The Eyes-Face Integration
The eyes are the focus of the face. When thinking about facial rejuvenation, we cannot ignore the periorbital region. Blepharoplasty (eyelid surgery) and facelift are frequently complementary — treating one without considering the other can create disharmony.
“A rejuvenated face with aged eyes looks odd. Rejuvenated eyes with aged face also. Harmonization is fundamental.”
- — Dr. Robério Brandão
Types of Blepharoplasty
Upper Blepharoplasty
Removes excess skin from upper eyelid (dermatochalasis). May include removal of herniated fat. Attention: Evaluate for eyebrow ptosis component before indicating.
Lower Blepharoplasty
Treats bags and excess skin on lower eyelid. Transcutaneous or transconjunctival approach. Attention: Evaluate eyelid laxity — canthopexy may be necessary.
The Critical Connection: Eyebrow-Eyelid A common mistake: indicating upper blepharoplasty when the real problem is eyebrow ptosis.
⚠️ The Important Test
Manually elevate the patient’s eyebrow to youthful position. If the eyelid skin “excess” disappears, the problem is the eyebrow, not the eyelid. Solution: Browlift (with or without limited blepharoplasty), not aggressive isolated blepharoplasty. Performing aggressive blepharoplasty when there’s eyebrow ptosis can:
✗ Pull the eyebrow further down
✗ Create “surprised” appearance if browlift is later performed
✗ Impair eye closure (lagophthalmos)
Advantages of Combined Approach
Harmonious Result
Eyes and face rejuvenated in integrated manner, without disproportion.
Single Recovery
One 2-3 week recovery instead of two separate recoveries.
Cost-Benefit
Surgical center, anesthesia and team in single time — significant savings.
Precise Planning
By doing browlift first (if indicated), you know exactly how much eyelid skin to remove.
Recommended Surgical Sequence
1
Browlift (if indicated)
Defines final eyebrow position, clarifies how much skin is truly eyelid excess. 2
Upper Blepharoplasty
Removes excess skin and fat as needed, after defining eyebrow. 3
Lower Blepharoplasty + Canthopexy
Treats bags, excess skin. Canthopexy prevents ectropion and improves eye shape. 4
Endomidface / Facelift
Completes facial rejuvenation after defining periorbital region.
Frequently Asked Questions
)) }
Learn Integrated Rejuvenation Techniques Mentorship programs teach comprehensive approach: eyelids, eyebrow, face and neck.
View Mentorship Programs
Related Articles
Endomidface Guide
Learn more about the midface lift technique.
Browlift Technique
Evolutionary frontoplasty with direct vision.
Biostimulators
Complementing surgery with skin quality treatments.
For surgeons: Master the art of combined procedures in our mentorship programs.