Blepharoplasty and Brow Lift in West Hollywood | Benjamin Eye Institute

You look in the mirror and see skin hanging over your upper lids. You look tired. People ask if you slept badly. The obvious fix seems simple: remove the extra skin.

It isn’t always that simple, and when the real cause is missed, the result can be worse than where you started.

The problem is often the brow, not the lid

With age and gravity, the eyebrow can descend. When it drops below the bony rim of the eye socket, skin that should sit under the brow is pushed down onto the upper lid. It looks like extra eyelid skin. But the problem is the position of the brow, not the amount of skin in the lid.

Many patients also compensate without knowing it. They lift their brows all day to keep the lids open, which can cause tired forehead muscles, headaches and a constant sense of fatigue.

What goes wrong when only skin is removed

If the brow is low and surgery removes only lid skin, three things can follow:

1. The brow is pulled lower. Removing skin shortens the outer layer of the eyelid, and that shortening pulls the brow further down.
2. The face looks angry or tired. A lower, heavier brow over a tight lid creates a stern, scowling expression, the opposite of the refreshed look you wanted.
3. The eye can become dry. A lid that is too short does not close or cover the eye the way it should. More of the cornea is exposed and tears evaporate faster, leading to burning, tearing and dry eye you may not have had before.

Why it matters that your surgeon is an ophthalmologist

Your eyelids, brows, tear film and cornea work together as one system. Form follows function. An eyelid operation that looks good for a month but leaves the eye uncomfortable for years has failed.

As an ophthalmologist who performs eyelid surgery, Dr. Benjamin plans each case from the inside out. He looks at:

• The position of your brow, at rest and when relaxed
• The strength and height of the upper lid, and whether a droopy lid (ptosis) is present
• How completely your lids close
• The health of your tear film and oil glands
• And only then, how much skin, if any, should be removed

Possible treatment plans

Depending on what the examination shows, the right plan may be:

• Conservative removal of excess lid skin
• A brow lift, alone or combined with eyelid surgery, to restore the brow to a healthier position
• Treatment of a droopy lid
• Treating dry eye first, so surgery doesn’t make it worse
• Non-surgical options, such as Morpheus8, PRP, Botox and fillers, when they will give you what you want
• And sometimes, a recommendation not to operate

We start with the gentlest option that will work and use surgery when surgery is the right answer.

Considering eyelid surgery?

Start with an evaluation that looks at the whole picture: brow, lids, tear film and eye health. Then you will know whether blepharoplasty, a brow lift, a combination, or something else will really give you the result you want.

Call 310-299-2056 to schedule an eyelid evaluation with Dr. Benjamin.