Upper face · For transgender patients
Eyelid & Brow Surgery
The upper third of the face reads as gendered largely through two things: where the brow sits, and how open the eye appears beneath it. Eyelid surgery and brow surgery are usually planned together, because each one changes how the other looks.
Dr. Henry Sandel — fellowship trained in facial plastic surgery
At a glance
Surgeon
Dr. Henry Sandel
Area
Upper face
Approach
Brow position and eyelid opening, planned together
Setting
One accredited facility
Often paired with
Rhinoplasty, Cheek Augmentation
What the procedure changes
Brow surgery repositions the brow itself. A higher brow with a more pronounced arch, particularly at the outer third, is one of the most reliably feminizing changes in the upper face; it also opens the eye without touching the lid. Held lower and flatter, the same brow reads masculine. Dr. Sandel performs brow lifting through incisions placed in or behind the hairline, and the same approach smooths the horizontal forehead lines that deepen with expression.
Eyelid surgery, or blepharoplasty, addresses the lid rather than the brow. On the upper lid it removes excess skin and reduces the hooding that makes the eye look heavy or tired; on the lower lid it reduces puffiness and the shadowing beneath the eye. For feminizing goals the aim is a more open, less hooded upper lid that shows more of the lid platform. For masculinizing goals the aim is usually restraint — removing genuine excess without opening the eye further than intended.
These two procedures combine well in a single operation and share one recovery, which is why most patients who want both have them together. Where the forehead itself is prominent, brow surgery is often discussed alongside forehead contouring; that is a separate conversation and one we will have honestly with you at consultation.
Toward a more feminine read
Raise the brow, especially the outer third
Add arch to the brow line
Open the upper lid platform
Soften a heavy, hooded upper lid
Toward a more masculine read
Keep the brow lower and flatter
Remove only genuine excess lid skin
Preserve a deeper-set eye
Address under-eye puffiness without opening the eye
These are directions, not a formula. What suits your face is decided with you, in consultation.
Worth knowing
Before you decide.
Most patients do not have every procedure at once. We will tell you which changes combine safely in one operation and which heal better apart.
Brow position and lid skin are separate problems. Treating one without assessing the other is the most common reason a result disappoints.
Photographs taken with a neutral expression are more useful than smiling ones for planning brow height.
Dry eye history, thyroid eye disease, and prior lid surgery all change the plan — mention them.
If forehead contouring is part of your goal, raise it at the first visit so brow work can be sequenced around it.
Often considered alongside
Start with a conversation.
Every patient receives an extensive consultation with a comprehensive review of options. No one feels rushed, and we answer every question before anything is scheduled.
Candidacy, staging, and expected outcomes are determined in consultation. Results vary from patient to patient.