this is one of the few cosmetic procedures that may be covered by insurance). An upper eyelid blepharoplasty specifically addresses sagging skin in the upper eye area, while a lower eyelid blepharoplasty can be used to treat under eye bags, excess skin, and more. For patients with a monolid who wish to add an eyelid crease, an Asian blepharoplasty may be performed.
Regardless of the type, Dr. Hilger notes that blepharoplasty techniques have evolved over time to deliver more natural results. “In years past, upper and lower blepharoplasty focused on removing — by surgical excision — redundant skin that created hooding and an aged face,” he explains, adding that this often led to a gaunt or hollowed appearance. Today's approach is more comprehensive and “includes tightening the supportive structures of the eyelids, repositioning some of the lax skin to preserve youthful contours, excising excessive skin that can block vision, or repositioning bulging fat pads,” he shares.
These below-the-brow procedures can, he says, “provide a smooth contour that starts at the lash line and continues across the eyelid-cheek junction.” Another benefit? The surgery also has the ability to “resurface the eyelid to reduce fine wrinkles that can not be corrected by skin excision,” Dr. Hilger notes.
As its name suggests, a brow lift lifts the brow. The primary impetus to undergo a brow lift is to correct the loss of elasticity that makes the forehead skin drape poorly. Done via small incisions hidden under the hairline, modern versions of the surgery create a natural lift as opposed to the ‘surprised’ appearance of brow lifts past. “A brow lift repositions the brow higher, which makes the eye aesthetic zone look larger, reduces wrinkles as the skin is tightened, and reduces some eyelid hooding,” Dr. Hilger explains. It should be noted that the so-called ‘chemical brow lift’ performed with neurotoxins (read: Botox®) can provide a temporary (think: three to four month) lift, but surgery is the best bet for those looking for long-term correction.
Benefits of Combining Blepharoplasty + Brow Lift
As we’ve covered, maintaining facial harmony is the main objective of any facial aesthetic treatment, and sometimes that means combining procedures for best results. So, how can this dynamic duo of blepharoplasty and brow lift be beneficial?
- It’s Cost-Effective: “Combining the procedures in one setting is more expensive than an isolated intervention, however, the cost is less than performing them individually,” Dr. Hilger explains. While he cautions that cost should not be the driving factor behind your decision, it will be more budget-friendly than going back for a second procedure.
- It’s Time-Effective: Surgery requires time for both the procedure and the recovery. According to Dr. Hilger, pairing the two together will take one to two hours and the recovery process will only be experienced once.
- It’s Less Painful: Some level of discomfort is to be expected after surgery, but, as we mentioned, combining the healing processes will save you from dealing with two rounds of recovery.
- It Looks More Natural: If both the brows and lids are heading south, correcting them at once may offer the most comprehensive result. “Addressing changes that span aesthetic zones provide a more natural result, as the transition from one aesthetic area to another is blended,” Dr. Hilger says.
- It Cuts Down on Maintenance: “The results are remarkably lasting and additional rejuvenation is rare for a decade,” Dr. Hilger shares. While the natural aging process will continue to be in play, the lifespan of each procedure is about 10 years.
The Ideal Candidate for Blepharoplasty + Brow Lift
This paired approach is preferred for patients who want a “natural rejuvenation that focuses on harmony, more comprehensive correction, and a more sophisticated result,” Dr. Hilger says. “These combined procedures are ideal for patients who have aging changes that go beyond isolated lid laxity.” When searching for the right provider, he recommends evaluating as many before and after photos as possible. “The results are best demonstrated with images rather than words, so study the before and after images attached,” he says.
Recovering from Blepharoplasty + Brow Lift
Post-op recovery of a combined blepharoplasty and brow lift will be similar to that of a solo eyelid or brow surgery. “After surgery, ice is your friend to reduce swelling,” Dr. Hilger says. Sleeping must be done upright, and physical mobility (aside from light movement) may be limited for a few days. But, for those worried about the length of recovery, Dr. Hilger says that “you will be back to your normal activities and social life in 10 to 14 days.”
When it comes to eye rejuvenation, many procedures can fit the bill, but, for those who are concerned about a lowered, droopy eyelid and sagging brow, pairing an upper eyelid blepharoplasty and brow lift may provide the most impactful result. “The combined approach is more comprehensive, provides greater visual field correction when lax skin blocks vision, provides more durable results, and generates a superior natural change,” Dr. Hilger concludes. Remember, genetics, lifestyle, and other external factors play a role in how your face ages, so be sure to consult with a board certified plastic surgeon to ensure you receive the best treatment for your aesthetic concerns and goals.
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