When Eyelid Sagging is Severe, Why Eye Surgery Alone Isn't Enough (Benefits of Endoscopic Forehead Lift) - Dr. Youngmoon Yoo, VIBE Plastic Surgery Gangnam Station

The eyes are the first area of the face to reveal aging.

In particular, sagging eyelids and the position of the eyebrows significantly impact one’s impression.

The case I am introducing today is a woman in her 30s who visited from overseas (Uzbekistan), for whom it would have been difficult to achieve satisfactory results through simple eye surgery alone.

Pre-operative Analysis | Severe Sagging Relative to Age

Despite being in her 30s, the patient exhibited the following distinct characteristics:

• Relatively severe eyelid sagging
• Low eyebrow position, resulting in a very narrow gap between the eyebrows and eyes
• A heavy and stifled impression due to the narrow spacing
• Thin skin with low elasticity, prone to sagging

In such cases, if only double eyelid surgery or ptosis correction is performed:

✔ It may look sharp temporarily

✔ There is a high probability of sagging again over time

✔ The gap between the eyes and eyebrows often remains frustratingly narrow.

Why Are There Limits to Eye Surgery Alone?

It is crucial to accurately distinguish whether the cause of eyelid sagging is:

✔ A problem with the eyes themselves

✔ Or originating from the sagging of the forehead and eyebrows.

In this patient’s case,

A significant portion of the pressure weighing down the eyelids was caused by the sagging of the forehead and eyebrows.

If only the eyes were operated on, excessive force would be required to open the eyes, potentially making the expression look unnatural.

Therefore, a surgical plan was established to combine eye surgery with a forehead lift.

Surgical Plan | Endoscopic Forehead Lift + Eye Surgery Combination

1️⃣ Endoscopic Forehead Lift

• Naturally lifting the low, sagging eyebrows
• Securing space between the eyebrows and eyes to improve the stifled look
• First correcting the overall balance of the forehead and eyes

2️⃣ Partial Incision Ptosis Correction

• Supplementing the eye-opening power without overdoing it
• Minimizing the burden on thin, weak skin

3️⃣ Epicanthoplasty

• Gently opening the inner corners of the eyes
• Completing a refreshed, open, and clear impression

👉 This was not just a surgery to enlarge the eyes, but a design that viewed the eyes, eyebrows, and forehead as a single integrated structure.

Surgical Results | A Difference Eye Surgery Alone Cannot Create

After the surgery:

• The gap between the eyebrows and eyes was naturally secured
• The eyes changed to a much more refreshed and clear impression
• Achieved comfortable-looking eyes without the feeling of forced opening
• Overall improvement to a bright and sophisticated impression

In particular, the patient remarked, ‘Rather than just my eyes getting bigger, my whole face looks much more refreshed.’

This is precisely the difference achieved when combining a forehead lift with eye surgery.

Why Combining Forehead Lift and Eye Surgery is Vital for Severe Sagging

✔ The maintenance period of the eye surgery results becomes much longer

✔ The possibility of re-sagging can be reduced

✔ Natural and stable results can be expected without excessive eye surgery.

Especially when:

• The eyebrows are low
• The eyelid skin is thin and sags easily
• Sagging has progressed rapidly relative to age

In these cases, the combination of an endoscopic forehead lift and eye surgery can be the most satisfying choice.

Why Patients Visit from Overseas

Recently, there has been a steady increase in international patients seeking:

✔ Naturalness

✔ Surgery that considers both function and structure

✔ A youthful impression that is not overdone

Patients from various countries, including Uzbekistan, are visiting VIBE Plastic Surgery for eye and forehead procedures that balance the entire face, rather than just ‘surgery to make the eyes bigger.’

Closing Thoughts | We Don’t Just Look at the Eyes

When worried about sagging eyelids, it is easy to think ‘I just need eye surgery,’ but in reality, the position of the forehead and eyebrows often determines the outcome.

VIBE Plastic Surgery does not just look at the eye; we analyze the forehead, eyebrows, and eyes as a single structure to propose the most natural method.

Consultations and surgeries should be performed by a board-certified plastic surgeon!

VIBE comes from rich experience.

Youngmoon Yoo, Representative Director, VIBE Plastic Surgery

VIBE Plastic Surgery complies with medical laws. These before-and-after photos were taken under the same conditions with the patient’s consent. Complications and side effects such as bleeding, inflammation, infection, and asymmetry may occur after surgery and vary by individual; caution is required.