Sub-Brow Lift (Subbrow Blepharoplasty)
Droopy eyelids and outer-corner sagging, keeping your existing double eyelid line
A sub-brow lift is a surgery that removes sagging upper eyelid skin and lifts it through an incision just below the eyebrow; it is also called subbrow blepharoplasty or infrabrow excision blepharoplasty.
It is considered when sagging eyelid skin covers the eyes, when the outer corners of the eyes look droopy, or when the skin at the outer corners becomes irritated.
Sub-Brow Lift at a glance
- Surgery time
- About 1 hour
- Anesthesia
- Local anesthesia or IV sedation
- Hospital stay
- Not required
- Stitch removal
- 7 days after surgery
- Swelling & bruising
- 1–2 weeks
- Return to daily life
- 1 week
This may vary depending on combined procedures and the individual.
Quick answer
When is a sub-brow lift recommended?
A sub-brow lift is considered when you want to address sagging upper eyelid skin without touching the double eyelid line. It is indicated when you want to keep your existing double eyelid line, when the skin at the outer corners sags and becomes irritated, or when thick eyelid skin makes it likely that you would look harsh after upper blepharoplasty. However, if your eyebrows are naturally low or the space between the eyebrows and eyes is narrow, a brow lift may be more suitable.
What is a sub-brow lift (subbrow blepharoplasty)?
A sub-brow lift is a surgery that lifts drooping eyelids by removing skin along the lower border of the eyebrow, without operating directly on the eyelid. Because it does not touch the double eyelid line, it can improve sagging while keeping your existing eye shape.
As the name suggests, it works below the eyebrow, trimming the eyelid skin that sags beneath it; it does not lift the eyebrow itself. It is also different from a direct brow lift, which places the incision above the eyebrow to raise the brow. If the eyebrows have drooped as well, an endoscopic brow lift is considered together.
Who is a sub-brow lift right for?
- You want to keep your existing double eyelid line as it is
- Sagging eyelid skin has covered your existing double eyelid line and changed your appearance
- You do not want a change in your overall impression
- Thick eyelid skin makes it likely that you would look harsh after upper blepharoplasty
- The skin at the outer corners sags so much that it becomes irritated
A study of 64 Asian women who underwent a sub-brow lift also listed indications such as wanting to keep the existing double eyelid line, having sagging toward the outer corner as the main concern, and having or planning eyebrow tattooing (Kim et al., 2008).
How is a sub-brow lift different from upper blepharoplasty, a brow lift, and ptosis correction?
If skin sagging is the cause, the first question is whether to create a new double eyelid line or keep your existing eye shape. To keep your current eye shape and appearance, a sub-brow lift is considered; to change the structure and line of your eyes, upper blepharoplasty is considered.
| Recommended surgery | Features | |
|---|---|---|
| When changing the double eyelid shape | Upper blepharoplasty | Sagging skin is removed through an incision along the double eyelid line, and ptosis correction and fat contouring can be done through the same incision |
| Sagging toward the outer corner, minimal change in appearance | Sub-brow lift | The incision is below the eyebrow, so the double eyelid line and eye shape do not change much |
| The eyebrow itself has drooped (with forehead wrinkles) | Endoscopic brow lift | The whole forehead is lifted to raise the position of the drooping eyebrows themselves |
| Weak eye-opening strength | Ptosis correction | The length of the eye-opening muscle is adjusted to strengthen eye opening |
If the eyebrows have drooped, a brow lift is also considered
If droopy eyelids are caused not by the eyelid skin but by drooping of the eyebrows themselves, cutting only the skin below the eyebrow may not solve the problem. When the eyebrow position is fine and only the eyelid skin sags, a sub-brow lift is often suitable; when the eyebrows themselves have drooped and forehead wrinkles come with droopy eyelids, an endoscopic brow lift is often more suitable.
When a sub-brow lift may not be suitable
If your eyebrows are naturally low or the space between the eyebrows and eyes is narrow, a sub-brow lift may not be suitable. If eye-opening strength is weak, removing skin alone may still leave the eyes looking sleepy, so ptosis correction is considered together.
Detailed comparison: upper blepharoplasty vs. sub-brow lift →Learn more about upper blepharoplasty →Choosing surgery by cause of sagging (Middle-Aged Eye Surgery) →Learn more about the endoscopic brow lift →
What is the scar like after a sub-brow lift?
Because the skin is incised, a scar does remain, but since the incision lies along the lower border of the eyebrow, it is often hard to notice after recovery. There may be redness early on that gradually fades over several months, and how visible the scar becomes depends on skin type, constitution, and aftercare.
In a study comparing 106 Asian women, scar assessments 1 year after surgery were better with an incision below the eyebrow than with an incision above the eyebrow (Qu et al., 2022).
Layered closure
If only the surface of the skin is sutured, the wound may widen over time or leave a white scar, so a layered closure is performed, pulling and securing the tissue step by step starting from the firm fascia layer beneath the skin. This helps the scar stay hidden along the eyebrow line.
How a sub-brow lift is performed
- 1
Design
The degree of sagging is measured, and the incision line is designed along the lower border of the eyebrow.
- 2
Removing sagging skin
Only as much loose skin tissue as needed is removed.
- 3
Lifting and fixation
The sagging muscle and skin are pulled up and secured below the eyebrow.
- 4
Closure
The incision is closed along the eyebrow line, and stitches are removed 7 days after surgery.
What we check in a sub-brow lift consultation
- The thickness of the eyelid skin and how much it sags
- Eyebrow position (whether the eyebrows themselves have drooped)
- The distance between the eye and the eyebrow
- How much you use your forehead muscles when opening your eyes
- Eye-opening strength (whether ptosis is present)
- How much sagging there is toward the outer corner
- Whether you want a double eyelid and how you feel about a change in appearance
Sub-brow lift recovery
Returning to daily life after a sub-brow lift usually takes about 1 week, and stitches are removed 7 days after surgery.
Days 2–3 after surgery
- Swelling and bruising peak
First 3–5 days
- Sleep with your head elevated
- Cold compresses for the first 7 days
Day 7
- Stitches removed
- Face washing from the day after stitch removal
By 1–2 weeks
- Most swelling and bruising has gone
After 4 weeks
- Eyebrow makeup and tattooing are OK
- Saunas, strenuous exercise, alcohol, and smoking can be resumed
Sub-brow lift side effects and precautions
What are the side effects of a sub-brow lift?
After a sub-brow lift, besides temporary swelling, bruising, and reduced sensation around the incision, rare side effects may include a widened or raised scar, asymmetry, and a change in eyebrow shape. Reduced sensation mostly recovers over several months, and scarring varies with constitution and aftercare. It is important to evaluate eyebrow position and the degree of skin sagging accurately before surgery to decide how much to remove.
Sub-Brow Lift FAQ
How is a sub-brow lift different from upper blepharoplasty?
The biggest difference is that a sub-brow lift removes sagging eyelid skin through an incision below the eyebrow, while upper blepharoplasty does so through an incision along the double eyelid line. A sub-brow lift is well suited to improving sagging toward the outer corner without greatly changing the double eyelid line or eye shape, while upper blepharoplasty can create a new double eyelid line along with removing the sagging skin. The choice depends on the distance between the eyebrow and the eye, eyelid thickness, and whether you want a double eyelid.
Can younger people or men have a sub-brow lift?
A sub-brow lift is decided by the degree of eyelid skin sagging rather than age, so it can be considered even in your 20s or 30s if excess eyelid skin covers the eyes or hides the double eyelid. Men often want to remove only the sagging skin without creating a double eyelid, so a sub-brow lift, which does not touch the double eyelid line, is often a good fit. However, if the eyebrows are naturally low or the space between the eyebrows and eyes is narrow, a brow lift may be more suitable.
How long is recovery after a sub-brow lift?
Returning to daily life after a sub-brow lift usually takes about 1 week, and stitches are removed 7 days after surgery. Swelling and bruising peak on days 2–3 and mostly disappear in about 1–2 weeks. Face washing is OK from the day after stitch removal, and eyebrow makeup and tattooing, saunas, strenuous exercise, alcohol, and smoking are best avoided for 4 weeks.
Can exercise or massage improve droopy eyelids?
Droopy eyelids are difficult to improve with exercise or massage. Stretched skin and loosened tissue do not shrink with exercise, and frequently rubbing around the eyes can actually irritate the skin. If the drooping blocks your vision or makes your eyes look sleepy, the cause is checked and surgical correction is considered.
How is the cost of a sub-brow lift determined?
The cost of a sub-brow lift depends on the extent of skin removal, whether combined procedures such as upper blepharoplasty or fat removal are included, and whether it is a revision. The scope of surgery differs depending on your eyelid condition, so an exact cost can be provided after a consultation.
Your doctor
Dr. Dahan Kim
Board-Certified Plastic Surgeon Medical Director, Steady Plastic Surgery
Steady Plastic Surgery is an eye-focused plastic surgery clinic in Gangnam (Sinnonhyeon), Seoul. Board-certified plastic surgeon Dr. Dahan Kim personally sees every patient from consultation to surgery and follow-up, focusing on double eyelid surgery, double eyelid revision, under-eye fat repositioning, lower blepharoplasty and middle-aged eye surgery.
- M.D. and master's degree, CHA University School of Medicine
- Plastic surgeon, CHA Bundang Medical Center
- Member, Korean Society of Plastic and Reconstructive Surgeons · Korean Society for Aesthetic Plastic Surgery · Korean Association of Plastic Surgeons
Have questions?
References
- Kim YS, Roh TS, Yoo WM, Tark KC, Kim J. Infrabrow excision blepharoplasty: applications and outcomes in upper blepharoplasty in Asian women. Plast Reconstr Surg. 2008;122(4):1199-1205. doi:10.1097/PRS.0b013e3181858fc0 PMID 18827656
- Qu L, Liang Z, Wang J, Zhang J, Yu Z, Song B. Comparison of Postoperative Scarring in Asian Women After Supra-brow and Sub-brow Blepharoplasty: A Retrospective Study. Aesthetic Plast Surg. 2022;46(5):2280-2286. doi:10.1007/s00266-022-02954-z PMID 35668229
- 박대환, 백봉수, Nahai F. 안성형외과학. 제3판. 군자출판사; 2009. ISBN 978-89-6278-139-7. [in Korean]
- Cho I. The Art of Blepharoplasty. Koonja Publishing; 2017. ISBN 979-11-5955-234-2.
- 대한미용성형외과학회. 미용성형외과학 2. 제2판. 군자출판사; 2023. ISBN 979-11-7068-001-7. [in Korean]