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Similar to the question of whether the chicken or the egg came first, there’s a minor controversy about sagging eyelids. The reason for this is because eyelid droop can be caused by a descending brow, the development of excess eyelid tissue, or both. An experienced facial plastic surgeon like Dr. Eugenie Brunner can identify whether the brows, eyelids, or both are contributing to your concerns. In the event that both forces are at work, a combination of brow lift surgery and an eyelid lift may be recommended.

Brow lift surgery (sometimes called a forehead lift) can elevate the descending tissues of the forehead to a higher, more youthful position. This can soften wrinkles and take the weight off heavy brows. If the forehead is contributing to eyelid droop too, this procedure can help open up the eyes and give them a more rested appearance. However, if excess eyelid tissue is also present, as is often the case, the brow lift will only provide partial rejuvenation of this area. Additionally, a brow lift typically will not improve the appearance of the lower eyelid area.

Eyelid surgery (blepharoplasty) is specifically designed to remove excess skin (and sometimes fat) from the upper and/or lower eyelids. If the brow is in a good position, eyelid surgery alone can often effectively address hooding and droop. However, if the brow is a contributing factor, this procedure alone may not achieve the desired result, and eyelids may re-develop sagging skin relatively quickly.

Each patient’s needs and cosmetic goals will be unique. During your initial meeting, Dr. Brunner will carefully evaluate your anatomic indicators to develop a customized treatment plan. She will also provide you with the information you need to make the best decision for you.