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Botox, Browlift, Blepharoplasty: How Do I Choose?

By Dr. Sutton Graham on June 25, 2008


How do I tell which procedure or combination will give me an improved appearance around my eyes? Well, during an in-person consultation, we would demonstrate on your face and help you decide, but here are some hints:

1. Frown lines and squint lines or crow's feet respond to Botox treatments. A browlift may give longer lasting improvement in frown lines, but more motion will usually remain. Only the Botox will reliably improve the squint lines.

2. Excessive active lines crossing the forehead do not go away with typical browlift. Instead the entire forehead unit moves up a little (gravity has pulled it down). Botox can diminish the lines, or make them go away if they're mild.

3. Be careful about using Botox for too much forehead treatment. You may have either no natural forehead expressions (people wonder about you) or you may have drooping brows (we use our forehead muscles to lift our brows).

4. If your eyebrows are slightly too low, a little Botox beneath the inner and outer corners can give a little lift, without surgery.

5. If your eyebrows and thick skin just under the brows closes-in around your eyes, that responds best to surgical browlift. In addition, that procedure may improve your upper eyelid appearance.

6. Hooding of the eyelid skin over the lid or lashes improves with blepharoplasty (eyelid lift, tuck)

7. Puffy, thick upper eyelid folds respond to blepharoplasty.

8. Finally, a laser peel can greatly improve the texture of the eyelid skin. Sometimes that would be enough, without skin removal.

Obviously, some or all of these techniques may work together to enhance your appearance.

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