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June 17, 2025
The question of blepharoplasty or brow lift usually starts with a story just like this one.
A patient came in with a complaint saying she had droopy lids and wanted a refreshed look. She pointed to the lids on her eyes, saying they were “hooded” and needed to go.
She was asked to let the muscles on her forehead relax. The idea was to see if she could find a way to release the constant tension in her forehead by simply relaxing. She couldn’t do it.
It is normal for most people to fail at this the first time they are attempting it.
She had been holding her eyebrows up for so long that when she released them, she felt as though she was about to fall off a chair. It took her several attempts before she succeeded.
After she released the tension in her eyebrows, her eyelids dropped slightly, and then everything looked different. The lines on her forehead weren’t from getting older, but fifteen years of working overtime had shifted the blame to her eyelids, when in fact, it was the eyebrows that had fallen.
If you are weighing blepharoplasty or brow lift right now, you might be pointing at the wrong suspect. We have a simple test for you to identify the problem.
Prefer to watch? It's all covered in the video below.
Try it now, before you read on
This is a test everyone can do from home.
- Step 1: Look straight at your mirror.
- Step 2: Relax your forehead.
- Step 3: Hold this position.
You might experience one of the two below:
- Your face will likely cheat and pull the eyebrows downward, which makes the eyelid look heavy.
- If you don’t notice anything moving or changing, then the skin on the eyelid is probably the issue.
Most people experience both, and just to clarify, it’s totally normal to have both issues.
It does not necessarily mean everything needs treatment.
Another good tip:
When people with limited expressions develop strong horizontal lines across their foreheads, it typically means that they are using their forehead muscles to raise their brows all day long. They were never meant to perform such a task; hence the wrinkles.
Hooded eyes feel like a single issue, but they can, in fact, be two.
Over time, eyebrows tend to droop and press on the lids. In the same manner, skin on the lid can also accumulate in excess and fold directly over the eye. Both look the same from the outside.
There is one other potential cause of hooding that should be discussed. In rare instances, the muscles responsible for lifting the eyelid become weak. When this happens, there is a loss of symmetry in the eyelids, also known as ptosis. This is completely different from a blepharoplasty. If your eyebrow appears normal and your skin looks fine, but you still have low eyelids, then we need to address this individually.
Upper eyelid surgery, or blepharoplasty, is performed to remove excess skin from the eyelid. Incisions are placed along natural folds of the eyelid. However, this doesn’t raise your eyebrows. If your eyebrows descend and the skin from your lid is removed, your eyebrows remain in the same position as they were prior to surgery, and you continue to experience frustration.
Brow lift surgery, also called forehead lift surgery, corrects positional issues by raising your brow back to its original position, relieving the pressure on your eyelids, allowing your forehead muscles to get some relief.
Depending upon your anatomy, this could be done via a more conservative method utilising direct browlift techniques, an endoscopic approach utilising smaller incisions, or a more complicated temporal lift addressing the most significant droop of the brow.
More information about how each of these procedures works can be found on our eyelid surgery and brow lift pages.
What’s important is not which procedure sounds better.
What is important is which one is causing the actual problem.
One thing to clear up while we are here. Everything on this page is about upper eyelids. Lower lids and under eye bags are separate operations for a separate problem. If that’s what is bothering you, then this isn’t quite your article.
The order matters more than the price
The upper lid needs sufficient skin to allow closure of the eye at nighttime. It’s not just about the appearance but also protection and lubrication of your eyes during sleep.
If the brow is not lifted and additional skin is removed from the eyelid, there will be no extra skin to use later. Therefore, you cannot lift the brow later as there won’t be enough skin to allow for comfortable closure.
This situation is common amongst patients who arrive here after having had surgery at another location. The issue of insufficient skin to close the eye comfortably can be very difficult to address and is stressful for the patient.
So brow position is assessed first. Eyelids second, every time.
One decision can be revisited later. The other is final and permanent.
What about the non-surgical options?
A question we get asked all the time, usually along the lines of something like “can’t I just have something injected?”
In all honesty, sometimes, yes. Anti-wrinkle injections may help relax the muscle that is pulling your eyebrow down, thereby creating a couple of millimetres of lift. Fillers can support volume loss in the temples, and each treatment has its own place.
However, neither can fix a dropped brow or eliminate extra skin.
One patient came in after she spent what would be equivalent to thousands of pounds in injectable treatments over multiple years and returned to us almost annually to continue getting progressively less satisfied. At one point, she told us she felt as if she was renting her forehead. She wasn’t far off. A complete evaluation revealed that she should have undergone a brow lift right from the beginning and that the use of the injectables was merely delaying the inevitable.
If a clinic tells you that an injection is going to provide the same results as a surgical procedure on a truly sunken brow, that is clearly a sales pitch and not a fair assessment.
Laser blepharoplasty is often promoted using CO2 lasers. Here’s how they actually work. The laser can improve fine crepey lines and texture around the lower eyelids by resurfacing the skin. However, it cannot take away a fold of excess skin. Some surgeons prefer to use a laser instead of a scalpel to create the incision in traditional blepharoplasty. That is primarily a technique decision and not a different type of surgery.
Kliniken offers CO2 laser treatments, and they’re great for improving the quality of the skin texture. Most patients end up needing both. The laser improves the texture around the area where the surgery removed the fold. Lasers are never used as alternatives to an operation that needs to happen.
Do you need both?
These two surgeries are never done in the same session at Kliniken. A lot of swelling occurs when you do these together. This swelling can cause distortion of your eyelids, sometimes requiring redoing your eyelid surgery. In addition, brow lifts require much more physical effort than blepharoplasty alone, therefore putting undue stress on your body by doing them simultaneously.
When you require both, we only follow a staged process.
- Firstly, the brow lift is performed as it determines exactly what your upper eyelids will require.
- Once you are completely healed from the brow lift, the eyelid surgery is performed.
By staging the two surgeries, each one heals independently without competition for the same swollen tissue, and you feel less pressure during the recovery process.
At Kliniken, our process is built around transparency more than anything, and we will never compromise or withhold information that could ease your mind about which process to go with.
Will the NHS pay for it?
Sometimes. But it’s mostly a functional decision, rather than cosmetic. The NHS will perform eyelid surgery if the excess skin obstructs your view. It doesn’t matter how you feel or that you appear tired.
Local GPs have varying standards for what constitutes an obstruction, and optometrists also frequently identify these conditions. A person walks in for an eye exam as part of their normal care, hears no mention of eyelid surgery during the exam, and leaves with a confused expression as to why a specialist clinic offering plastic or cosmetic surgery is now being discussed. This is totally normal and has nothing to do with vanity.
Peripheral vision is an important function of sight to protect. If you’re concerned about how you appear rather than how much of the world you can see, then you’re looking at having eyelid surgery done privately.
What it costs
Blepharoplasty cost depends upon how many eyelids you want operated on (upper, lower, or both), as well as if you choose to do a brow lift along with your blepharoplasty.
The fees for blepharoplasty or brow lift are posted on the pricing page, and the price listed there is the cost for blepharoplasty or brow lift at Kliniken.
There is no surprise bill after you consult us.
If it is an issue to pay the entire amount when you first visit us, we offer payment plans. This is certainly a better alternative than getting something cheaper, hoping it will work.
A “less expensive” procedure that accomplishes nothing is easily the most costly item listed here.
Recovery, honestly
People often plan their weddings based on when they will get back into a normal routine after surgery.
The amount of time that you can expect to see swelling or bruising is typically anywhere from 10 days to 2 weeks post-surgery. However, it may take longer than that, depending on how your body deals with physical trauma.
This is probably the worst part of getting cosmetic surgery, but it is also something that most people tend to exaggerate. For example, most patients feel comfortable being seen in public long before all of the swelling has completely resolved. There is a big difference between feeling healed or recovered, and looking like you had a successful surgery. Typically you would want to avoid anything physically demanding for approximately four weeks after either procedure.
Under local anaesthesia, blepharoplasty means going in, staying awake and comfortable throughout, and leaving the same afternoon.
What going wrong actually looks like
Photographs of blepharoplasty or brow lift surgery gone wrong can be easily found online. A simple search for “eyelid surgery gone wrong” will give you many cases. The majority of these types of failures fall into one of two groups.
- Either too much skin has been removed so the eyelids don’t close.
- The wrong initial surgical approach was taken in terms of how to improve the brow; therefore, no attempt was ever made to address the brow.
Both tend to stem from the exact same mistake of deciding before assessing, which is why brow position is checked before any adjustments are made.
What about men?
Men generally arrive late and quietly. They are often encouraged by others, such as a colleague who asks them if they got poor sleep or a coworker who asks them about their appearance after taking a photo at a work function, which does not sit well with them.
Generally, there is no real concern. It’s just a worry of looking tired or irritable, but in fact none of those things are true.
Anatomy differs just enough to make this matter. In general, the male brow is naturally placed lower and less prominent; therefore, lifting a male brow in order to achieve a similar lift to a female brow will result in an unintended surprised expression. The approach to eyelid surgery varies depending on each face, and most patients want to appear rested post op versus appearing to have had obvious surgical intervention.
At Kliniken, eyelid surgery for men is one of the fastest growing procedure types for men, but it’s rarely discussed.
Where this leaves you
The honest answer to what procedure you need is something that cannot be determined by looking at your picture alone. Even if you post multiple pictures of yourself, no one will ever know from those pictures.
You have to consider brow positioning, the texture of your eyelid skin, and how much your forehead is compensating for these two areas to get a clear answer as to whether you are going to get less than expected.
After this, a simple decision would follow.
Before committing to anything, book a consultation.
Frequently asked questions
- Can blepharoplasty go wrong? Yes, if done by inexperienced hands. Dry eyes for a few weeks is the most common one. Taking too much skin is the complication that matters most, & it’s why brow position is checked first.
- Is blepharoplasty worth it? For the right problems, absolutely.
- What age should you have blepharoplasty? Whenever it starts bothering you. Patients in their thirties and their seventies have both had this done. Eyelids don’t care what year someone was born.
- Will blepharoplasty get rid of my wrinkles? No. It takes skin off the lid. Crow’s feet & forehead lines are different problems. If forehead lines come from holding a heavy brow up, that’s a brow lift job.
- How many times can you have blepharoplasty? Usually once. Every operation uses skin that doesn’t grow back, so there may not be enough for a second go.
- How long does blepharoplasty last? A decade or more, often for good. Brow lift surgery holds up similarly well. Neither one stops the ageing process; they just move the starting point.
- Can I get eyelid surgery on the NHS? Only if the skin is measurably blocking vision. Not if it’s simply bothersome in photos. A GP or optician will confirm where things stand.
- Is a non surgical brow lift any good? For a small lift, yes. For a brow that has properly dropped, no. Nobody has ever injected skin away.
Still not sure which one you need?
That’s the normal state of arrival.
Come in, do the forehead test with our expert team at Kliniken, and get a straight answer either way.
