Doctor's Column

This is a case of a patient whose distance between the eyebrows and eyes appeared narrow, and who experienced severe pressure on the eye shape due to sagging upper eyelid skin and forehead descent. We analyze the 4-month post-operative results where downward pressure on the forehead and eyebrows was relieved through an endoscopic forehead lift, and a natural eye shape was restored by combining non-incisional double eyelid revision and upper blepharoplasty. We explain an approach to blepharoplasty centered on structural restoration rather than simple line correction.

Face Designer, Dr. Sung-Hoon Kim, Director of SH Plastic Surgery

Hello, I am Dr. Sung-hoon Kim of SH Plastic Surgery.

In the past, after undergoing non-incisional double eyelid surgery, the line had partially loosened over time;

however, the patient stated that they actually liked the natural, loosened feel of their eyes as they were.

Nevertheless, because the distance between the eyebrows and eyes looked narrow, making the overall eye area look heavy and stifled,

they came in for a consultation to improve this.

As a result of the consultation, a forehead lift was necessary to elevate the position of the eyebrows and widen the distance between the eyes and eyebrows;

and because the double eyelids could look even more loosened after the forehead lift,

we planned a non-incisional double eyelid revision together to maintain a natural eye shape.

This patient had significant forehead descent, and the eyebrows were pressed downward.

Consequently, the sagging of the upper eyelid skin appeared more prominent,

and a lack of eye-opening strength occurred, creating pressure on the eye shape.

Many people only think of upper blepharoplasty in this condition.

However, the starting point of the problem was the "position of the eyebrows."

CASE

Pre-operative Frontal Photo

Narrow distance between eyebrows and eyes

Sagging upper eyelid skin -> hooded eyes

Forehead descent

Downward pressure caused by forehead descent

Lowered eyebrow position

Structural instability of the existing double eyelid line

As the frontalis muscle and corrugator muscles continuously apply downward pressure,

the eyebrows droop, worsening the sagging of the upper eyelid skin beneath them.

At this point, pressure on the eye shape occurs.

The eyes open, but they do not open sufficiently.

This is why the distance between the eyebrows and eyes appears narrow.

Surgical Strategy — The structure must be resolved

Endoscopic Forehead Lift

Lifts the forehead through an incision inside the hairline.

Resolves forehead sagging and induces natural bilateral movement of the eyebrows.

The key here is not "excessive lifting," but structural normalization.

Non-incisional double eyelid revision surgery

Reorganizes the structure of the line without excessive incisions.

Reduces pressure on the eyes and creates a natural eye shape.

Combined with upper blepharoplasty if necessary

Distinguishes whether skin sagging is due to structural factors or simple aging.

Changes 4 months after surgery

The true results appear after 4 months.

Normalization of the exposure of the previously compressed pupil

Reduction of upper eyelid skin sagging

Improvement in the distance between the eyebrows and eyes

Resolution of the sleepy appearance

The important point is that the eyes have become clear without intentionally opening them wide.

Endoscopic forehead lifting is not merely a cosmetic surgery,

but a procedure that restores the functional opening of the eyes.

Before and after surgery comparison

Relief of eye pressure

Transformation into a clear and natural eye shape

Reflections by Facial Designer Dr. Kim Seong-hoon

Eye surgery fails if you only look at the eyes.

Many cases cannot be resolved through upper blepharoplasty alone.

Sub-brow lift, endoscopic forehead lift, and non-incisional double eyelid revision surgery

are not competing procedures.

They are chosen based on the location of the problem.

If the distance between your eyebrows and eyes appears narrow,

it is not simply a matter of cutting away skin.

If the structure is compressed, the structure must be released.

I always ask:

"What is the reason these eyes are compressed?"

If you cannot answer that question,

no matter how elaborate the incision is, it cannot resolve the core issue.

FAQ

Q1. If the distance between the eyebrows and eyes is narrow, is a sub-brow lift unconditionally required?

No. If the cause is forehead ptosis (sagging), an endoscopic forehead lift comes first.

Q2. Does an endoscopic forehead lift leave scars?

Since the incision is made inside the hairline, there is almost no external exposure.

Q3. Can't I just get upper blepharoplasty?

If forehead ptosis is the cause, it may actually look more heavy and unnatural.

Q4. Why was non-incisional double eyelid revision surgery necessary?

Because the structure of the existing line was not stable.

Q5. Does it also improve weak eye-opening strength?

Once the structural pressure is resolved, functional improvement follows.

Q6. How long is the recovery period?

Major swelling subsides in 2 to 3 weeks, and natural results settle in 3 to 4 months.

(620) If you get a forehead lift in your 20s, will it sag more later? - YouTube

SH Plastic Surgery Clinic