Sagging Eye Surgery: Upper Blepharoplasty Alone is Not Enough! Anti-aging Eye Surgery with Endoscopic Forehead Lift & Upper/Lower Blepharoplasty - Dr. Young-moon Yoo, VIBE Plastic Surgery

Hello.

I am Dr. Young-moon Yoo, Director of VIBE Plastic Surgery.

A while ago, a female patient in her 60s visited our clinic holding her daughter’s hand.

‘I want my mom to look beautiful and young at my wedding,’

the daughter said, bringing her mother in as a special gift of filial piety.

During the consultation, I realized that the issue was not simply a matter of ‘eye surgery.’

✅ Concerns Before Surgery

• Deep-set forehead wrinkles
• Heavily descended eyebrows
• Sagging upper eyelid skin
• Under-eye sagging and fat protrusion
• A constantly sleepy and tired impression

In particular, she had a severe habit of forcing her eyes open using her forehead muscles. This created a vicious cycle where forehead wrinkles deepened and eyelids sagged even further.

In cases like this, many people think:

‘Can’t I just get upper blepharoplasty?’

However, in reality, ❌ upper blepharoplasty alone cannot solve the problem.

✅ Why is Upper Blepharoplasty Alone Not Enough?

The core cause is not the eyelids, but rather ‘eyebrow and forehead sagging.’

When the eyebrows descend, the eyelid skin below them is pushed down and sags. If you perform only upper blepharoplasty in this state:

• ⚠ The surgery becomes a mere skin-cutting procedure
• ⚠ The distance between the eyes and eyebrows becomes even narrower
• ⚠ The impression can look stuffy and more aggressive
• ⚠ Forehead wrinkles remain as they are

In short, it becomes a treatment that fails to address the root cause.

✅ The Chosen Surgical Method

For this case, we performed a combination of three anti-aging procedures:

• Endoscopic Forehead Lift
• Upper Blepharoplasty
• Lower Blepharoplasty

1️⃣ Endoscopic Forehead Lift

This was actually the most important point of this surgery. An endoscopic forehead lift is a procedure that pulls up and fixes the sagging forehead and eyebrows through small incisions inside the scalp.

🔹 Effects of Endoscopic Forehead Lift

• Elevated eyebrow position
• Fundamental solution for eyelid sagging
• Improvement of forehead wrinkles
• Clearer eye shape
• A much younger and softer impression

Since the patient no longer needs to use forehead strength to open their eyes, it has the advantage of reducing the recurrence of wrinkles.

💡 Common Misconceptions

‘Isn’t a forehead lift too big of a surgery?’

‘Isn’t it dangerous?’

These are the questions I hear most often during consultations. However:

• Use of endoscope → Minimal incision
• Scars are barely visible (inside the scalp)
• Low bleeding/swelling
• Fast recovery
• Daily activities possible on the same or next day

It is a safe surgery with less burden than one might think. Nowadays, it is practically an ‘essential surgery’ for eye rejuvenation in the 50s and 60s.

2️⃣ Upper Blepharoplasty

After first raising the eyebrow position with the forehead lift, only the remaining excess eyelid skin was minimally excised. This resulted in:

• Natural double eyelid lines
• Clear eyes without a stuffy look
• A non-artificial impression

There are almost no ‘signs of surgery.’

3️⃣ Lower Blepharoplasty

We also corrected the sagging and fat protrusion under the eyes.

• Removal of under-eye bulging
• Improvement of fine lines
• Reduction of dark circles
• A much brighter and younger image

Correcting both the upper and lower eye areas completes the true anti-aging effect.

✅ Post-Surgery Changes

• Softened forehead wrinkles
• Natural elevation of eyebrows
• Clear and comfortable eye appearance
• Smooth under-eye area
• An overall impression that looks over 10 years younger

It was memorable when the daughter said, ‘It feels like my mom has returned to how she looked in old photos.’ The most ideal result is not an excessive change, but the ‘feeling of being restored to one’s original youthful appearance.’

✅ I Strongly Recommend a Forehead Lift for These People:

• Those with a narrow space between the eyebrows and eyes
• Those with deep forehead wrinkles
• Those who use forehead strength when opening their eyes
• Those for whom upper blepharoplasty alone seems insufficient
• Those in their 50s–70s worried about sagging eyes/aging
• Those who want to look younger naturally

✅ VIBE Plastic Surgery Principles

I do not perform surgery that simply cuts away skin; I perform surgery that accurately identifies the cause. Distinguishing whether the cause of sagging eyes is the eyelid, the eyebrow, or the forehead determines the result. This allows for:

• Safe surgery without over-excision
• A natural impression
• Long-lasting results

Closing

Many people come in thinking they only need upper blepharoplasty, but their satisfaction becomes much higher after a forehead lift consultation. A forehead lift is not a large or scary surgery, but an essential process that enhances the perfection of eye surgery. If you are considering filial piety surgery for your parents, middle-aged eye surgery, or anti-aging procedures, I recommend getting an accurate diagnosis first.

Thank you.

This was Dr. Young-moon Yoo of VIBE Plastic Surgery.