Whilst the eyelids behave as a functional unit, in cosmetic terms is important that they are viewed in the context of the remainder of the face in particular the eyebrow and the cheek (the midface). With age the eyebrow typically lowers and affects the appearance of the upper eyelid. Similarly, the cheek also tends to move downwards with age. This is often relevant to patients considering blepharoplasty.

Brow surgery such as endoscopic brow lift, often in conjunction with a upper eyelid blepharoplasty, gives selected patients the best possible cosmetic outcome. Likewise, if there is significant descent of the midface it is important that lower eyelid blepharoplasty also addresses this. Andrew Coombes is experienced in surgery in all of these areas.