If your double eyelid line keeps collapsing, the cause might be your ‘forehead’. SH Plastic Surgery's Endotine Endoscopic Forehead Lift for the upper face.

A 54-year-old female patient was considering double eyelid revision surgery. The root cause of the problem was not her eyes, but sagging of her forehead and upper face. We introduce a case of structural lifting by Dr. Kim Sung-hoon of SH Plastic Surgery, who used an Endotine endoscopic forehead lift to reduce the burden on the eyelids and naturally restore the double eyelid line. Dr. Kim Sung-hoon, Face Designer at SH Plastic Surgery.

Hello, I am Dr. Kim Sung-hoon, a face designer at SH Plastic Surgery.

Among those who consider revision surgery because their double eyelids seem to have loosened,

it is not uncommon for the forehead, rather than the eyes, to have descended and covered the eyes.

Today, I will explain the reason through the case of a 54-year-old woman for whom a forehead lift was prioritized over double eyelid revision surgery.

‘Have my double eyelids loosened again?’

This is the most frequent question I hear in the consultation room.

However, upon closer inspection, the problem is often with the forehead, not the eyes.

Today, I will discuss a representative case of a 54-year-old woman.

Patient Basic Information

Female, born in ‘71 / 54 years old

2019: Sub-brow lift

2021: Lower blepharoplasty

After consulting for double eyelid revision surgery at another clinic,

she was told that ‘the cause of eye sagging is the forehead, not the eyes’

and visited SH Plastic Surgery, a hospital specializing in forehead lifts.

Pre-surgery Condition Analysis

‘My eyes look saggy, but is the double eyelid really the problem?’

This patient had a history of sub-brow lift surgery.

Nevertheless, over time, her eyes started to look heavy again,

and she complained that her double eyelid line became blurry and covered.

The reason is relatively clear.

Because a sub-brow lift is primarily a skin excision-focused surgery,

over time, the weight of the forehead and upper facial muscles presses down again.

Especially in cases where more than 5 years have passed,

gravitational sagging of the forehead and upper cheekbones often covers the eyelids again.

That is,

outwardly, it looks ‘as if the double eyelid has loosened’,

but the actual cause is the descent of the entire upper face, not just the eyelids.

If double eyelid revision surgery is performed in this state,

the line will become thick,

the impression will become strong,

and there is a high possibility that it will sag again over time, leading to re-revision surgery.

This case is not simply a problem of sagging eyes.

The forehead and upper face are entirely descending, pressing down on the eyes.

Eyelids pressed down by the descent of the forehead and upper face

Reduced distance between eyebrows and eyes

Double eyelid line blurred as eyelids are covered

Left eyebrow descent is more severe, making asymmetry prominent

Although a sub-brow lift was performed in the past,

because it is primarily a skin excision-focused surgery,

over time, the weight of the forehead and muscles acts downwards again.

→ Consequently,

it looks like an eye problem, but the actual cause is the structural descent of the forehead and eyebrows.

This case ultimately

required a surgery to correct the structure first, rather than a surgery to recreate the line.

7 Days Post-Surgery

For this patient,

the forehead, eyebrows, and entire upper face were repositioned upwards.

As the forehead tissue moved upwards,

the eyebrow position naturally elevated

the distance between the eyebrows and eyes immediately recovered

the difference in height between the left and right eyebrows was alleviated, improving asymmetry

The important point is

that ‘the eyes were not directly touched’.

The double eyelid was not recreated,

nor was the eyelid skin excised.

Instead, the forehead–eyebrow–eyelid was viewed as a single structure,

and the entire structure was lifted from above.

In the photo 7 days post-surgery,

swelling and bruising are still present,

but it can be confirmed that the power to open the eyes has become much more comfortable.

The eyebrow position naturally rises,

and the space above the eyelid is gradually secured.

1 Month Post-Surgery Photo

‘What changes occurred?’

One month after surgery,

the key changes in this case become clear.

• Eyelids feel lighter
• Vision is wider
• Double eyelid line is stable even without artificial creation
• Overall impression is much brighter and more relaxed

Particularly noteworthy is

that ‘even though the forehead was lifted, it doesn’t look awkward’.

This patient

• had a relatively long face
• had a long philtrum
• did not have a long nose
• was the type whose upper face was pressed down, making her impression look heavy

In such facial proportions,

even if the forehead is lifted to a certain extent,

the central balance of the eyes, nose, and mouth often improves.

In other words,

the forehead lift did not simply ‘lift the forehead’

but played a role in refining the overall facial proportions.

CASE Summary

If your double eyelid line keeps collapsing

and your eyes look heavy,

the cause might be your ‘forehead’ rather than your ‘eyelids’.

If you have already had a sub-brow lift or double eyelid surgery,

but sagging has recurred over time,

the next choice should not be a stronger double eyelid,

but a surgery to correct the structure of the upper face.

Dr. Kim Sung-hoon’s Reflection, Face Designer

The core problem for this patient was not her double eyelids,

but the forehead and upper facial structure that had continuously pressed down on her double eyelids.

Although she had already undergone sub-brow lift surgery,

skin excision-focused surgery can lead to recurrence of sagging over time

as the weight of the muscles and forehead acts downwards again.

If double eyelid revision surgery is performed in this state, the line will become thick,

and there is a high possibility that the impression will become heavy.

An Endotine endoscopic forehead lift is a surgery that lifts the entire upper facial structure without directly touching the eyes,

thereby reducing the burden on the eyelids.

In cases like this, where the structure is the cause, a forehead lift is the most reasonable solution.

SH Plastic Surgery’s Endotine Endoscopic Forehead Lift

• Analyzes the eyes, forehead, and upper face as a single structure
• Corrects muscle and position, not just skin
• Aims for long-lasting results without excessive changes in impression

In cases like this,

where ‘structural improvement is needed before double eyelid revision surgery’

more natural and stable changes can be expected.

FAQ

Q1. I’ve already had a sub-brow lift, why can it sag again?

A sub-brow lift is primarily a skin excision-focused surgery.

Over time, the weight of the forehead and upper facial muscles can press down again,

causing the eyelids to be covered again.

This recurrence of sagging is common, especially after 5 years or more.

Q2. Should I not have double eyelid revision surgery in this state?

It is possible but not recommended.

If a line is recreated while the upper face is heavy,

the eyes may look puffy or the impression may become strong,

and it is highly likely to sag again, leading to re-revision surgery.

Q3. Won’t a forehead lift make my eyes look too lifted?

It depends on facial proportions.

In cases like this, where the face is relatively long and the philtrum is long,

even if the forehead is lifted to a certain extent, it does not look awkward,

and often the central balance of the eyes, nose, and mouth improves.

Q4. What is different about an Endotine forehead lift?

An Endotine forehead lift involves

• minimal incision inside the scalp
• precise dissection using an endoscope
• fixing muscles and structures from above

This method aims for a natural and long-lasting lift

without excessively pulling the skin.

Q5. Will the double eyelid line be maintained even without separate surgery?

When the upper facial structure is corrected with a forehead lift,

the force pressing down on the eyelids disappears,

and the existing double eyelid line often naturally appears and stabilizes.

This case is a prime example.

Q6. Is a forehead lift necessary for all such cases?

No.

If the eyelid skin itself is the problem, upper blepharoplasty or double eyelid surgery may be appropriate.

However, if the line keeps getting covered and revision surgery is repeatedly needed,

a diagnosis of the upper face and forehead structure must precede.

(545) Introduction to Sub-brow Lift & Forehead Lift Cases! You can change too~ - YouTube

SH Plastic Surgery Clinic

※This content is for general medical information purposes only,

and results and recovery processes may vary depending on individual conditions.

Actual treatment and surgical methods are determined after diagnosis by medical staff.