This 45 year old white female complained of loose upper eyelid skin and requested a blepharoplasty. Actually an endoscopic brow-lift would have served her far better since her eyebrows were very low indeed. However, the patient declined this suggestion since she already had a high hairline and was afraid that a brow-lift would make this worse. Furthermore, the brow-lift would have required a general anesthetic and involved greater expense.
Certainly the blepharoplasty was of benefit, but it is doubtful whether it would have been necessary if the brow-lift had been performed first.