Both a brow lift and upper blepharoplasty can improve upper eyelid hooding. For too long, a high-positioned or high-arching brow was seen as a sign of youth. That notion is clearly challenged by the many young, attractive models in magazines who have low brows. Dr. Patel's approach to this question is to ask the patient if they feel that their brows have descended with aging.

A brow lift is a bigger procedure, but has the added benefit of improving the position/shape of the brow and softening forehead lines. For those whose brows have dropped, or who also want to treat glabellar and forehead lines, a brow lift may be best.

For those who feel their brows look the same or prefer low brows, an upper bleph may be the best procedure. Sometimes, a patient will need both. It is all about choosing the right procedure for a given patient.

Dr. Patel's advice is the following:

1. If you do believe your brows have lowered over time or flattened, a brow lift may be the best procedure. Also, a brow lift allows the forehead and glabellar muscles to be weakened (like a longer lasting Botox treatment) to relax the “eleven” and forehead lines.

2. If you like the position of your brows and believe they have always been about the same, then an upper blepharoplasty may be best for you.

3. If you have very heavy upper eyelid skin, then a combination of both may be necessary but with great restraint and in the hands of a specialist.