Eyelid Surgery and Brow Lift in Mexico City
In a study of 2,134 patients, satisfaction with the eyes improved by 48 points out of 100 and patients reported looking 3.3 years younger. It is among the facial procedures with the greatest change and the shortest recovery.
What it is and how it works
the first thing we do, before operating on an eyelid, is check your brow. If the brow has dropped and only skin is removed, the gaze can end up more closed rather than more open. A tired-looking gaze rarely has a single cause. In the upper eyelid there may be excess skin, the inner fat pad may protrude, or what actually dropped may be the brow, pushing skin down onto the lid. In the lower eyelid, the bags are not excess skin: they are orbital fat pushing forward because the membrane containing it weakened, and alongside it the tear trough appears. That is why we assess all three components before deciding what to operate.
What it treats, in detail
- Excess upper eyelid skin weighing on the gaze.
- The inner fat pad of the upper eyelid.
- Lower eyelid bags.
- Structural under-eye hollowing, with a marked groove between lid and cheek.
- Descent of the brow tail, which creates a tired or angry look.
- Superior visual field obstruction in advanced cases.
How we do it here
in the upper eyelid we remove skin conservatively and treat the inner fat pad only when it protrudes, never routinely, because over-hollowing leaves an aged, sunken lid. When the brow contributes, we perform a brow pexy in the same procedure: it elevates the brow tail and avoids having to resect excess skin. In the lower eyelid we work from the inside, with a transconjunctival approach: the incision runs inside the lid, does not touch the septum and leaves no external scar. It is our preference because of its safety profile, and we also tell you the debate remains open: highly experienced surgeons advocate the external approach with good results. What is standard today, and matches how we work, is the combination of less aggressive fat removal, repositioning the fat rather than simply removing it, minimal skin removal, lid support when needed, and volume restoration with fat grafting. We first address the fat from within, repositioning it over the groove rather than simply removing it, and only then assess whether skin truly needs to be removed. We often add fat grafting to the tear trough, because removing the bag without treating the groove leaves the lid hollow. And when the lower eyelid has laxity, we reinforce the outer corner of the eye in the same procedure, which is called canthopexy: it is not a separate procedure, it is a step added when needed to prevent the eyelid from retracting.
Who it’s for
if people often tell you that you look tired or angry when you are not, if your eyelid feels heavy, if you have bags, or if makeup no longer sits the way it used to.
Who it’s not for
we do not operate with significant dry eye without prior assessment, with uncontrolled thyroid eye disease, or with uncontrolled glaucoma. There are four conditions that increase the risk of lower eyelid malposition and that we always check before operating: preexisting ptosis, lid laxity, prominent eyes and dry eye. If any is present, it is corrected in the same procedure or the approach is reconsidered. And if what you have is true eyelid ptosis, a problem of the levator muscle rather than excess skin, the surgery is different and we will tell you.
What to expect
- 01
if we operate only the upper eyelid, it is done in-office under local anesthesia and takes an hour and a half.
- 02
If we operate all four eyelids, it is under general anesthesia.
- 03
In both cases sutures come out at one week.
- 04
Swelling and bruising largely resolve in 7 to 10 days for the upper eyelid and 10 to 14 for the lower, with social return in one to two weeks with makeup.
- 05
Three weeks without exercise, and residual swelling continues to subside progressively over the following 8 to 12 weeks, so the result is judged with patience.
- 06
The upper eyelid scar hides in the natural crease.
Risks and what we tell you honestly
first the reassuring part, because eye surgery is frightening. In the systematic review of lower eyelid blepharoplasty, no major complication with visual involvement, such as blindness or double vision, was reported in any of the included studies, and rates of hematoma, bleeding and infection are low. Lower eyelid retraction, the most relevant functional complication, is reported between 0% and 4.3%. That said, the error we most want to avoid is removing too much skin, because it can prevent your eye from closing fully and is difficult to correct. That is why we are conservative. The same applies to fat: over-hollowing ages the gaze. In the lower eyelid, excess skin removal is the main cause of retraction and ectropion, which is why we prefer the internal approach. There can be dry eye or temporary irritation, asymmetry and, very rarely, bleeding behind the eye requiring immediate attention. In the brow, over-elevation produces a permanently surprised look, and scalp numbness is frequent and can last months.
Beyond aesthetics
the satisfaction data for this surgery are among the most robust in facial surgery, because they come from a prospective multicenter study of 2,134 patients. At 6 months, satisfaction with the eyes and with the upper eyelids improved by 48 points out of 100, with very large effect sizes; overall facial appearance improved by 26 points, psychological well-being by 11 and self-perceived age by 22. Patients reported looking on average 3.3 years younger.
For the lower eyelid with a transconjunctival approach, one study reported 67% of patients very satisfied and 29.9% satisfied, and notes that in every case fat herniation resolved and the tear trough improved significantly, without overfilling the area. That is exactly what we aim for with this technique.
And when excess upper eyelid skin obstructs your visual field, correction additionally has a documented functional indication, and it is the scenario where insurers may consider it medically necessary, with criteria including visual field testing and photographs. Additionally, many patients report something everyday: being able to wear makeup again and use glasses without the lid getting in the way.
Myth vs reality
Myth
“Eyelid surgery removes dark circles.”
Reality
it depends on which kind you have. Structural hollowing, the groove and the bag, is corrected. But pigmented dark circles, the color ones, and vascular ones, the bluish ones, are not removed by surgery: they require other treatments. We identify that in consultation, because promising you that surgery will erase a pigmented dark circle would not be honest.
Book your consultation and we will assess eyelid, brow and under-eye separately.
This consultation carries a fee, which is not credited toward treatment.
Advisory session with our teamComplimentary. We answer questions about process, estimated pricing and travel logistics.