For more information on brow lift or eyelid surgery at our Winnetka and Chicago-area facilities, please contact Dr. John Q. Cook.






737 North Michigan Avenue
Suite 760
151 East Chicago Avenue (Entrance)
Chicago, Illinois 60611
312-751-2112
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118 Green Bay Road
Winnetka, Illinois 60093
847-446-7562
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Eyelid Surgery, Brow Lift - Chicago and Winnetka

"The eyes are the window to the soul." Cicero (106-43 BC)

The eyelids and the structures that immediately surround them, the brows and the upper cheeks, are rich in expressive information, arguably the richest expressive zone of our body.  Through subtly nuanced motion these structures convey to our friends and acquaintances the myriad emotions of human experience with all their subtle differences: contentment, joy, excitement, disappointment, fear, exhaustion. The utmost care must be taken when refining these areas through eyelid surgery or brow lift procedures. At his Chicago and Winnetka centers, Dr. John Q. Cook helps his patients restore a natural appearance and functionality to these regions.

As we age the structures of the eyelid region can change in ways that cause others to misperceive our moods and emotions.  Furrows may begin to develop between the brows that impart a sense of anger.  The brows may settle into a resting position that obscures the beautiful contours of the upper eyelid and suggests a look of sadness.  The upper eyelid itself may develop a fold of skin and perhaps a heavy bulge that conveys tiredness.  The lower eyelid may develop heavy bulges or even lose its natural tone that makes a person look “under the weather.”  The upper cheek may lose its tone and fullness so that a hollow may develop beneath the lower eyelid that gives a somewhat gaunt appearance. 

One could argue that refinement in this area through eyelid surgery and brow lift procedures surgery provides a skilled surgeon with his greatest opportunity and also his greatest risk.

 The opportunity is to favorably alter the position and dynamics of the structures around the eyes so that a person’s true emotions are conveyed to the surrounding world.  One of Dr. Cook’s greatest joys is when a patient reports to him that she no longer feels that she is being misperceived.  The fundamental feedback mechanism between the patient and the person who perceives the patient is altered in a favorable way.  Whether we like to admit it or not, people respond to us differently when we look tired or angry, and that response in turn cannot help but affect our mood and sense or well-being.

The risk is that overdone or manneristic surgery carried out in this area will substitute a new set of problems for the old ones.  As you walk down the street and look at the faces there are plenty of examples of brows pulled high and taut to a level that suggests perpetual surprise.  There are upper eyelids that have been emptied of their natural fat, so that the eyes look like hollow sockets.  There are lower eyelids where the skin has been so aggressively tightened that they assume a perpetual sad stare.

Dr. Cook offers a portfolio of eyelid surgery/brow lift procedures to patients at his Chicago and Winnetka offices. His treatment plans are a response to his patients’ need to achieve a natural restoration of this key expressive zone. He seeks to attract patients who have a similar naturalistic bias.

PROPER TREATMENT BEGINS WITH CAREFUL EVALUATION

Dr. Cook has studied the expressive dynamics of the eyelid region for many years.  He brings this knowledge base and his extensive surgical experience to your service when he performs an in-depth evaluation of the brows, the eyelids, and the upper cheek during an eyelid surgery/brow lift consultation at his Chicago or Winnetka centers.

Dr. Cook will pay careful attention to aspects of your medical and family history that may play a role in the treatment plan.  He will observe your individual expressive pattern with regard to how this may have contributed to the changes that may have come about.  He will pay attention to how changes in the cheek, eyelid and brow may affect the overall mood of the face.  He will take the time to carefully note your observations of the changes in your own face, so that he understands your goals for the surgery.  He will examine you in a variety of lighting conditions in order to obtain the most complete understanding of the contours of the eyelids and neighboring structures.

It is always helpful if you bring to your eyelid surgery or browlift consultation pictures that show the eyelid area in the best possible detail that were taken at various times throughout your life.  Pictures that show the face in expression are particularly helpful.

Dr. Cook will also take pictures of the face and eyelid area under varied lighting conditions.  Dr. Cook studies these pictures in detail and they help him to obtain a highly individualized treatment plan for each patient.

During your eyelid surgery or brow lift consultation at our Chicago or Winnetka centers, Dr. Cook will explain in detail the options that are available to restore harmony and balance to this important expressive region.  He has an extensive portfolio of techniques of upper and lower eyelid surgery, upper cheek lift, brow lift, and facial volume balancing from which he will select your treatment plan.  Often the result of the surgery will be enhanced with non-surgical treatments such as Botox® and injectable fillers and various skin rejuvenation techniques which we offer at The Whole Beauty Institute™.  We will make certain that you understand the full range of your options.

Eyelid Surgery


View Dr. Cook's Gallery Dr. Cook carries out eyelid surgery, medically known as blepharoplasty, based on a precise treatment plan that has been formulated during your consultation.  If appropriate, the surgery may be combined with brow lift or surgery to the upper cheek.  Dr. Cook will select the technique that is appropriate to reduce heaviness or fullness of the upper lids, puffiness or loss of tone of the lower lids, and signs of aging or stress that are present in the eyelid region.  Dr. Cook will remove excessive skin, contour excess bulges of fat, and restore support to the eyelid in order to provide a naturalistic rejuvenation that preserves your natural identity.  In selected patients relaxants such as Botox® and injectable fillers such as Restylane® and JUVÉDERM™ can further refine the enhancement.

Dr. John Q. Cook is a board-certified plastic surgeon with a deep interest and extensive experience in eyelid surgery.  His depth of experience, careful attention to detail, and individualized approach to eyelid surgery form the foundation of his reputation in the field of eyelid rejuvenation.

Eyelid Surgery Procedure

Depending on your aesthetic goals and the treatment plan that you formulate during your consultation Dr. Cook can perform upper eyelid surgery, lower eyelid surgery, or both.  If appropriate, eyelid surgery can be easily combined with other aesthetic plastic surgery procedures.  Eyelid surgery is performed on an outpatient basis and takes from one to three hours to complete, depending on the specific combination of procedures.

Most patients chose to recover at home with a friend or family member serving as the caregiver.  We can also arrange for recovery at a nearby hotel with one of our staff serving as caregiver.

Upper Eyelid Surgery

Upper eyelid surgery, also know as upper blepharoplasty, addresses the appearance of tiredness that results from overhanging skin and protruding fat of the upper eyelid.  In severe cases the skin may overhang the lashes of the upper lid and affect vision.  Under magnification Dr. Cook identifies the natural eyelid crease and makes the incision along this line.  Excess skin and muscle are precisely trimmed while allowing for normal eyelid motion.  Dr. Cook will also identify any forward protrusion of the upper eyelid fat that was noted during the consultation and judiciously contour this to provide a fresh appearance.  It is critical to avoid over resection of the fat, since this leads to an upper eyelid that is hollow and harsh.  A precise closure along the line of the natural eyelid crease leads to a scar that is most cases is extremely difficult to detect after the normal healing process is complete.

Lower Eyelid Surgery

Dr. Cook addresses four key issues in surgery of the lower eyelid (lower blepharoplasty).  The relative importance of each of these issues will have been discussed in detail during your consultation with Dr. Cook. 

Fullness or heaviness of the lower eyelid is related to a forward bulging of the natural pillows of fat on which the eye rests.  The solution to this problem relates to a combination of judicious sculpting of the fat and a tightening of the supporting structures of the lower lid.  In some patients the fullness is made more apparent by the descent of the upper cheek that occurs with the aging process.  If this is the case Dr. Cook may carry out a limited upper cheek lift through the blepharoplasty incision.  Sometimes the upper cheek loses its fullness due to a decrease in the natural fat of the upper cheek that may accompany the aging process or significant weight loss.  In this case the appearance of a heavy lower eyelid is increased due to a loss of the natural “camouflage” of the upper cheek fat.  To correct this Dr. Cook rebalances the volume of the upper cheek with the procedure known as autologous fat transfer.  This involves the uniform harvesting of a small volume of fat from a zone of excess (essentially a miniature liposuction) and the transfer of the fat with specialized instruments to the natural fat compartments of the upper cheek.

Skin tone is corrected most often through a fine incision hidden beneath the margins of the lower eyelashes.  Under magnification Dr. Cook releases the skin from the underlying orbicularis muscle (the squint muscle of the lower eyelid) in order to restore proper lid tone.  The skin is trimmed after other steps of the operation are carried out so that there will be a precise correction.  In some cases of mild skin excess chemical peel and laser techniques can be used to improve skin tone.

Muscle tone is related to the quality of the orbicularis muscle, which lies beneath the eyelid skin and is activated whenever we squint.  With the aging process and certain patterns of animation this muscle may lose its tone or develop bulges (sometimes referred to as festoons) that can be seen through the skin.  Dr. Cook formulates a treatment plan that relates to the particular circumstances of each patient. This will involve a combination of trimming excess bulging muscle and tightening the support of the muscle.

Lower eyelid support must be carefully assessed in each patient.  If the aging process or previous surgery has led to diminished support of the lower eyelid, Dr. Cook will detect this during the physical exam of the eyelid as part of the consultation.  This will be corrected with a procedure known as a canthoplasty or canthopexy.  A lower eyelid that lacks adequate support often has a sad rounded out appearance along the outer curve of the eyelid margin.  In more advanced cases the lid will drift away from the eye itself, which can lead to a drying out of the natural layer of tears that protects the eye and its surrounding structures.  Standard lower eyelid surgery procedures will cause an undesirable pulling down of the lid margin if diminished lid support is not detected on physical exam.

Eyelid Surgery Recovery

Your eyes will likely be lubricated with an ointment after the procedure. You can expect some degree of swelling and bruising around the eyes for the first couple of weeks following the procedure; however, and discomfort can be alleviated with medication. In some cases, patients have experienced sensitivity to light, excessive tearing, and blurred or blurred vision. These side effects are generally temporary and will dissipate as the eyelid region heals. You will likely be able to resume normal daily activities after 10 days.

10 Things You Need to Know about Eyelid Surgery

In many ways, the eyelids form the most nuanced region of the face. Surgery must be done with tact and respect for the beautiful organization of the eyelid structures. In my opinion, many “standard” eyelid procedures lack clarity of purpose, since they needlessly disrupt important contours and definition points and produce changes that actually move away from what we find in attractive youthful eyelids. Surgery in this region should respect the soft curves of nature and allow for the natural dynamics of eyelid motion.

  1. All plastic surgery requires skill, but eyelid surgery requires an exquisite fusion of dexterity, artistic visualization and judgment. Patients who are considering this surgery would be well advised to trust this area only to a surgeon who takes this responsibility seriously. One demonstration of seriousness of purpose is that your doctor has invested years of advanced study in order to perfect his skills. Another indication is the degree of thoroughness with which he evaluates the eyelid region.

  2. Successful surgical rejuvenation of the eyelids requires an in-depth understanding and visualization of the structures of attractive youthful eyes. Otherwise, the surgeon will not understand what he or she is trying to achieve. In the attractive youthful lower eyelid, skin is supple and well toned, but not overly tight. The supporting muscle is resilient and allows for the thousand nuances of expression. The eyelid has a pleasing fullness, but it does not bulge, and it blends imperceptibly with the structures of the upper cheek. The attractive upper eyelid has a clearly defined natural crease that is not excessively high. The area above the crease should not bulge, but it should not be sunken. This transition zone should lead smoothly to a beautifully defined prominence on which the brow rests.

  3. As we age, many of us gradually lose the support of the lower eyelid. If this is not recognized by the surgeon in advance, eyelid surgery may destabilize the delicate balance between eyelid structures and cause an undesirable drooping of the lower lid margin. Not only is this unattractive; it can cause increased evaporative loss of the layer of tears that protect the eyes. In some cases this can become a serious problem.

    You can get a general sense of your lower eyelid tone by gently pinching the lower eyelid skin below the lashes and pulling the lid away from the eye. In the lid with good support it will snap back vigorously when released. If the lid drifts slowly back to the eye it may lack adequate support. As long as the surgeon recognizes this, measures can be done to tighten the lid support during surgery. This will enhance both appearance and function. If your doctor does not evaluate the tone of the eyelid during your examination, you would do well to find another surgeon.

  4. Eyelid surgery should not harm and ideally should enhance the expressive qualities of the eyes. Our ability to recognize a face and to make deductions about a person’s mood is related to subtle details and refined motions inherent to eyelid dynamics. We must always keep in mind the eyes' unique expressive qualities when we formulate a plan for rejuvenation.

  5. Clear communication between doctor and patient is important in all forms of plastic surgery, but particularly in eyelid surgery. There are doctors (and patients) who desire a look that I would consider tight and unnatural. There are some women who have undergone aggressive plucking of the fat from their upper eyelid, resulting in a new look that does not reflect their youth. I prefer a softer, gentler look. The key point is to make sure that your surgeon can clearly articulate his goals and that these goals match your own visual esthetic.

  6. It is not just about how the eyelids look, but how they function. During the evaluation of your eyelids, the surgeon must take the time to obtain information about eyelid function. Here are five important aspects that must be evaluated in each patient:

    1. Evaluation of lower eyelid support by physically testing the resistance of the lower eyelid gentle distraction.
    2. Evaluation of the position of the eye on side view to determine its relationship to structures of the cheek. This is known as vector analysis.
    3. Evaluation of the position of the upper eyelid margin in resting gauze. This is necessary to detect what is known as ptosis, a weakness of the muscle that elevates the upper eyelid.
    4. Questions about eye comfort – whether you experience a sensation of dryness or scratchiness of the eyes and need to use eyedrops on a regular basis to maintain comfort. These questions help your doctor determine whether you have a tendency toward the dry eye syndrome, which can be stirred up by eyelid surgery if not recognized.
    5. Questions about seasonal and food allergies – anything that causes cyclical eyelid swelling and irritation. Each of these areas, if properly recognized, can be compensated with modified surgical techniques. If your doctor just looks quickly at you and says, “Yeah, you need a bleph”, you may be exposed to unpleasant surprises after the surgery.

  7. It is critical in all aspects of plastic surgery that your doctor keeps the big picture in mind. Definition of the upper eyelid is affected by more than the eyelid itself. Often it is more an issue of the brow settling to obscure normal eyelid structures. Brow settling, or brow ptosis, causes an undesirable phenomenon known as “hooding” in which a heavy pleat of brow skin settles in front of the upper eyelid to obscure its beautiful form.

    You can obtain a rough idea of the degree of brow descent in your own face, if you look into the mirror and gently elevate the brow by pushing upward on the forehead above the brow. Look at what happens when the brow is brought to an elevated position on the forehead and the clear lines of the region above the upper eyelid are restored. If this resolves the heaviness that you noted in the upper eyelid area, then the proper surgical solution is a brow lift, not a blepharoplasty. The surgeon who fails to help his patient recognize this point does his patient a disservice. He will be forced to over compensate in the upper blepharoplasty and will end up removing brow skin, as well as, eyelid skin. This in turn will affect the beautiful flow of the three-dimensional forms in this area and may compromise brow function. I have even seen cases where this injudicious approach results in the brow being pulled down further. Taking too much skin from this important area may make it difficult for a future surgeon to correct the problem, since when the brow is brought back to its position of harmony, then the upper eyelid may not close adequately.

    As we evaluate the lower eyelid, similar considerations apply. If the upper cheek has lost its volume due to the aging process, the missing cheek fat needs to be replaced or repositioned. Lowering an eyelid bulge to the level of a sunken upper cheek produces a flat look that is precisely the opposite of the beautiful curves of youth.

  8. The most common mistakes in upper eyelid surgery are over resection of skin and a lack of respect for the natural eyelid crease. Surgeons who fail to recognize these details run the risk of producing a harsh, hollow look or even preventing normal eyelid dynamics.

  9. The most common mistakes in lower eyelid surgery include excessive fat removal, over resection of skin, and disruption of eyelid support. The tight sunken look of an overdone lower blepharoplasty represents, in my opinion, a failure of artistic conceptualization.

  10. For most patients, recovery from eyelid surgery is relatively easy. Of course, as with all surgery, there will be degrees of swelling, followed by bruising and a general process of settling in after surgery. It is very important to avoid sun after eyelid surgery. Fortunately, this is relatively easy with high quality sun glasses and nonirritating sun blocks.  

Brow Lift


View Dr. Cook's Gallery For many patients a gradual settling of the upper facial structures occurs with the passage of time.  This may be increased in individuals who develop habits of expression that activate the frown muscles and naturally pull the brow in a downward direction.  As a result of these factors, the brow begins to crowd the upper eyelid and obscures the beautiful contours of this region.  A settled brow often imparts a tired, weary, or even an angry appearance, and this often leads to a misperception of the patient’s mood on the part of friends and acquaintances.

Many patients with significant brow descent experience a sensation of heaviness in the brow and upper eyelid area that may become more severe as the day progresses.  Some patients actually notice a change in their ability to see objects on upward gaze, since the settled brow structures cut across the upper range of vision.

Patients develop compensatory patterns of facial expression to correct the low position of the brow structures.  They activate the frontalis muscle, which is the prime brow elevator of the forehead.  This activity brings the brow back to proper position, but patients often note a sense of fatigue in the forehead due to the constant over activity of the frontalis muscle.

With the constant over activity of the frontalis muscle comes the development of horizontal expression lines across the forehead that can often be quite deep.  Women often compensate for this by wearing their hair forward in bangs.

Many patients do not have a full understanding of the mechanics of brow descent.  They often remark that “people tell me I look angry all the time” or they may have a sense that it is difficult to put eye shadow on the upper lid.  Often the patient comes to the surgeon asking for an upper blepharoplasty (upper eyelid surgery).

Dr. Cook will educate you during the consultation as to whether the heaviness you experience in the upper eyelid region is mostly caused by brow descent, mostly caused by true excess of upper eyelid skin, or caused by a combination of factors.  In this was a proper treatment plan will be constructed.  This is extremely important.  If an inexpert surgeon attempts to correct what is fundamentally a matter of brow descent by operating on the upper eyelid, he will usually remove too much skin and compromise eyelid function.  He will also alter the beautiful three-dimensional form of this region in a way that may be very difficult for a subsequent surgeon of greater skill to correct.

Dr. Cook has several brow lift techniques at his disposal. The brow lift is one of his favorite procedures because of its ability to restore a sense of balance and harmony to one of the key expressive zones of the face.  Dr. Cook often combines the brow lift with other facial rejuvenation procedures including upper eyelid surgery, lower eyelid surgery, face lift, neck lift, and facial fat transfer.

Brow Lift Procedures

Dr. Cook’s most common technique for brow lift is the endoscopic brow lift.  Dr. Cook makes several short incisions behind the hairline through which he uses special instruments and an endoscopic camera that allows the surgery to be seen on a video monitor.  He precisely mobilizes the brow structures and carefully weakens the activity of the frown muscle between the brows.  Dr. Cook then establishes the brows in a proper but not overcorrected position with a secure method of fixation that is typically undetectable to the patient. 

The lateral subcutaneous brow lift is done through incisions that follow the highest point of the temporal hairline.  This technique can be well-suited to the patient who requires a correction of the outer curve of the brow arch but who is reasonably happy with the inner aspect of the brow position. 

The classical brow lift with endoscopic assist involves an incision that runs along much of the forehead hairline.  This technique can be useful for selected patients who desire a forward advancement of a relatively stable hairline.

With each of the brow lift techniques patients will notice a softening of the horizontal lines that have developed across the forehead.  With the brows back in a position of balance it is no longer necessary for the patient to overwork the forehead elevator muscles.  This over activity is the prime cause of the horizontal expression lines of the forehead.

Brow Lift Recovery

Numbness, swelling and bruising occur after brow lift surgery as with any facial aesthetic procedure.  Pain is typically well-controlled with standard prescription pain medications, and most patients are able to discontinue these medications after the first few days.  Because of gravity bruising may settle into the cheek.  The team at The Whole Beauty Institute™ will instruct you in the application of camouflage cosmetics.  Patients will apply ice compresses and sleep with the head elevated for the first few days after surgery.  Most patients return to normal daily activity in seven to ten days, some even sooner.  It is important for you to limit heavy exercise for the first few weeks after surgery.  Our team will provide specific instructions based upon the details of your surgery.

Contact Whole Beauty Institute™

Eyelid surgery and brow lift at our Chicago and Winnetka-area facilities can take years off your face and rejuvenate your spirit. Whole Beauty Institute™ located on Michigan Avenue in the Gold Coast and on Green Bay Road in the North Shore, is the professional home of Dr. John Q. Cook, one of the most respected and experienced aesthetic plastic surgeons in the region. Please contact our practice to schedule a consultation with Dr. Cook.

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