#21 Forehead Lift Review: Why Do Some People Not See Results? Feat. Self-Diagnosis Method for Forehead Lift

Endoscopic Brow Lift / Forehead Lift has been one of the fastest-growing facial lift surgeries in Asia, including Korea, Japan, and Thailand, between 2024 and 2025. It has garnered significant interest, promoted as ‘a surgery that brightens the eyes without direct eye surgery’ because it simultaneously addresses droopy eyelids, eyebrow ptosis, forehead wrinkles, and a heavy upper face. However, in actual clinical practice, many patients feel they ‘saw no effect at all’ or ‘nothing has changed’ despite undergoing a forehead lift. Dr. Sung-Hoon Kim of SH Plastic Surgery attributes these reasons to anatomical factors such as the levator muscle, skin thickness, ligament structure in the temporal region, dissection range, and fixation failure. This article summarizes the principles of forehead lift, the three core reasons for ineffective results, situations requiring revision surgery, and a self-diagnosis method for patients to check themselves. This will be the most practical guide for those considering a forehead lift or those who have not achieved the desired results after surgery. – Dr. Sung-Hoon Kim, Facial Designer at SH Plastic Surgery

‘Why didn’t I feel the effects of my forehead lift?’

Many patients come to the clinic with this question.

‘Doctor, I had a forehead lift… but why do I not see any difference at all?’

When forehead lifts spread like a trend,

the misconception arose that ‘everyone who gets it will have their eyes open wide.’

However, a forehead lift is not a panacea,

and under certain anatomical conditions, it may show no effect at all.

I will summarize the reasons why a forehead lift might not be effective

into three anatomical categories.

1. When the eye-opening strength (Levator) is weak — ‘Lifting only the forehead can make you look even sleepier’

A forehead lift is not a surgery that directly enlarges the eyes.

It is merely an indirect effect of lifting the eyebrows to ‘secure extra eyelid skin.’

But what happens if someone with weak eye-opening muscles (levator palpebrae superioris) only lifts their forehead?

The distance between the eyes and eyebrows widens,

while the eyelid opening remains the same,

which can actually make the eyes look even sleepier.

In other words, if you have ptosis or insufficient eye-opening strength,

a forehead lift alone will not be effective.

The solution in such cases?Eye-shaping surgery (ptosis correction) to reinforce the strength of the eyelids first is paramount.

2. When there is a lot of skin redundancy — ‘No change without directly excising the excess skin’

A forehead lift is a surgery that repositions the skin upwards,

not one that reduces the amount of skin.

Therefore, its effect is limited under the following conditions:

If the skin is thick,

If there is a large amount of excess skin,

And if eyelid sagging is severe.

In such cases, no matter how much the forehead is lifted,

the excess skin continues to droop,

preventing the eyes from looking refreshed.

The solution?Direct excision surgeries such as sub-brow lift (direct skin excision) or incisional upper blepharoplasty (skin excision) are necessary.

3. Problems with the surgical method itself — ‘Insufficient dissection + insufficient ligament release + fixation failure’

I believe the most common cause of failure in forehead lifts

is ‘insufficient temporal dissection.’

The reasons are as follows:

The forehead moves in conjunction with the temporal region.

Strong ligaments that pull down the eyebrows (such as the orbicularis retaining ligament)

are present in the temporal region.

These ligaments must be released for the eyebrows to truly lift.

Insufficient dissection range → Forehead does not lift

If only a small part of the forehead is dissected

or if the temporal ligaments are not released,

the eyebrows will never lift.

Weak fixation leads to ‘return to original position’ over time

If fixation is not done properly,

it will drop within 3 to 6 months, ‘reverting to the pre-surgical state.’

That is,

indirect effect + precise dissection + secure fixation

All three of these must be correct for it to be a true forehead lift.

This layer is a very firm and strong fibrous tissue.

It is used as the most stable anchor point in endoscopic forehead lifts.

The image shows sutures placed in the deep layer →

Meaning that after lifting the eyebrows, they are securely fixed to this layer.

This is the principle behind:‘The reason eyebrows stay lifted for a long time = deep temporalis fascia fixation’ and why the temporal region must be dissected.

Self-Diagnosis Method to Check Yourself

‘Will a forehead lift be effective for me?’

1. Completely relax your eyebrows and open your eyes.

→ If your eyes look blurry and heavy at this point,

= Insufficient eye-opening strength → Forehead lift ‘no effect alone’

2. Lift your forehead upwards with your hands.

→ If your eyes become refreshed,

= Forehead lift effect present

3. You have a habit of raising your eyebrows every time you open your eyes.

→ = Overcompensation of the frontalis muscle → Effect may be minimal

4. Your skin is on the thicker side.

→ Effect may be reduced due to weaker force transmission

You can check the explanation from 2 minutes 19 seconds in the video below. ^^

‘Did your forehead lift fail? It’s because of ‘this’.’ The reason why only you didn’t see the effect of a forehead lift

In the next installment, I will explain forehead lift revision surgery.

Some people ask if forehead lift revision surgery is even possible,

and there are those who believe that ‘a forehead lift can only be done once in a lifetime.’

However, that is not always true, and I can tell you it’s a misconception (?).

Recently, many people have visited our clinic considering forehead lift revision surgery,

and even if you have undergone revision surgery 2 or 3 times or more, with proper analysis and consultation,

and after an accurate solution is devised, if you undergo the surgery,

you can achieve a better forehead lift effect than before.

If you are concerned, please visit our SH Plastic Surgery clinic for a consultation

so we can discuss thoroughly whether revision surgery is possible for you.

The story about forehead lift revision surgery will continue in the next installment. ^^

SH Plastic Surgery Clinic