What Is the Difference Between Upper Eyelid and Lower Eyelid Surgery? Are There Different Procedures for Different Eyes? (Explanation by a Board-Certified Plastic Surgeon)

What Is the Difference Between Upper Eyelid and Lower Eyelid Surgery? Are There Different Procedures for Different Eyes?

(Explanation by a Board-Certified Plastic Surgeon)

Hello, this is Obje Plastic Surgery.

When we consult with patients who visit Obje, there is one area they often say feels especially uncomfortable.

It is that the area above and below the eyes has sagged.

Many people say they are worried that sagging upper eyelids make their eyes look heavy, and sagging lower eyelids create an impression of fatigue.

Skin sagging is a symptom that occurs as tissue elasticity gradually decreases with aging. However, the cause of sagging around the eyes differs slightly from person to person.

It can also happen because the strength used to open the eyes weakens, or because the double eyelid line loosens. Since the cause of sagging around the eyes differs for each patient, it is important to identify it in detail and receive the surgery that matches it.

That is why, at Obje, we carefully examine each patient’s eye shape during consultations and recommend the surgical method suited to the cause. Usually, people who come in because of sagging around the eyes think only of upper eyelid surgery or lower eyelid surgery. However, some people are not familiar with the difference between upper and lower eyelid surgery, and they also often have difficulty deciding which procedure is appropriate.

Surgery to improve sagging around the eyes is not limited to upper eyelid surgery and lower eyelid surgery. In addition to those, there are several other surgical methods. But many people are not aware of those other options.

So Obje prepared today’s post. We want to take the time to explain in detail the difference between upper and lower eyelid surgery, as well as other surgical methods that can improve sagging around the eyes! Even if you read today’s post just once, it should be easier to understand when you come in for a consultation. So if you are preparing for a consultation because of sagging around the eyes, please take a moment to read this post carefully.^^

When the eyelids sag, is upper eyelid surgery the answer?

It may be more suitable to undergo something other than upper eyelid surgery!

Sagging around the eyes is divided into sagging above the eyes and sagging below the eyes. Therefore, the recommended surgical method changes depending on where the sagging is located.

First, let’s talk about sagging above the eyes.

Above the eyes are the eyelids first, then the eyebrows, and above them the forehead. Because of this, the procedures performed on the upper eye area include upper eyelid surgery, brow lift, and forehead lift.

Let’s start with the forehead lift, which is performed on the forehead at the top. A forehead lift is, as the name suggests, a surgery that pulls up the forehead to improve a sagging forehead and sagging eyebrows.

Because the forehead itself is lifted, it can naturally improve the eyebrows and sagging eye shape. In addition, since the surgery is performed through a small incision made between the scalp areas and using an endoscope, many patients are satisfied because the scar is not visible after surgery.

Next is the sub-brow lift. A sub-brow lift is a surgery that tightens sagging eyelids by removing the skin just below the eyebrow. It is recommended for people whose eyebrows are far from their eyes, or for those who want to improve sagging eyelids naturally without creating a double eyelid line.

The last is upper eyelid surgery, which is the most commonly used procedure for sagging eyes.

Some people often confuse the difference between upper and lower eyelid surgery, but simply put, upper eyelid surgery improves sagging above the eyes, and lower eyelid surgery improves sagging below the eyes.

Upper eyelid surgery removes excess skin while creating a double eyelid line, helping the sagging eyes look more defined. If necessary, it can also remove bulky fat and be performed together with eye-opening correction to strengthen the muscles used to open the eyes, improving a narrowed field of vision at the same time.

However, if the eyelids are significantly sagging and the eyebrows are also drooping, a forehead lift may be recommended.

Normally, the eyebrows should be positioned slightly above the brow bone. If the eyebrows have sagged below the brow bone and you keep using your forehead muscles to open your eyes, a forehead lift that improves both the sagging eyebrows and forehead is the most appropriate option.

There are also cases where the eyebrows are not very droopy, but the outer part of the eyelid is especially sagging, making the eyes look triangular. In such cases as well, a sub-brow lift can naturally improve the sagging eyes rather than upper eyelid surgery.

Lastly, for people who have sagging eyes without a double eyelid and want to open their eyes more clearly, or who have a lot of fat in the upper eyelid making the eyes look heavy, or who have weak eye-opening strength and look sleepy, upper eyelid surgery is recommended. Upper eyelid surgery can create a clear double eyelid line, remove fat, and be performed together with eye-opening correction to strengthen the muscles used to open the eyes.

For under-eye sagging, which is better: under-eye fat repositioning or lower eyelid surgery?

If the lower eyelids are sagging and there is bulging fat, many people consider under-eye fat repositioning or lower eyelid surgery. However, some people think under-eye fat repositioning and lower eyelid surgery are the same procedure.

Under-eye fat repositioning is a surgery that makes an incision in the conjunctiva on the inside of the eye and redistributes protruding fat to resolve the bulging under the eyes.

Lower eyelid surgery is a procedure that improves not only the bulging fat under the eyes, but also sagging and loosened muscles and skin. A skin incision is made below the eyelashes, then the under-eye fat is repositioned, the sagging muscles are tightened, and some of the sagging skin is removed.

Both procedures address concerns under the eyes, but under-eye fat repositioning literally only repositions the fat, while lower eyelid surgery improves the sagging muscles and skin as well.

These two procedures are often chosen differently depending on age, though it varies somewhat by patient.

This is because the degree of skin elasticity differs by age. Under-eye fat repositioning is usually performed in people in their 20s and 30s. It is suitable for those whose under-eye fat protrudes while the tear trough looks hollow.

Patients in their 20s and 30s generally still have some degree of under-eye elasticity, so under-eye fat repositioning alone can achieve the desired effect.

However, for patients in their 50s and 60s, the skin sags, the under-eye groove becomes deeper, and under-eye wrinkles look more pronounced, so lower eyelid surgery is recommended.

However, among the patients who visit Obje, there are some for whom under-eye fat repositioning alone feels insufficient, but lower eyelid surgery feels too extensive. For these patients, Obje recommends our Dual Lower Eyelid Surgery. Dual Lower Eyelid Surgery is performed with an incision of about half the length of a regular lower eyelid surgery.

It is a surgical method developed by combining the simplicity of under-eye fat repositioning with the benefits of lower eyelid surgery, which improves sagging skin and muscles under the eyes. This special procedure exclusive to Obje is effective for improving bulging fat under the eyes as well as moderately sagging skin and muscles.

There is a separate post with more detailed information about Dual Lower Eyelid Surgery, so if you are interested, please be sure to check it out.^^

Each patient who visits Obje has different skin condition, eye shape, and natural features. Therefore, it is difficult to say that everything explained today is 100% exact. To know which surgery is truly right for you, it is best to have an in-person consultation.

The most important thing in eye surgery is not stopping at self-diagnosis, but having a detailed consultation with a board-certified plastic surgeon. At Obje Plastic Surgery, we listen carefully to the concerns each visiting patient brings and recommend the surgical method that can improve those concerns.

Because we carefully assess each patient’s different conditions and recommend surgery accordingly, please make sure to receive a detailed consultation and an accurate diagnosis from a board-certified plastic surgeon before consulting about eye surgery.

Please think of the information explained today only as a guideline to help you figure out what kind of surgery you may need before your consultation.

Also, if a visiting patient is not familiar with the difference between upper and lower eyelid surgery, Obje Plastic Surgery explains the characteristics of each procedure in detail. If there was anything difficult to understand while reading today’s post, please feel free to visit Obje Plastic Surgery and ask. We will kindly explain everything in an easy-to-understand way.^^

Thank you for reading to the end of this long post. This has been Obje Plastic Surgery.

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• This post is medical information written by Obje Plastic Surgery Clinic in compliance with the Medical Advertising Act.

• Depending on the individual, the effect of the procedure may vary, and side effects may occur.

We strongly recommend having sufficient consultation with medical staff in advance before deciding on the procedure.