2026-01-14
#31 Why the upper and mid-face should be designed together! Endoscopic Forehead Lift, Brow Lift, Buried Suture Double Eyelid, Lower Blepharoplasty, Mid-face Lift: A Unified Facial Design at SH Plastic Surgery
This article explains why endoscopic forehead lift, brow lift, buried suture double eyelid, and lower blepharoplasty + mid-face lift should be designed together, based on anatomical aging and research. It details the meaning of scar design from the temple hairline to behind the sideburns and ears, and why treating the upper and mid-face as a single structure yields natural and long-lasting results.

An endoscopic forehead lift is not just a surgery for the eyes. In this article, we explain why an endoscopic forehead lift with thread fixation, brow lift, buried suture double eyelid, and lower blepharoplasty + mid-face lift should be designed together, based on anatomical aging processes and research evidence. We detail the significance of scar design, extending from the temple hairline to behind the sideburns and ears, and why approaching the upper and mid-face as a single structure leads to natural and long-lasting results. – Dr. Kim Sung-hoon, Director of SH Plastic Surgery, Facial Designer
Hello. I am Dr. Kim Sung-hoon, a facial designer.
The weather has been getting extremely cold lately.
The flu has also made its rounds like an epidemic,
and I, too, need to pay attention to my immunity.
The first words from a patient I consulted yesterday were,
‘Doctor, I thought I only needed eye surgery.’
Indeed, many people think this way when they visit and consult with us.
However, when we look at the face as a whole,
eye problems are often not just isolated to the eyes.
Sagging starting from the forehead presses down on the eyebrows,
the eyebrows cover the eyelids,
and that weight, in turn, connects and descends to the undereyes and mid-face.


Today, I would like to explain the surgical procedures for patients who visit for these reasons,
using a case study.
I will explain why an endoscopic forehead lift + brow lift + buried suture double eyelid + lower blepharoplasty + mid-face lift
should be designed as a single, continuous flow.
The Connected Structure of Upper and Mid-face Aging
Upper face aging is explained in the following sequence:
Forehead soft tissue descent
Brow ptosis
Excess upper eyelid skin and heavy sensation when opening eyes
Weakening of undereye support
Mid-face descent and connection to nasolabial folds
Surgical Procedures
1. Endoscopic Forehead Lift
An endoscopic forehead lift
is not just a surgery to lift the forehead.
Sufficient dissection up to the temporal region
Severing of the retaining ligaments that pull down the eyebrows
Long-term position maintenance through thread fixation
These three must be performed together
for the eyebrows to ‘truly’ lift.
2. Brow Lift
A brow lift
is a surgery that removes the weight covering the upper eyelid from above.
Improved vision without eyelid skin excision
Minimal change in overall impression
Increased stability when combined with a forehead lift
3. Buried Suture Double Eyelid – ‘Thin, Light’
With the forehead and eyebrows lifted,
there is no need to create a double eyelid again with an ‘incision’.
Assists eye opening with a thin buried suture line
Minimizes swelling and scar burden
Design that does not compromise the effect of the forehead lift
First, correct the structure, then create the line as an auxiliary measure.
4. Lower Blepharoplasty + Mid-face Lift
If only undereye fat is repositioned,
it may sag and loosen again over time.
Lower blepharoplasty: Addresses undereye fat and loose skin
Mid-face lift: Restores cheek support structure
Improves tear trough and nasolabial fold connection




Why Scar Location is Important
One of the biggest advantages of endoscopic forehead lift surgery is
that it is designed to have almost no visible scars.
However, ‘small incision’ does not mean ‘no scar’.
To minimize scars, the incision location, direction, and fixation method are all important.

Principles of Endoscopic Forehead Lift Scar Location
The incision for an endoscopic forehead lift is
typically located 1.5-2cm behind the hairline within the scalp.
Incision in the **scalp** rather than the forehead skin
Hidden among the hair, with almost no external exposure
Incision parallel to the direction of hair follicles to minimize damage


Reflections from Facial Designer Dr. Kim Sung-hoon
‘The core of this surgery
is not that multiple surgeries were performed.
It is that the forehead – eyebrows – eyelids – undereyes – mid-face
were designed as a single structure.
If you only look at the eyes, the eyes become stuffy,
and if you only look at the forehead, the impression becomes awkward.
The face should not be viewed in parts,
but understood as connected.’

FAQ
Q1. Who is this surgery suitable for?
It is suitable for those who have both upper face heaviness and undereye sagging.
Q2. Are the scars really invisible?
They are hidden along the hairline and behind the ears, making them almost unnoticeable in daily life.
Q3. What is the recovery period?
Major swelling subsides in 2-3 weeks, and a natural look is achieved in 2-3 months.
Q4. Can't I just have a forehead lift?
If there is undereye and mid-face sagging, there are limitations.

SH Plastic Surgery Clinic
(407) Introduction to Brow Lift & Forehead Lift Cases! You can change too~ - YouTube