Subbrow Lift

What is Subbrow Lift

The subbrow lift (sub-brow lift) is a surgical procedure that removes skin along the lower edge of the eyebrow and directly lifts sagging upper eyelids. When skin becomes excessive due to aging and gravity, the eyelids appear heavy, the double eyelid line becomes buried, and the eyes appear smaller. The subbrow lift removes excess skin just below the eyebrow, cleanly eliminating sagging without changing the contour of the eye area.

Scientific Evidence for Surgery

A clinical study published in the academic journal Aesthetic Plastic Surgery in 2016 (DOI: 10.1007/s00266-016-0632-y) of 496 Asian women demonstrated that removal of excess skin and orbicularis oculi muscle via the subbrow approach was effective in improving upper eyelid sagging. Among 432 cases at least 6 months post-surgery, 94.7% (409 cases) reported satisfaction with the surgical results. Facial nerve injury was zero, and transient forehead numbness occurred in only 8 cases (1.9%), confirming safety. It was also noted that the palpebral fissure (eye opening) improved without significant change in the distance between the eyebrow and eye.

In a report of 60 cases published in Archives of Plastic Surgery (2013, DOI: 10.5999/aps.2013.40.5.603), removal of an average of 8 mm (5-15 mm) of skin and subcutaneous fat from the upper border of the eyebrow and fixation of the orbicularis oculi muscle to the frontalis muscle resulted in significant improvement of post-operative scarring. All preoperative chief complaints were resolved, with no serious complications noted.

Surgical Procedure

Surgery is performed under local anesthesia. A design line is set 1-2 mm inward from the lower edge of the eyebrow, and excess skin is typically removed in a 5-10 mm width. The orbicularis oculi muscle and/or orbital fat are partially removed and adjusted as needed, and the orbicularis oculi muscle is fixed to the frontalis muscle to maintain eyebrow position and eye area lift. Sutures are carefully placed with fine threads that are less noticeable, and sutures are removed approximately 1 week post-surgery. Surgical time is approximately 1-1.5 hours for both sides.

Downtime and Recovery Period

Swelling and bruising occur within several days after surgery, but since the lower edge of the eyebrow conceals them, foundation and eyebrow pencil can cover them during outings. Swelling peaks at 2-3 days post-surgery and largely subsides within 1-2 weeks in most patients. After suture removal (around 7 days post-surgery), eye makeup becomes possible. The guideline for when the final result stabilizes is 3-6 months.

Difference from Double Eyelid Surgery

Double eyelid surgery (blepharoplasty) approaches the central line of the eyelid to create or modify the double eyelid line. Subbrow lift removes excess skin between the eyebrow and eyelid without changing whether a double eyelid exists or altering its line. This makes it especially suitable for needs such as "improving sagging naturally while keeping single eyelids" or "bringing out an existing double eyelid line beautifully." Additionally, because subbrow lift can remove more skin on the lateral aspect of the eyelid, it is also effective in improving lateral eyelid sagging.

Precautions and Risks

・Avoid intense exercise, alcohol consumption, and saunas for 1-2 weeks post-surgery.
・UV protection is important during wound healing (sunscreen use recommended).
・Depending on eyebrow shape and hair density, scars may be noticeable. The surgeon will confirm hair direction and skin thickness preoperatively and propose an optimal design.
・In rare cases, asymmetry, scar hypertrophy, or sensory disturbance may occur.
・There is no guarantee that revision surgery will not be necessary, so please have thorough counseling with your physician before surgery.