Sagging Upper Eyelids: Do I Need a Browlift Too?

Most individuals are best served by eyelid surgery (blepharoplasty) alone to restore a youthful appearance to the upper eyelids. Browlifts add a layer of complexity to the process, as well as increased operating time and cost. However, browlifts significantly improve results when used in the right situations. Also, the recovery time is about the same as with a blepharoplasty alone. Modern methods require only a few small scalp incisions. This reduces the scope of the procedure compared to older techniques and minimizes the risk of hair loss, which is an important concern for many patients.

When is a browlift unnecessary?

Low eyebrow position by itself is neither abnormal nor a sign of aging. Many individuals have them from an early age and it is part of their facial character. Therefore low eyebrow position by itself is not a sufficient reason for a browlift. Experienced surgeons appreciate this and realize that having the tools to raise the eyebrows does not justify a knee-jerk reaction to do so.

So who really needs a browlift?

The best candidates for a browlift are older individuals with both upper eyelid hooding and drooping eyebrows. One of the effects of sagging eyebrows and adjacent forehead tissues and is that it obscures the underlying bony shape of the upper orbit. Blepharoplasty alone is not sufficient in these individuals to both restore a crisp appearance to the upper eyelids and reveal the smooth orbital contour that is also a hallmark of eye beauty. Adding a browlift in these situations will accomplish both goals while also permitting less aggressive eyelid skin removal and a shorter upper eyelid incision. A combined procedure like this produces a pleasing and natural result (Figure 1).

454a7d0ffe4c6478a616415a3082a197
FIGURE 1. DROOPING EYEBROWS AND FOREHEAD TISSUE OBSCURES THE SHAPE
OF THE OUTER ORBIT AND ADDS TO THE PERCEPTION OF EXCESSIVE UPPER
EYELID SKIN (LEFT). A COMBINED BROWLIFT AND UPPER BLEPHAROPLASTY
EFFECTIVELY RAISES THE EYEBROW POSITION, REVEALS THE SMOOTH
SHAPE OF THE ORBIT, AND REJUVENATES THE EYELID APPEARANCE (RIGHT).

What about browlifts in men?

Men typically have lower eyebrows than women. Browlifts can look feminizing or odd in men. As a rule they are not recommended. Even very low eyebrows associated with hooded upper eyelids are best treated with blepharoplasty alone in men. However in extreme cases it is possible to do a conservative lift of the eyebrows called a browpexy. This is done through the blepharoplasty incision and is much less involved than a browlift.

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A new drawing continuing in the American flag theme!

#flag #American #girls

A new drawing continuing in the American flag theme!

#flag #American #girls
...

Reverse abdominoplasty is appealing but only applys to those who have all of the following:

1. Loose skin in the middle
2. A perfect lower abdomen
3. Tight muscles
4. Breasts that will hide the scars or existing surgical scars in the breast crease

 Unlike traditional abdominoplasty, done for a different purpose, there is almost no swelling, little discomfort (no muscle work), and the scars are hidden. As indicated above though, true candidates for this procedure are uncommon. 

For the surgeons: this procedure is conceptually simple but challenging to execute. Enough skin has to be removed (4 cm or so) to get the job done yet avoid midline bunching. The inframammary crease has to be re-established and this is most effectively done sitting up, a tedious process!

#abdomen #tummy #wrinkles

Reverse abdominoplasty is appealing but only applys to those who have all of the following:

1. Loose skin in the middle
2. A perfect lower abdomen
3. Tight muscles
4. Breasts that will hide the scars or existing surgical scars in the breast crease

Unlike traditional abdominoplasty, done for a different purpose, there is almost no swelling, little discomfort (no muscle work), and the scars are hidden. As indicated above though, true candidates for this procedure are uncommon.

For the surgeons: this procedure is conceptually simple but challenging to execute. Enough skin has to be removed (4 cm or so) to get the job done yet avoid midline bunching. The inframammary crease has to be re-established and this is most effectively done sitting up, a tedious process!

#abdomen #tummy #wrinkles
...

Breast feeding results in atrophy of the gland, often manifesting as a deflated appearance. In these cases, the most common type, breast implants alone will re-establish pre-pregnancy aesthetics by simply replacing lost volume. More complex cases, like this one, also require removal of stretched skin to provide a simultaneous lift. When skin is removed it only takes a small implant to restore upper breast fullness. 

For the surgeons: Since implant size is small in these cases it typically represents less than 40% of total breast volume. Therefore the “feel” advantage of silicone implants typically becomes moot. Saline implants in this  setting are reliably stable for 20 years or more and are therefore preferred (125cc saline implants in this case).

#breast #lift #restore

Breast feeding results in atrophy of the gland, often manifesting as a deflated appearance. In these cases, the most common type, breast implants alone will re-establish pre-pregnancy aesthetics by simply replacing lost volume. More complex cases, like this one, also require removal of stretched skin to provide a simultaneous lift. When skin is removed it only takes a small implant to restore upper breast fullness.

For the surgeons: Since implant size is small in these cases it typically represents less than 40% of total breast volume. Therefore the “feel” advantage of silicone implants typically becomes moot. Saline implants in this setting are reliably stable for 20 years or more and are therefore preferred (125cc saline implants in this case).

#breast #lift #restore
...

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