The brow, upper eyelid and midface are connected, but they are not the same anatomical problem. A heavy upper eyelid may reflect excess skin, brow descent, true eyelid ptosis, volume loss—or a combination. Likewise, an under-eye hollow may come from orbital fat, midface position, skeletal support or previous fillers. Treatment should follow diagnosis rather than a predetermined package.
What each procedure is designed to treat
| Procedure | Main target | Does not automatically correct |
|---|---|---|
| Video-assisted brow surgery | Brow position and selected upper-face descent | True eyelid ptosis or all eyelid skin |
| Video-assisted midface lift | Selected midface tissue descent | Pigment, festoons or lower-face jowls |
| Upper blepharoplasty | Selected excess upper-eyelid skin | Brow descent or hollow orbit |
| Lower blepharoplasty | Selected fat bags and eyelid support | Every dark circle or malar edema |
| Fat grafting | Selected volume deficit | Tissue descent requiring repositioning |
Dr. June’s Hybrid Blepharoplasty concept
Hybrid Blepharoplasty is an individualized framework, not a mandatory combination. Upper-eyelid planning favors conservative skin removal and orbicularis preservation. In selected lower lids, a transconjunctival approach treats the fat compartments without a routine external lower-eyelid incision. Cantopexy, microfat at the lid-cheek transition, nanofat and skin treatment are considered separately. Mild true ptosis may require a specific levator or conjunctivo-Müller assessment.
Learn more about what Hybrid Blepharoplasty can and cannot treat.
Where video-assisted surgery fits
Small scalp incisions allow endoscopic visualization and release of selected brow and midface tissues. Fixation and vector are adapted to anatomy. Video surgery does not remove eyelid skin and does not replace a lower facelift or neck lift. Risks include bleeding, infection, temporary or persistent sensory change, asymmetry, hair loss near incisions, fixation awareness and temporary or persistent weakness involving facial nerve branches.
Eye health and previous treatments
Dry eye, contact-lens use, previous eye surgery, thyroid disease, eyelid laxity and difficulty closing the eyes require assessment. Botox can reveal or worsen apparent brow descent in some patients. Fillers, biostimulators, threads and energy treatments may contribute to edema or alter tissue planes; dermatologic ultrasound may help define previous material.
Recovery is regional and gradual
Swelling and bruising are expected. Temporal discomfort with chewing, scalp sensitivity, forehead numbness, eye dryness and temporary asymmetry may occur. Social recovery often precedes internal healing, which continues for months. Increasing pain, vision change, rapidly expanding swelling, fever or breathing difficulty requires urgent assessment.
International-patient planning
Belvivere performs major combined facial surgery in a hospital with anesthesia monitoring. International patients commonly plan at least 15 days in Brazil, depending on the procedures and recovery. Review the midface recovery guide, hospital information and concierge support.
