Upper Blepharoplasty vs Brow Lift vs Forehead Lift: What's Best for Droopy Eyelids?

Sagging eyelids and loose skin around the eyes are among the earliest signs of aging.

In this post, we’ll introduce three common eye rejuvenation surgeries for middle-aged patients—upper blepharoplasty, sub-brow lift, and endoscopic forehead lift—used to restore youthful, refreshed eyes.

How to treat drooping eyelids

Aging around the eyes is one of the earliest and most common concerns. Among them, drooping upper eyelids can lead to discomfort such as lashes poking into the eyes, foreign body sensation, and even obstructed vision—making this one of the most in-demand anti-aging procedures.
Many people consider upper blepharoplasty after seeing results from friends or family. However, during consultations at plastic surgery clinics in Gangnam, it’s not uncommon for surgeons to recommend alternative procedures better suited to the patient’s anatomy.

Based on my experience performing over 500 surgeries for aging eyes, I introduced an algorithm for middle-aged eyelid surgery in the journal Aesthetic Plastic Surgery.

There are three popular procedures for eyelid sagging for Asian patients:

In this post, I’ll introduce the characteristics, pros, and cons of each.

Upper Blepharoplasty

What is upper blepharoplasty?

It’s one of the most common procedures people consider for drooping eyelids—often referred to as the “middle-aged double eyelid surgery.”

Advantages

• Removes sagging skin while creating a double eyelid fold.
• Can improve sleepy-looking eyes or change existing double eyelid shapes.

Disadvantages

• In some cases, it can result in a tired appearance.
• Narrowed distance between eyes and brows can cause angry-looking appearance in Asian women.
• Over-removal of skin can lead to an overly thick "sausage-like" eyelid fold.
 

That’s why it’s essential to examine eyelid skin thickness and brow-to-eye distance in the context of overall facial balance before surgery.

Under Brow Lift

What is a sub-brow lift?

A great option to correct thick eyelid skin, especially for Asians. This technique avoids harsh-looking double crease by removing skin just beneath the eyebrows.

Advantages

• Can uncover an existing double crease obscured by excess eyelid skin.
• Ideal for people who want natural results.
• Technically simpler, so results are less affected by surgeon skill.

Disadvantages

• Scar risk, but typically fades in 2–4 months without treatment.
• Like upper blepharoplasty, this can shorten the distance between eye and brow.

Low-set eyebrows may appear youthful in younger Asians, but after the mid-40s, they can sometimes create a stern or fatigued look.
 

Endoscopic Forehead Lift

What is an endoscopic forehead lift?

It elevates the brows from above, improving drooping eyelids. This procedure are quite common in Korea in recent years—where a moderate distance gives a younger and fresh look.
The incision is hidden in the hairline and looks natural from the early recovery phase if performed by skilled surgeons.

Even patients with hair loss, the scar may be less visible after 6months.

For more anatomical insight, see other articles about Forehead lift.

Advantages

• Improves forehead wrinkles, frown lines, and droopy eyelids in one procedure.
• Can soften a stern appearance and create a calm, youthful expression.

Disadvantages

• In some faces, over-widen the eye-brow distance is not recommended.
• In less skilled hands, results may be underwhelming, or hair loss may occur at incision sites.
• While it helps with droopy eyelids and wrinkles, it doesn't correct sleepy-looking eyes caused by ptosis.

In such cases, ptosis correction may be performed simultaneously.

Final Thoughts on Middle-Aged Eyelid Surgery

There’s no single anti-aging surgery that erases all signs of aging at once.
Plastic surgery heavily depends on the surgeon’s technique. Especially for high-skill procedures like upper blepharoplasty or forehead lifts, outcomes and side effects can vary widely.

The three surgeries introduced here are the most common eye rejuvenation options in Korean plastic surgery clinic.
Each case is unique—your doctor’s aesthetic standards, confidence in the procedure, and your goals all affect the recommended plan.
If you understand the concepts in this post before your consultation, you’ll be able to communicate more effectively with your doctor.

Have more questions?
📲 feel free to reach out via 🔗WhatsApp

Noonopi Plastic Surgery | Dr. NK Park

This blog post is for educational purposes only.
All treatments carry individual risks and individual results may vary.
Please consult with a certified professional.