Brow Lift Surgery for Hooded Eyes | Natural Eye Rejuvenation
Understanding the Benefits of a Temporal Brow Lift
Hooded eyes can make you look tired, serious, or older than you feel. For many people, the issue is not just the eyelid. The position of the eyebrow, the quality of the skin and the underlying eyelid muscles all work together to shape the upper eye area.
A brow lift can be a powerful way to open the eyes and soften heaviness.
In some patients, the best result comes from combining a brow lift with upper eyelid surgery. The goal is always the same. Eyes that look brighter and more relaxed, while still looking like you.
What Do “Hooded Eyes” Really Mean
Patients use the phrase “hooded eyes” to describe several different problems. During a consultation, Dr. Balikian breaks this area into a few key parts so he can understand exactly what is creating the heaviness.
Common causes of hooded eyes include:
- Brow ptosis. The eyebrow has drifted lower on the bone and pushes skin downward.
- Extra upper eyelid skin. The lid skin has stretched over time and now folds or rests on the lashes.
- Eyelid muscle weakness. The lifting muscle is weaker, so the lid margin covers more of the pupil.
- Fullness from fat pads or the lacrimal gland. Extra volume in the upper lid can create shadow and heaviness even when the skin itself is not too loose.
Most patients have a combination of these factors, not just one. That is why a careful examination of both the brow and the eyelid is so important before choosing surgery.
How Brow Position Affects Hooded Eyes
As we age, the brow slowly drifts downward. This is especially common in the outer third of the brow.
When the brow sits too low it can:
- Crowd the upper eyelid and increase hooding
- Make it harder to apply makeup without smudging
- Add weight to the outer eye and create a sad or tired expression
- Force the forehead muscles to work harder just to keep the eyes open
A brow lift addresses the frame of the eye. By gently lifting and reshaping the brow to a more youthful position, the brow lift can:
- Reduce heaviness on the upper lid
- Soften forehead lines that form from constant lifting
- Improve the balance between the brows, eyelids, and temples
- Help the eyes look more open and alert without changing your identity
When the brow is restored to its natural height and contour, the entire upper face looks brighter, softer and more refreshed.
See the Difference a Brow Lift Can Make
A Natural Brow Lift That Still Looks Like You
The brow is one of the most expressive parts of the face. Small changes here can have a big impact. Dr. Balikian focuses on a natural, preservation based approach.
Key elements of his technique include:
- Preserving your natural expression – The goal is a rested and refreshed look, not a “surprised” or pulled forehead. He follows your natural brow shape and raises it just enough to restore openness.
- Targeted lifting of heavy areas – Many patients are heaviest in the outer brow and temple. Dr. Balikian often concentrates the lift where you feel the most weight, so the result looks soft and believable.
- Minimally traumatic techniques – He uses advanced techniques to release the tissues and smooth the forehead with small, well placed incisions. This supports faster healing and more refined scars.
- Balancing the entire upper face – He does not look at the brow in isolation. Instead, he studies how the brow, upper lid, and temple work together so the final result feels harmonious, not pieced together.
For some patients, this type of brow lift alone is enough to unmask the upper lid and improve hooding. For others, the eyelid itself also needs attention.
When a Brow Lift Is Not Enough
There are many situations where lifting the brow alone will not fully correct hooded eyes. The most common patterns include:
1. True Extra Upper Eyelid Skin
If there is real extra skin on the lid itself, a brow lift cannot remove it.
In these cases:
- Skin rests on or over the lashes even when the brow is gently lifted to its ideal position
- There are multiple folds of skin that do not smooth out when the brow is supported
- Eye makeup constantly transfers to the upper lid
In this setting, an upper blepharoplasty is usually needed to carefully remove the extra skin and shape the crease. A brow lift can improve the frame of the eye. Blepharoplasty refines the lid itself.
2. Eyelid Muscle Weakness or Ptosis
Sometimes the problem is not only skin. The eyelid lifting muscle can stretch or weaken with age. The lid margin then sits lower on the eye and covers more of the pupil.
Signs of eyelid ptosis may include:
- Lids that look half closed even when you feel wide awake
- One lid hanging lower than the other
- Needing to raise your brows to see better
In these cases, raising the brow alone is not enough. The lid itself needs to be addressed, often with a ptosis repair combined with upper blepharoplasty. A brow lift can be added to complete the frame if the brow is also low.
3. Heaviness from Fat Pads or the Lacrimal Gland
Some patients have fullness in the upper lid caused by pseudoherniated fat or a mild descent of the lacrimal gland. This can create roundness and shadow that look like “extra skin” in photos.
In this situation:
- A brow lift may improve the brow position
- A tailored upper blepharoplasty is needed to sculpt the lid and remove or reposition the fullness
- The goal is not to hollow the eye, but to restore a clean and youthful contour
Together, these adjustments create a smooth, natural upper eyelid contour that looks refreshed rather than operated on.
4. Hidden Brow Ptosis Under “Extra Skin”
Sometimes a low brow is the main problem, but it hides underneath the appearance of extra skin. If eyelid surgery is done without addressing brow ptosis, the brows can actually look lower after surgery. Once the skin is removed and the forehead muscles relax, the brow may settle into an even lower position.
This is why Dr. Balikian always evaluates brow position first. If the brow is clearly low, it needs to be corrected during the same operation or separately to protect the overall balance of the upper face.
A Brighter, More Refreshed You
When Combining a Brow Lift and Upper Blepharoplasty Makes Sense
A combined approach is often the best choice when:
- The brow is low, especially on the outer third
- There is real extra skin and fullness on the upper lid
- Heaviness affects both your appearance and your visual field
- You want a smooth transition from forehead to eyelid instead of a lifted brow over a heavy lid
In a combined procedure, Dr. Balikian can:
- Elevate and shape the brow to a naturally youthful position
- Remove just the right amount of eyelid skin
- Refine or reposition fat pads when needed
- Protect eyelid function by respecting the muscles and tear gland
The result is a more complete rejuvenation of the upper face. The forehead looks relaxed. The eyes look more open. The lids look cleaner and more defined, without a drastic change in who you are.
What Results Can You Expect
Every patient is unique, but in general patients can expect:
- A more open and rested eye area – Less heaviness on the outer eye and a softer fold of skin above the lash line.
- Improved symmetry – Brows and lids that look more even and balanced between sides.
- Long lasting improvement – Some settling is normal over the first year. The overall improvement in heaviness, field of vision, and eye definition is typically long lasting.
- A natural look – Dr. Balikian favors subtle, thoughtful changes. You should look like a more rested version of yourself, not like a different person.
He will review realistic expectations with you in detail, including how brow lift and eyelid surgery can age over time and what maintenance treatments, such as neuromodulators or skin resurfacing, can support your result.
Is Brow Lift Surgery for Hooded Eyes Right for You
If you feel that heavy brows or lids are making you look tired, unhappy, or older than you feel, it may be time to explore your options. A thoughtful, anatomy based approach that looks at both the brow and the eyelid can make a real difference.
To learn what is right for you, schedule a consultation with Dr. Balikian. Together you can review your photos, discuss your goals, and design a plan that opens your eyes while keeping you recognizably yourself.
Discover the Possibilities
FAQs About Brow Lift Surgery for Hooded Eyes
What is “hooded-eye” surgery?
“Hooded eyes” can come from a variety of anatomical issues, a low brow (brow ptosis), excess upper-lid skin (dermatochalasis), weak eyelid muscles (ptosis), or fullness from fat pads or gland tissue. Which procedure is right depends on precise evaluation.
Some patients benefit from a brow lift, others from upper blepharoplasty, and some from a combination. This tailored, anatomy-guided approach is the foundation of Dr. Balikian’s surgical philosophy.
How do I know whether I need a brow lift, an upper blepharoplasty, or both?
If the brow is low and pushing skin downward, a brow lift is usually sufficient.
If true extra eyelid skin remains even when the brow is held in its ideal position, upper blepharoplasty is indicated.
If both low brow and excess lid skin (or lid fullness) exist, a combined brow lift + blepharoplasty often gives the most natural, balanced result.
During consultation, Dr. Balikian may manually support your brow to help you visualize what a brow lift alone can do, and whether lid surgery is needed as well.
Can a brow lift alone fix hooded eyes?
Sometimes, yes. When brow descent is the primary cause of hooding, lifting the brow into a more youthful position can unmask the upper lid, reducing skin heaviness and opening the eye frame. Long-term data show that endoscopic brow lifts yield sustained brow elevation: in a 2025 meta-analysis, average long-term elevation was ~ 3.25–4.35 mm depending on brow region.
What are the benefits of upper blepharoplasty beyond appearance?
Upper blepharoplasty can significantly improve visual function in patients with dermatochalasis (excess upper-lid skin). Studies have documented:
- Improved contrast sensitivity — patients show better visual function after blepharoplasty.
- Enlarged upper visual field and relief from skin obstructing vision.
- Reduction in eye strain and headaches in some cases, especially when heavy lids forced constant brow lifting prior to surgery.
Because of these functional benefits, upper blepharoplasty is considered reconstructive (not just cosmetic) when excess tissue or lid position interferes with vision or comfort.
How long do results last for brow lift and blepharoplasty?
For brow lift: Multiple long-term studies show stable elevation over years.
For upper blepharoplasty: Results in eyelid contour, skin redundancy, and lid fold definition tend to be durable. Functionally, patients often continue to enjoy improved visual field and comfort years after surgery.
That said, natural aging continues. Dr. Balikian uses conservative, preservation-based techniques so results age gracefully without a “pulled” look or abrupt changes.
Will I still look like myself after the surgery?
Yes. The goal is not drastic transformation, but subtle rejuvenation. By preserving your natural brow shape and eyelid anatomy, and avoiding excessive skin or fat removal, the result looks like a more rested, refreshed you, not a “different” you. This conservative, anatomy-aware philosophy aligns with modern surgical standards.
What are the risks?
As with any surgery around the eyes and forehead:
- For brow lift (especially endoscopic), complications may include temporary scalp numbness, alopecia, mild asymmetry, or need for minor revision.
- For upper blepharoplasty, risks include temporary dryness, delayed healing, lid sensitivity, or rarely, eyelid closure issues.
Importantly, when done by an experienced surgeon and with appropriate preoperative evaluation, serious complications are uncommon.
What is recovery like if I combine brow lift and blepharoplasty?
Combining the procedures generally means one recovery period instead of two. In published series, combined forehead/brow and upper-lid surgery has shown high patient satisfaction and acceptably low complication rates.
What if I have asymmetry or prior eyelid/brow surgery?
Asymmetry is common and can often be improved with tailored brow lift or blepharoplasty (or both). In revision cases, extra care is required due to scarring or altered anatomy. Experienced surgeons plan conservatively and tailor the approach to avoid overcorrection or hollowing.
Are non-surgical treatments (like fillers or Botox) a good alternative to surgery?
Non-surgical treatments can help in select cases, e.g., Botox may gently lift the outer brow, fillers or fat grafting may soften hollowness. But they cannot permanently correct issues like excess skin, true brow descent, or weakened eyelid muscles. For structural problems, surgery remains the gold standard.
Trust Your Face to a Facial Plastic Surgeon
Dr. Richard Balikian is a highly respected facial plastic surgeon serving the San Diego area.
With over 20 years of experience and double board certification in Facial Plastic and Reconstructive Surgery as well as Head and Neck Surgery, Dr. Balikian offers a unique combination of technical expertise and artistic vision.
He is part of an elite group of surgeons with extensive training focused exclusively on the face and neck.
Learn More About Facial Plastic Surgery
Richard V. Balikian, MD, FACS
Double Board-Certified Facial Plastic Surgeon
Balikian Facial Plastic Surgery: Richard V. Balikian, MD, FACS
