How to Find the Right Surgery for Drooping Eyelids (Upper Blepharoplasty vs Brow Lift Under the Eyebrow vs Endoscopic Forehead Lift)

What should you choose among upper blepharoplasty, brow lift under the eyebrow, and forehead lift?

When people come in for a consultation because of drooping eyelids,

they usually ask less about “how many surgeries are there?” and more about “which one is right for my face?”

All three can improve “drooping eyes,”

but the pulling location and the range of effect are completely different.

| To start with, the conclusion (10-second summary) If you want to create a new double eyelid line, and the eyelid skin itself is sagging → upper blepharoplasty is often the better option.If you want to keep your existing double eyelid line, and the outer area around the eyes is noticeably sagging → consider a brow lift under the eyebrow.If the distance between the eyes and eyebrows is narrow, and you also want to address forehead/glabellar wrinkles → consider an endoscopic forehead lift.If sunken eyes are also present, lifting alone may make the hollowness look more pronounced, so diagnosis is especially important. |

The key is “where to pull”

Even for the same “drooping eyes,” if the actual location of the sagging is different, the surgical choice changes.

• Upper blepharoplasty: addresses the issue from the eyelid (lowest area)

• Brow lift under the eyebrow: addresses the issue from under the eyebrow (middle area)

• Endoscopic forehead lift: addresses the issue from the forehead to the eyebrows (highest area)

1-minute self-check (it’s good to confirm just this much before your consultation)

1. Do you want to keep your existing double eyelid line, or create a new one?

2. Is the sagging especially severe on the outer corners of the eyes?

3. Has the distance between your eyes and eyebrows always been narrow?

4. Do your upper eyelids look sunken (hollowed)?

The answers to these four questions almost decide the direction of surgery.

When upper blepharoplasty is the right choice

Upper blepharoplasty removes eyelid skin and then pulls and sutures it.

If needed, a new double eyelid line can also be created.

• People with thin eyelid skin and sagging

• People who want a new double eyelid line

• People with sunken eyes, for whom doing “lifting only” may make the hollowness stand out more (if necessary, consider fat grafting/volume correction together)

The key points are how much skin is removed, from where it is removed, and how the line is designed.

Upper blepharoplasty illustration diagram

Before-and-after upper blepharoplasty photo - new double eyelid line surgery

When a brow lift under the eyebrow is the right choice

This method removes skin and lifts it from below the eyebrow.

Because it lifts directly from a closer distance than a forehead lift, it helps improve sagging around the outer eye area.

• People who do not want to alter their existing double eyelid line

• People with noticeable sagging on the outer corners of the eyes

• People with relatively thick eyelid tissue (often preferred by men)

However, because the incision is under the eyebrow, scar management is important depending on your constitution and skin condition.

Brow lift under the eyebrow surgical diagram illustration

When an endoscopic forehead lift is the right choice

This method lifts the forehead to the eyebrows after dissecting the entire area endoscopically. Because the range is large, the area of effect is also broad.

• People with a narrow distance between the eyes and eyebrows

• People concerned about forehead wrinkles or glabellar wrinkles at the same time

• People with inward-side sagging of the eyes (judgment should be made based on overall facial balance)

A forehead lift is not simply a procedure that “pulls harder.”

The key is designing it according to the condition of the muscles and tissues.

Before-and-after endoscopic forehead lift comparison photo - changes in forehead wrinkles and eyelid sagging

Do you only need one procedure? Cases that require a combination of two

Depending on the degree of sagging and accompanying symptoms, two procedures may be combined.

• Improve overall sagging with a forehead lift + refine the line/skin sagging with upper blepharoplasty

• Improve outer sagging with a brow lift under the eyebrow + evaluate eye-opening correction (ptosis) if needed

The important thing is that you should not recommend the same surgery just because of the single phrase “eyelid sagging.”

If the facial structure is different, the answer will be different too.

Before your consultation, organize just this much

• Desired change: keep the double eyelid line vs create a new line

• Concern: looking sleepy vs visual obstruction vs overusing the forehead muscles

• History of previous surgeries/procedures (upper blepharoplasty, eye-opening correction, fillers, fat grafting, etc.)

• Most concerning area: outer eye area / inner eye area / forehead wrinkles

Frequently asked questions (FAQ)

Q. Can all three surgeries be performed at the same time?

A. It is possible, but it is not common.

Usually, two procedures are combined, and which combination is appropriate is determined after diagnosis.

Q. Will my expression look unnatural after a forehead lift?

A. The results differ between a method that simply pulls and a method designed with the muscles and tissues in mind.

Correction tailored to the individual condition is important.

Q. Will the habit of using the forehead to lift the eyes decrease after surgery?

A. If eyelid sagging improves, the habit of assisting vision with the forehead may decrease. However, this varies from person to person.

To summarize

Thin skin + sagging + new double eyelid line → upper blepharoplasty

Keep the existing double eyelid line + outer eye sagging → brow lift under the eyebrow

Forehead wrinkles + narrow distance between the eyes and eyebrows → endoscopic forehead lift

The most important thing is finding the surgery method that fits your facial structure.

Rather than there being one correct answer, the answer is the combination and design that suits your condition.

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This content was written directly by MOOI Plastic Surgery Clinic in compliance with Article 56, Paragraph 1 of the Medical Service Act, for the purpose of conveying information in an easy-to-understand way about procedures and surgeries. Since each individual may experience differences and side effects in all procedures/surgeries, we recommend that you 반드시 consult with the responsible medical staff before proceeding.