Total Anti-Aging Case: Improving Full-Face Sagging All at Once ~ by Dr. Young-moon Yoo, VIBE Plastic Surgery (Sinnonhyeon Station)

By the late 50s, aging often manifests as a simultaneous decline across the entire face rather than just sagging eyelids.

Forehead and eyebrow sagging

Upper eyelid drooping

Under-eye fat and dark circles

Mid-face (cheek) sagging

Jowls and a collapsing jawline

Neck wrinkles and sagging

And more.

Because multiple areas age together, it is often difficult to achieve sufficient improvement by operating on just one specific area.

In this case, the patient presented with severe sagging from deep frown lines down to the neck. We developed a comprehensive surgical plan to lift the entire face:

✔ Forehead ~ Eyelids ~ Under-eye & Mid-face

✔ Jawline ~ Neck

1. Endoscopic Forehead Lift + Sub-brow Lift + Natural Adhesion Double Eyelid Surgery

The fundamental solution for sagging eyes

The most important aspect of eye surgery after the age of 50 is not simply creating a double eyelid, but addressing the root cause of sagging around the eyes.

For this patient:

The forehead and eyebrows had sagged overall.

The eyelids were heavily hooded.

Frown lines were very deep.

In such cases, performing upper blepharoplasty alone can result in:

Overly thick double eyelids

An unnatural or harsh impression.

Therefore, the surgery was performed as follows:

① Endoscopic Forehead Lift

An endoscopic forehead lift is a procedure that raises the sagging forehead and eyebrows.

Effects:

✔ Fundamental improvement of eyelid sagging

✔ Softening of frown lines

✔ A much gentler impression

✔ Clearer, more defined eyes

This is particularly effective for those who use their forehead muscles to open their eyes.

② Sub-brow Lift

This method removes sagging skin through an incision below the eyebrow to naturally tidy up the eyelids.

Advantages:

✔ Improves thick, heavy eyelids

✔ Creates a natural eye shape

✔ Minimal visible scarring

③ Natural Adhesion Double Eyelid Surgery

Finally, a natural adhesion technique was used to complete a subtle, natural line that is not overdone.

In eye surgery for those in their 50s, a ‘clear yet natural line’ is the most critical factor.

2. Lower Blepharoplasty + Mid-face Lift

Solving under-eye fat and cheek sagging simultaneously

As we age, two problems often appear under the eyes at once:

1️⃣ Bulging under-eye fat

2️⃣ Deepening dark circles as the cheeks sag

This patient also exhibited:

Protruding under-eye fat

Under-eye wrinkles

Mid-face sagging.

Therefore, we performed lower blepharoplasty and a mid-face lift together.

① Lower Blepharoplasty

Lower blepharoplasty improves a tired appearance by:

✔ Removing bulging under-eye fat

✔ Tidying up loose skin

✔ Improving under-eye wrinkles

② Mid-face Lift (Cheek Lift)

A mid-face lift is a procedure that elevates saggy tissue from the under-eye area to the cheeks.

Effects:

✔ Softening of dark circles

✔ Restoration of cheek volume

✔ Mid-face lifting

✔ A much younger-looking face

Recently, lifting the ‘under-eye + mid-face’ together produces much more natural results than simply removing under-eye fat alone.

3. Facelift + Neck Lift

Improving the collapsed jawline and neck wrinkles at the same time

After the 50s, the following often occur simultaneously:

Jowl sagging

Loss of jawline definition

Double chin

Neck wrinkles

This patient also had a heavy lower face with sagging extending down to the neck. Thus, we performed a facelift and neck lift together.

① Facelift

A facelift is not just about pulling the skin; it involves lifting from the SMAS layer.

Effects:

✔ Improvement of sagging jowls

✔ Defined jawline

✔ Creation of a V-line

✔ Softening of nasolabial folds

② Neck Lift

A neck lift is a procedure that improves:

Loose neck skin

Neck wrinkles

Sagging under the chin

Notably, if a facelift is done without a neck lift, the boundary between the jawline and neck can look unnatural. Therefore, it is recommended to perform them together.

Why is comprehensive surgery necessary for severe facial sagging?

Aging after 50 is a phenomenon where the entire facial structure sags together, not just one part. Therefore, improving only one area—such as:

✔ Only eye surgery

✔ Only under-eye surgery

✔ Only a lift

—can actually make the overall balance look awkward. It is crucial to analyze the face as a whole, from the forehead to the neck, and create a surgical plan accordingly, as seen in this case.

Anti-Aging Principles of VIBE Plastic Surgery

At VIBE Plastic Surgery, we prioritize:

✔ Natural changes

✔ Overall facial balance

✔ Long-lasting results

Especially in cases of complex aging, we analyze the patient’s facial structure and degree of sagging to design a customized anti-aging surgical plan.