another strong weapon for aging
In drooping eyelids or eyebrows, we can recommend various procedures like upper
blepharoplasty, brow lift, and subbrow lifting.
Even though upper blepharoplasty is the most fundamental surgery for aging eyelids,
it has some limitations like long recovery period, inability to correct lateral
wrinkle such as crow's feet, insufficient correction of severe lateral hooding,
descent of eyebrows after surgery, occasional unnatural or fierce look.
So, we should know various procedures for aging eyelids.
(unnatural and fierce look after upper blepharoplasty which was done in another
Today, I'll introduce subbrow lifting.
Subbrow excision has been performed for 30 years, but couldn't gain popularity
because of its limited availability.
But, modern plastic surgeons resurrected subbrow excision by combining brow
It's becoming popular because of its simplicity and versatility.
In subbow lifting, an ellipse of skin is excised beneath eyebrows and eyebrowbrow
is lifted and fixed to supraorbital periosteum through the same incision.
Through subbrowlifting, eyebrows can be lifted and drooping eyelids skin can
be corrected together.
It’s like catching two birds with one stone.
red arrow : brow lifting
blue arrow : eyelids lifting
black x : supraorbital periosteal fixation)
As you can see in this picture, is lifted and fixed to underlying periosteum.
Drooping eyelids skin is disappeared, brow is lifted and the shape is corrected
also, lateral hooding is corrected and crow's feet becomes fainter, whole impression
around the eyes becomes brighter and more vivid, eyelids below eyebrow looks
lighter and thinner, double fold crease looks crisp and natural
Stand in front of mirror and put finger beneath eyebrow and lift your eyebrow
0.5 or 1 cm by .
You will be startled by the changes that this small lifting of eyebrow can make.
That's the exact effects of subbrowlifting.
1. The scar can be hidden easily by cosmetics in early recovery period and becomes
Scar irregularity rarely happens because underlying tissues are proficient and
movement of eyelids is minimal.
Later, the scar is hardly noticeable because the scar hides behind the shading
eyebrow hair and eyebrows can be easily covered with cosmetics.
If the patient has eyebrow tattoos or is going to have his/her eybrow tattooed,
the scar can be hidden more easily.
In case the eyebrow tattoos or eyebrows are too wide, the surgery can excise
part of it easily and the shape of eyebrows can be improved easily.
2. Recovery is extremely fast.
Even immediately after surgery, the patients looks fine because the stitches
look similar to eyebrow hair.
After removal of the stitches at 5th postoperative days, most people look nearly
Because the eye shape is not changed a lot, the patients can go back to their
3. Brow position can be fixed easily without complex endoscopic brow lift or
brow lift through scalp incision.
Endoscopic brow lift and brow lift through scalp incision are good procedures
for brow lifting.
However, this subbrow lifting is much more simpler and cheaper.
In addition, it can remove excess upper eyelid skin and muscle together.
As I wrote earlier its like catching two birds with one stone.
4. This can be repeated as many times as needed.
Because the scar is placed under eyebrow which is flat area, this procedure
can be repeated many times without fear of prominent scar.
5. Subbrow lifting is especially helpful to following patients.
1) A person who doesn't want to change their double fold
crease and want subtle change with faster recovery.
As you know, upper blepharoplasty needs long recovery period.
Subbrowlifting, however, needs only a week of recovery.
Because the double fold crease is not touched, the impression of eyes will not
be changed at all.
This can avoid occasional unnatural or fierce look after upper blepharoplasty.
▲(6 months after subbrow lifting to person who has good double fold crease with
droopy eyelids and lateral hooding.
droopy eyelids was removed without changing of double fold shape.
lateral hooding was removed and crow's feet became fainted.)
2) A person who has high eyebrows with droopy eyelids
As eyelid skin becomes droopy, people lift their eyebrows subconsciously.
This kind of unconscious lifting of eyebrows can make high eyebrows with long
distance between eyebrows and eyelashes.
By removing the intervening upper eyelids tissue, eyebrows can be correctly
placed to their usual position and droopy skin can be removed at the same time.
Once again, two birds with one stone.
▲ (5 days after subbrow lifting to person who has high eyebrow and droopy eyelids
the distance between eyebrow and eyelids was shortened and droopy eyelids was
subbrow area look lighter and less puffy.)
3) A person who has lateral hooding and depressed eyebrows
Lateral hooding is not corrected properly by upper blepharoplasty.
Sometimes, blepharoplasty can make the lateral hooding worse and exacerbate
But subbrow lifting can correct lateral hooding, excessive Crow's feet, and
depressed eyebrow altogether.
This time, catching three birds with one stone.
4) A person who has thick eyelids skin with droopy eyelids.
Even though eyelids skin is the thinnest skin in our body, it becomes thicker
as it goes higher.
So, this thickness difference between pretarsal skin and subbrow skin may lead
to an unnatural and fierce look t in upper blepharoplasty to thick skinned person.
But subbrow lifting doesn't make this kind of thickness mismatching in eyelids.
Instead, it lifts whole eyelids skin higher and remove the thickest eyelids
So, the eyelids look lighter, flatter, and double folds become crisp.
▲(6 months after subbrowlifting in thick skinned person.
Brow shape was changed, eyelids became lighter, and double fold crease becomes
5) A person who doesn't want double fold crease but wants
to remove droopy eyelids.
If a person doesn't want double fold crease and just want to remove droopy eyelids,
subbrow lifting is recommended.
Many people are afraid of blepharoplasty because they have observed too many
examples of worsening of impression after blepharoplasty around them.
This kind of misunderstanding usually comes from too many improper upper blepharoplasty,
and their resulted prejudice is hard to break.
To these people, subbrow lifting is a more comfortable choice.
If they want double fold crease later, double fold surgery can be done more
easily because the eyelids were lifted.
Sometimes, non-incision method can be done at the same time of subbrow lift
to minimize change in their eyelids shape.
▲ (1 month after subbrow lifting to the person who doesn't want to make double
6) To a person who has excessive drooping of eyelids and
eyebrows, both subbrow lifting and upper blepharoplasty are recommended together.
Compared to removal of excess skin in one place, removal of the excess in two
separate places can make the result more efficient and can prevent some unwanted
complications such as worsening of Crow's feet, excessively long scar and drooping
of eye brows after upper blepharoplasty.
▲ (1 month after subbrow lifting and upper blepharoplasty.)
7) Young people who have puffy eyelids due to droopy eyebrows.
Brow ptosis or droopy brow is not for old individuals only.
They can be happened regardless of age.
Young people who have droopy brow have puffy and heavy eyelids because skin
is crowded between eyebrows and eyelids.
Even if they undergo fat removal, they won’t see any improvement because the
underlying cause is depressed brow.
If they undergo skin excision, the brows drop more and worsen the puffiness.
To these people, subbrow lifting is the ideal procedure because it can lift
eyebrows, can flatten and make lighter in subbrow area, and can lift eyelids
and expose more double fold crease.
As you can see, subbrow lifting is a simple, but very versatile and effective
Of course, this doesn't mean that subbrowlifting can replace upper blepharoplasty
or upper blepharoplasty is bad.
It just means subbrow lifting is a fascinating complementary procedure which
can remedy upper blepharoplasty's shortcomings in certain cases.
All surgeons and patients should consider subbrow lifting whenever they should
correct droopy upper eyelids or brow ptosis.
Hyuncheol Park MD
OZ Cosmetic Clinic