Drooping Eyes: It Might Not Just Be a Problem with the Eyelids… What Should You Consider When Thinking About Endoscopic Forehead Lift Surgery?

<JAYJUN Plastic Surgery & Dermatology Clinic> Medical Director Kang Hyungjoo, Board-Certified Plastic Surgery Specialist

The appearance of the eye area is determined by various factors, including not only the shape of the eyelids but also the position of the eyebrows, the movement of the forehead muscles, and the elasticity of the surrounding skin. In particular, when the eyebrows droop and cover the upper eyelids, there may be limitations to improving the appearance through double eyelid surgery or eyelid reshaping alone. Therefore, it is necessary to comprehensively evaluate not only the eyelids but also the position of the forehead and eyebrows.

If only the eyelid skin is excised while the forehead and eyebrows are sagging and pressing down on the upper eyelid skin, the underlying sagging of the eyebrows and forehead will remain unchanged. Furthermore, if too much skin is removed, the skin below the eyebrows may be pulled taut, or the proportions around the eyes may change, resulting in a harsher facial appearance. Consequently, when planning surgery, it is essential to diagnose not only the degree of skin sagging but also how the forehead and eyebrows move in coordination when opening and closing the eyes.


In such cases, an endoscopic forehead lift—which involves making several micro-incisions within the scalp along the hairline, then using an endoscope to visualize the internal structures while dissecting the tissues around the forehead and eyebrows and lifting and securing them upward—is an option to consider. The goal is to adjust the position of the eyebrows and forehead to restore proportion and balance to the entire upper face.

However, the presence of drooping eyebrows does not necessarily mean that an endoscopic forehead lift should be performed in conjunction with blepharoplasty in every case. The decision to perform the procedures separately or in combination must be based on the individual’s skeletal structure, the degree of soft tissue sagging, and the desired scope of improvement.


Whether the patient excessively uses their forehead muscles when opening their eyes or has a habit of unconsciously raising their eyebrows is also a key diagnostic factor. If these habits persist, forehead wrinkles may deepen and the position of the eyebrows may change. However, the act of raising the eyebrows may also be a compensatory response to other causes, such as ptosis or simple eyelid sagging. Therefore, a thorough examination must be conducted first to distinguish between eyelid opening and closing function and the movement of the forehead and eyebrows.

Medical Director Kang Hyungjoo of JAYJUN Plastic Surgery stated, “‘The appearance of drooping eyes is not solely a problem with the eyelid skin but results from a combination of various factors, including the position of the eyebrows and forehead, as well as one’s habitual eye-opening patterns,’ adding, ‘Before surgery, the overall structure of the upper face must be accurately diagnosed to select a surgical technique that best suits the individual’s condition.’”