Blepharoplasty vs. Brow Lift: What To Know

One look in the mirror and the reflection tells you that the area around your eyes might benefit from a little cosmetic surgery. So, what type of procedure should you consider?

Either an eyelid lift (blepharoplasty) or brow lift can “brighten” your peepers and help you look more youthful and alert. But while both surgeries may improve the real estate around your eyes, they do so in different ways.

Let’s look at the options with ophthalmologist and oculoplastic surgeon Julian Perry, MD.

Reasons for an eyelid or brow lift

Time isn’t always kind to your skin. As birthdays add up, your skin naturally and gradually loses some of its elastin and elasticity. That aging effect can lead to saggy and baggy skin building around your eyes.

That droopiness can make you look sad and tired, which typically aren’t sought-after appearance features.

But reasons for an eyelid or brow lift often extend beyond the cosmetic, too. Loose skin accumulating around your eyes and eyelids can cause eye fatigue and eventually interfere with your field of vision.

“These procedures can take care of those problems as well,” notes Dr. Perry.

The difference between eyelid and brow lifts

Both procedures target sagging skin around your eyes. The approaches, however, are very different, says Dr. Perry. Ditto for some of the results you see.

Let’s break down what happens during both surgeries.

What a blepharoplasty treats

A blepharoplasty (eyelid lift) focuses specifically on the skin right around your eyes. There are two types of eyelid surgery. One aims high while the other goes low:

• Upper lid blepharoplasty removes skin (and sometimes fat) from your upper eyelid. “This is a very straightforward procedure,” explains Dr. Perry. “It involves light sedation and takes around a half-hour in expert hands.”
• Lower lid blepharoplasty addresses bags and hollows beneath your eye. The procedure involves a small incision to allow for the removal or repositioning of fat. Excess skin may be tightened up, too.

A blepharoplasty can improve some dark circles, but not the ones caused by extra skin pigment. (Sorry.) It’s also not the solution to pesky crow’s feet at the corner of your eye or other facial wrinkles that spread out into an unwanted roadmap. (Sorry, again.)

The good news, though? Those issues can be addressed with other procedures (such as wrinkle-reducing laser resurfacing) that can be done in conjunction with an eyelid lift. Nonsurgical solutions, such as Botox® and fillers can help with these areas as well.

What a brow lift treats

As the procedure’s name implies, the surgical work on a brow lift takes place above your eyes.

Incisions for the skin-tightening procedure typically are made near your hairline, explains Dr. Perry. Segments of skin, tissue and muscle can then be moved to smooth out forehead wrinkles, soften frown lines and lift sagging eyebrows.

The effect of a brow lift is limited primarily to your eyebrows (which will appear to be slightly higher) and your forehead. By lifting eyebrows and heavy skin up from the eyelids, some of the upper eyelid bags will be lessened. But the procedure doesn’t remove any of the extra eyelid skin.

The surgery can take anywhere from one to two hours depending on the amount of work being done. A brow lift also can be done in conjunction with other cosmetic surgeries, such as a facelift or laser resurfacing.

How long do eyelid or brow lifts last?

Cosmetic surgery may turn back the clock on your appearance, but it doesn’t stop time.

“The results of these surgeries last a lifetime, but the aging process will always continue,” says Dr. Perry. “In other words, your face — just like the rest of you — will keep getting older and aging will likely begin to show at some point.”

It often takes a decade or more for the aging process to begin leaving its mark again. Follow-up cosmetic procedures (like Botox) can be an option at that point.

You can also keep your facial skin looking more youthful by:

• Regularly applying moisturizer and sunscreen.
• Not smoking.
• Using chemical peels for fine wrinkles.

Are these cosmetic surgeries safe?

Any surgery comes with risks. (It is a surgery, after all.) But overall, eyelid and brow lifts are extremely safe, reassures Dr. Perry. Odds are you’ll only experience some swelling or bruising that is gone in a week or so.

There is a chance, however, for negative cosmetic results such as an asymmetrical appearance. Scarring or skin discoloration is also a possibility, though new techniques can correct or minimize these issues.

Major issues such as blurred vision or loss of eyesight, bleeding, infection, nerve damage or other problems are rare.

Are you a candidate for an eyelid or brow lift?

If you’re physically healthy and want to address skin droopiness around your eyes, consider yourself a candidate for either procedure. Talk to a healthcare provider to decide the best route for you.

An eyelid lift may be the better course of action if your concern solely centers around your eyelids. A brow lift can help with some eyelid issues but addresses more issues from the eyebrows up.

“If you’re thinking it’s time to take action against bags and wrinkles around your eyes, start the process by talking with a surgeon who specializes in these techniques,” advises Dr. Perry. “Weigh all of your options before making a decision.”