Eyebrow sagginess can be caused by excessive eyelid skin as well as brow ptosis that causes the eyebrow skin to sag. In general, the brow elevation procedure is performed first before an upper lid blepharoplasty, if indicated. Often, after correction of the brow position, the amount of upper lid eyelid redundancy or sagging is significantly reduced, allowing the surgeon to accurately assess the need for blepharoplasty.