How do I tell if it is my eyelids or my brow that dropped?

Been staring at myself far too long over this so bear with me. 54, the outer bit of both lids has gone heavy and my right one droops more than the left, and for two years I assumed it was just loose eyelid skin that a snip would sort. Booked a consult expecting them to draw a line and quote me. Instead the surgeon put a finger just under the tail of my eyebrow, pushed up maybe half a centimetre, and said "look, a lot of what you think is lid is actually your brow sitting low." I honestly could not tell the difference in the mirror. It all just looks TIRED.

So now I don't know what I'm booking. If it's the brow then apparently taking lid skin off is the wrong move and can make me look worse, which terrifies me. If it's the lid then the brow stuff is a distraction. How is a normal person meant to know which it is? Is there a test I can do at home before I spend another £250 on a second opinion? And can it be both at once, because that seems to be what he was hinting at without quite saying it.

The finger test IS the home test basically. Lift your brow gently with a fingertip to where it sat in your 30s. If most of the heaviness lifts away, it's brow. If the hood is still sitting on your lashes with the brow held up, that part is lid. Mine was mostly lid so I only ever needed the upper bleph.

Please get the brow properly assessed before anyone touches your lids. I am the cautionary tale.

I had upper blepharoplasty at 58 from a surgeon who never once mentioned my forehead. The skin came off, and for about six months I looked great. Then the tired look crept back and a second surgeon told me my brow had been low the whole time and taking lid skin off under it had pulled my brow down even further. What I actually needed from the start was the forehead lifted, not the lid trimmed. Now I am weighing a brow lift to fix what the first operation half caused. It is not that the blepharoplasty was botched, it is that it was the wrong operation for my face.

This is the exact fork I spent the better part of a year stuck at before my own surgery, so a few honest things from the patient side.

When I finally found a surgeon who assessed properly, she did the same finger lift Tom describes, but she also took photos with my forehead relaxed and then with my eyes gently closed and reopened, because a lot of us unconsciously hold our brows UP with our forehead muscle all day to see past the hood. That habit hides how low the brow really sits. The moment she told me to let my forehead go completely slack, my brow dropped and suddenly half the "lid skin" I was complaining about was actually brow. In my case it was genuinely both, so I had the upper skin addressed knowing the brow would still need watching later, and I went in clear-eyed that the surgery would not hold my forehead up for me.

That last part is the bit worth burning into your memory before you book. Eyelid surgery takes years off a tired upper lid and the skin does not grow back, but it does nothing for the brow, and the forehead keeps descending with age regardless. Our own write-up on the brow test before an upper blepharoplasty walks through exactly what a good surgeon is checking with that finger, and if it turns out the forehead is the real culprit then blepharoplasty versus a brow lift lays out why they are two different operations solving two different problems. Go into the next consult with the question, not the conclusion, and ask them to show you on your own photos how much is lid and how much is brow.

Update for anyone who finds this later. Booked the second opinion, asked her flat out to show me on my photos how much was lid and how much was brow, and she was delighted to, said most people never ask. Turns out mine is mostly lid with a slightly droopier brow on the right, which is why the right looked worse. Plan now is upper blepharoplasty on both, no brow work, and I go in knowing the forehead is a job for another decade maybe. Feels completely different making the decision with the numbers in front of me instead of just a vague "you look tired" feeling. Thank you all.