Sub-brow Lift
This procedure removes sagging eyelid skin through an incision immediately below the eyebrow and uses fat and muscle from the same area to fill a hollow upper eyelid. It is primarily performed by Dr. Chang Min Kang.
- Where are the incisions?
- The incision is placed immediately below the eyebrow so the eyebrow hairs help conceal the scar.
- What does it involve?
- Excess eyelid skin is removed, and the muscle that raises the eyelid is corrected if necessary. Subcutaneous fat and muscle below the eyebrow are used to fill hollow areas.
- Fat harvesting
- Eyelid hollowing is addressed without separately harvesting fat from another part of the body.
How the Approaches Differ
Conventional approach
Sagging eyelids are commonly treated with upper blepharoplasty, using an incision along the eyelid crease to remove excess skin. When the upper eyelid is hollow, fat may also be harvested from another area and injected.
Limitations
When eyelid skin is thick, fat is abundant, or the brow bone is prominent, removing skin near the eyelid crease can bring thicker skin down above the crease and create a bulky appearance. If sagging and hollowing coexist, the need for a separate fat harvest adds to the procedure.
Dr. Kang’s approach
An incision immediately below the eyebrow allows sagging skin to be removed from above. Thick skin, muscle and fat can be reduced together in this area. Subcutaneous fat and muscle below the eyebrow are then repositioned to fill the hollow upper eyelid. The plan is tailored to each patient’s degree of sagging and hollowing.
Benefits and considerations
The scar is concealed below the eyebrow, and hollowing can be improved without harvesting fat elsewhere. The eyes can appear softer without substantially changing the eyelid crease.
If the eyebrow itself has descended significantly, a sub-brow lift alone may be insufficient and a forehead lift may be needed. Depending on the individual, scars may remain visible between the eyebrow hairs.
Surgical Steps
Sagging skin is removed first, followed by filling hollow areas with tissue from below the eyebrow.
| Step | Details |
|---|---|
| 1. Planning | The incision line is planned according to the degree of sagging and hollowing. |
| 2. Incision below the eyebrow | The incision is placed close to the lower edge of the eyebrow to minimize scarring. |
| 3. Removal of excess skin | Excess eyelid skin is carefully removed. |
| 4. Correction of the eyelid-opening muscle | If ptosis is present, the muscle that raises the eyelid is also corrected. |
| 5. Filling the hollow area | Subcutaneous fat and muscle below the eyebrow are used to fill the hollow area. |
| 6. Closure | The incision is carefully closed with fine sutures. |
Who May Be a Candidate
- Those seeking improvement in both eyelid sagging and hollowing
- Those seeking a softer, less heavy-looking eye area
- Those whose sagging and hollow eyelids create an aged appearance
- Those with little eyelid fat and a sunken upper eyelid
- Those whose brow bone appears relatively prominent
Expected Changes
- More defined, lively-looking eyes
- A softer expression
- Improvement in functional discomfort, such as vision obscured by sagging eyelids
Article: When combining a forehead lift and a sub-brow lift may be helpful