Blepharoplasty & Internal Brow Lift in London
Expert blepharoplasty with browpexy in Harley Street, London
Key facts
Heavy or hooded upper eyelids are not always caused by excess eyelid skin alone. As the face ages, the eyebrows can gradually descend, particularly towards the outer part of the brow. This can push skin down onto the upper eyelids and contribute to a tired, heavy or hooded appearance.
For selected patients, combining upper blepharoplasty with an internal brow lift, also known as browpexy or internal browpexy, can provide a more balanced approach to rejuvenating the upper face.
Dr Gino Vissers is a triple board-certified consultant plastic surgeon in London with a specialist interest in facial plastic surgery. At his Harley Street clinic, he carefully assesses the position of the eyebrows as well as the upper eyelids before recommending the most appropriate surgical approach.
The aim is not simply to remove skin, but to restore balance between the eyelid, eyebrow and forehead while preserving a natural appearance.
How it works: upper blepharoplasty with internal brow lift
Anaesthesia: local anaesthesia
Recovery time: 7-10 days
Results: after swelling has settled down
Lasts: ± 10 years
What is blepharoplasty with internal brow lift?
Upper blepharoplasty is an eyelid surgery designed to address excess skin and prominent fat from the upper eyelid.
An internal brow lift or browpexy is a technique used to provide additional support to the brow through the same upper-eyelid incision.
Rather than creating a separate incision above the eyebrow or within the hairline, the brow can be accessed through the upper blepharoplasty incision. The tissues around the brow are carefully released and secured to provide support, particularly to the outer portion of the eyebrow. This can be particularly useful when a patient's upper eyelid heaviness is partly related to a low or descending brow.
The degree of brow elevation achieved with an internal brow lift is generally more subtle than with a formal endoscopic, temporal or coronal brow lift. The objective is usually support and refinement.
Why combine upper eyelid surgery with browpexy?
The upper eyelid and eyebrow are closely connected. Treating one without considering the other can sometimes produce a less balanced result. If a low brow is contributing to upper eyelid hooding, simply removing more eyelid skin may not be the best solution. Removing excessive skin can make the eyelid look tight or hollow and does not address the underlying position of the eyebrow.
By combining upper blepharoplasty and internal browpexy, each component can be addressed appropriately:
- Upper blepharoplasty treats excess eyelid skin
- Browpexy provides additional support to a descending brow
- Less reliance may be placed on removing excessive eyelid skin
- The outer brow can be subtly elevated or stabilised
- The upper eyelid can have a cleaner, more open appearance
- The transition between the brow and eyelid can be improved
- The result can look refreshed while maintaining your natural facial character
The combination is particularly useful when both true eyelid skin excess and brow descent contribute to a heavy upper eyelid.
Do you need a brow lift with your blepharoplasty?
This is one of the most important questions to answer before undergoing upper eyelid surgery. A heavy upper eyelid does not necessarily mean that you need more skin removed.
During your consultation, Dr Gino Vissers assesses:
- The position of your eyebrows
- The amount and distribution of upper eyelid skin
- The position of the eyelid crease
- The shape and symmetry of your eyes
- Forehead and eyebrow movement
- The relationship between your brow and upper eyelid
If the brow position is appropriate and the problem is primarily excess eyelid skin, an upper blepharoplasty alone may be sufficient. If the brow has descended and is contributing to the hooding, an internal brow lift or browpexy may be recommended alongside your blepharoplasty.
Who is suitable for blepharoplasty with browpexy?
You may be suitable for combined upper blepharoplasty and internal brow lift if you have:
- Heavy or hooded upper eyelids
- Excess skin on the upper eyelids
- A low or descending outer eyebrow
- Brow-related upper eyelid heaviness
- A tired or aged appearance around the eyes
- Both eyelid skin excess and mild brow descent
- A desire for subtle, natural rejuvenation
The procedure is not suitable for everyone. If the main problem is significant forehead or brow descent, an internal brow lift may not provide sufficient elevation. In these circumstances, Dr Gino Vissers may recommend a different brow-lifting procedure.
How is an internal brow lift performed?
An internal brow lift is performed through the same incision used for upper blepharoplasty. The incision is positioned within the natural crease of the upper eyelid, where it becomes well concealed once healed. Through this incision, Dr Gino Vissers can access the tissues beneath the brow. Carefully selected tissues are released and then secured to stronger supporting structures.
The aim is to provide internal support to the brow, particularly towards the lateral eyebrow, without creating a separate visible brow incision. The amount of brow elevation is carefully controlled.
The goal is not to create an artificially high or surprised-looking eyebrow, but to restore a more harmonious relationship between the brow and upper eyelid.
What does upper eyelid surgery with an internal brow lift achieve?
The combination of upper blepharoplasty and internal brow lift can create a subtle but meaningful rejuvenation of the upper face.
Potential benefits include:
- Less hooding of the upper eyelids
- A more open appearance to the eyes
- Reduction of excess upper eyelid skin
- Subtle elevation or support of the outer brow
- A more defined upper eyelid crease
- A fresher and less tired appearance
- Better balance between the eyebrow and eyelid
- Natural-looking facial rejuvenation
The objective is not to change the character of your eyes. Dr Gino Vissers' approach is focused on maintaining your natural facial proportions and avoiding an over-operated or surprised appearance.
Preparing for eyelid surgery with internal brow lift
Getting ready for your blepharoplasty with internal brow lift is just as important as the surgery itself. A little preparation goes a long way in making your recovery smoother, more comfortable, and stress-free. Here are some simple steps to help you feel confident and ready:
Follow your surgeon's guidance
Dr. Vissers will give you clear instructions to follow before surgery, such as pausing certain medications, supplements, smoking, or alcohol. These steps are all designed to keep you safe and help your body heal quickly, so think of them as part of your recovery plan.
Arrange support for after surgery
You’ll need someone you trust to take you home after your procedure, since you won’t be able to drive yourself. It’s also helpful to have a friend or family member nearby for the first day or two, just in case you need an extra hand. Give yourself permission to take a proper break from work and daily tasks so you can focus on resting.
Create a comfortable recovery space
Before your surgery, set up a cozy spot at home where you can relax. Keep a few extra pillows ready to support your head, and have ice packs available to ease any swelling. Place everything you might need, like your medication, gauze, and ointment, within easy reach so you don’t have to get up too often.
Why choose
Dr. Gino Vissers?
Choosing the right surgeon is the most important decision when considering blepharoplasty or brow lift surgery in London. Facial plastic surgery is one of the most delicate and technically demanding procedures in plastic surgery, requiring a precise understanding of facial anatomy, ageing, and aesthetic balance to achieve natural-looking results.
At Dr. Gino Vissers' Harley Street Clinic, blepharoplasty procedures are performed by Dr. Gino Vissers, an award-winning and triple board-certified consultant plastic surgeon in London with a specialist interest in facial surgery and eyelid rejuvenation. Every patient receives a personalised assessment to determine the most suitable treatment plan, whether that involves upper eyelid surgery, lower blepharoplasty, fat repositioning, skin tightening, or a combination of procedures.
Dr. Gino Vissers has a 5.0 star rating on Google. Patients travel from across London, the UK, and internationally for blepharoplasty with Dr Gino Vissers because of his refined surgical approach, attention to detail, and focus on achieving elegant, natural outcomes that preserve facial character rather than creating an “overdone” appearance.
Recovery after blepharoplasty with internal brow lift
Recovery varies between patients, but most people experience bruising and swelling around the eyes during the first few days. Most patients will need to take about a week off from work to rest and recover. Dr Gino Vissers may prescribe you some eye drops and/or ointment during this time for comfort. Most patients begin to look significantly more presentable after one week, although some residual bruising or swelling may remain.
Sleep on your back during the first 1-2 weeks to help minimise swelling and improve the healing process. You may wear glasses the day after your surgery, but wait for 2 weeks before using contacts lenses. You can exercise again after 2-4 weeks.
Patients should also avoid exposing their eyes to the sun, and use sunscreen (SPF50) to protect their scars from damage during healing. Dr Gino Vissers will provide detailed post-operative instructions to promote optimal healing and ensure a smooth and comfortable recovery process.
Swelling continues to settle and the eyelids and brow gradually take on their final appearance after several weeks. After 3-6 months, the scars and tissues continue to mature, with the final result becoming increasingly refined.
Recovery timeline after blepharoplasty with internal browpexy
Days 1 to 3
Blepharoplasty with internal browpexy is typically performed as a day-case procedure, meaning patients return home the same day. During the first few days, it is normal to experience:
- Mild to moderate swelling around the eyes
- Bruising of the eyelids
- Tightness or mild discomfort
- Temporary watering or dryness of the eyes
Patients are advised to keep the head elevated, apply cold compresses as instructed, and take prescribed medication if required. Reading, prolonged screen use, contact lenses, and strenuous activity should be avoided during this early healing phase.
Days 4 to 7
Swelling and bruising usually begin to improve noticeably during the first week. Sutures are generally removed between 5 and 7 days after surgery at your first post-operative review appointment. By the end of the first week, most patients feel significantly more comfortable, although mild puffiness around the eyelids can still be present.
Weeks 1 to 2
Most patients feel ready to return to work, social activities, and light daily routines after approximately 7 to 10 days. Bruising continues to fade and the eyes begin to look fresher and more open.
During this period, it is still important to avoid contact lenses, heavy lifting, intense exercise, and other activities that significantly raise blood pressure
Weeks 2 to 4
Residual swelling continues to settle and the eyelid contours become increasingly refined. Patients can usually wear contact lenses again and resume light exercise and most normal activities gradually during this stage of recovery.
The results of the blepharoplasty and internal browpexy become more noticeable as the eyes appear brighter, less hooded, and more refreshed.
Around 6 Weeks
By six weeks after eyelid surgery, most patients have returned fully to their normal lifestyle and exercise routine. The majority of swelling has resolved, and the upper eyelids look significantly more defined and rejuvenated.
After 3 to 6 Months
Final results continue to develop over several months. By 3 to 6 months, residual swelling has fully resolved, scars have softened further, and the eyelid contours have settled into their final position.
Blepharoplasty with browpexy: Natural-looking results
Good eyelid surgery is often subtle. The aim is not for people to notice that you have had surgery. Instead, they may notice that you look more rested, brighter or less tired.
For this reason, Dr Gino Vissers takes a conservative approach to tissue removal and considers the position of the eyebrow before deciding how much eyelid skin should be removed. In suitable patients, supporting the brow can allow the eyelid surgery to focus on the eyelid itself rather than using excessive skin removal to compensate for brow descent.
Eyelid surgery with an internal brow lift can achieve:
- A more open and defined upper eyelid contour
- Reduction of heaviness and hooding of the upper eyelids
- A brighter, more awake, and refreshed appearance
- Improvement in peripheral vision where excess skin was affecting the visual field
- Natural-looking rejuvenation that remains appropriate to your facial features
- A lifted and balanced appearance of the eyebrow
In some patients, additional procedures such as facelift surgery, or facial fat grafting may be recommended to achieve more comprehensive facial rejuvenation.
Book eyelid surgery with a leading plastic surgeon in London
Looking for a consultant plastic surgeon in Harley Street with an expertise in eyelid surgery? Dr. Gino Vissers is ready to help you look and feel your best.
Call 020 375 00 422 or get in touch today to explore treatments and pricing.
Frequently Asked Questions: Blepharoplasty with Internal Brow Lift
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