Please be more definitive about twilight sedation. A forehead and brow lift is the same procedure. This is done to elevate the height of the eyebrows rather than take skin out of the eyelid. I have never encountered that. Surgery is a very controlled environment and precautions are taken so that this does not happen.
Cosmetic surgery is an elective procedure and is a choice made by the patient.
It is the same as making a decision to take a vacation to Europe. It does not need to be done, but can be done if it is important to the person. If the patient has realistic expectations and the correct motivations, then it makes sense. It is non-surgical, painless and very effective. It is the most common procedure that I perform.