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Upper Blepharoplasty vs Sub-Brow Lift
Both remove the skin that has settled over your eyes. The question is where to take it from, so the eye still looks like yours.
Upper blepharoplasty suits mature eyelids that are relatively thin, where removing skin at the crease also refreshes or creates a defined fold. A sub-brow lift suits thicker eyelids or people who want to keep their existing crease, because skin is removed just below the brow instead. Both treat hooding but differ in scar position and crease change.
At a glance
- Compares
- Skin removal at the crease vs below the brow
- Main difference
- Effect on the crease and where the scar lies
- Changes crease shape
- Upper blepharoplasty, often
- Keeps existing crease
- Sub-brow lift, in most cases
- Key deciding factor
- Lid thickness and crease preference
- Decided by
- Dr. Kim after assessing skin, fat and brow position
How do upper blepharoplasty and the sub-brow lift compare?
Upper blepharoplasty vs sub-brow lift is a common decision for people in their forties and beyond whose upper eyelid skin has begun to fold over the lashes. Both remove excess skin. The difference is location. Blepharoplasty removes skin at the crease line near the lashes. The sub-brow lift removes it from just below the eyebrow. That choice affects how the crease looks, how thick the lid appears, and where the scar sits.
| Factor | Upper Blepharoplasty | Sub-Brow Lift |
|---|---|---|
| What it corrects | Hooding, excess skin and fat; can define or restore a crease | Hooding, especially at the outer lid, without altering the crease |
| Incision / scar | Within the crease; hidden when the eye is open in most cases | Along the lower brow edge; usually blends into brow hairs |
| Anesthesia | Local, with sedation if desired | Local, with sedation if desired |
| Surgery time | About 1 to 1.5 hours | About 1 to 1.5 hours |
| Recovery | Sutures out ~day 5 to 7; swelling 2 to 3 weeks | Sutures out ~day 5 to 7; swelling 1 to 2 weeks |
| Longevity | Long-lasting; skin continues to age | Long-lasting; skin continues to age |
| Reversibility / revision | Not reversible; further refinement possible | Not reversible; can be followed by a crease procedure later |
| Typical candidate | Thinner lids, wants a clearer crease, fat to address | Thick lids, likes current crease, heaviness at outer third |
How upper blepharoplasty works
In upper blepharoplasty for mature eyelids, Dr. Kim marks the crease and measures the skin that can be removed while leaving enough for comfortable closure. Through this incision he can remove skin, a thin strip of orbicularis oculi muscle, and bulging fat behind the orbital septum. The skin is then fixed so a crease forms along the scar line. If the eye also opens weakly, the levator aponeurosis can be tightened in the same operation.
How the sub-brow lift works
In a sub-brow lift, a crescent of skin is removed along the lower edge of the eyebrow. Skin near the brow is thicker than skin near the lashes, so removing it there leaves the thinner, more delicate lid skin close to the eye. The existing crease is untouched. For people with thick lids, this avoids the heavy, doubled look that can result when thick skin is pulled down to a crease near the lashes.
Which should I choose?
- Lid thickness. Thick, heavy lids often do better with a sub-brow lift, which removes the thickest skin.
- Crease. If you want a clearer or new crease, blepharoplasty creates one. If you like your crease, a sub-brow lift keeps it.
- Fat. Bulging upper-lid fat can only be addressed through the crease approach.
- Brow position. If the brow itself has descended, neither may be enough. See sub-brow lift vs endoscopic brow lift.
- Brow styling. Brow tattoos and shaping influence sub-brow scar planning.
Why skin thickness matters so much
Eyelid skin changes in thickness from the lash line up to the brow. Near the lashes it is among the thinnest skin on the body; near the brow it is noticeably thicker and more padded. When a surgeon removes skin at the crease in a thick lid, the thicker upper skin is pulled down toward the lashes. The crease can then look bulky or heavy, and the eye may appear more altered than intended.
This is especially relevant for many patients of East Asian descent, whose lids often have more soft tissue. For them, the sub-brow approach can offer a lighter, more natural-looking result. For thinner lids, however, the crease approach can be more efficient because it treats skin, fat and crease together.
When does combining make sense?
Occasionally both are combined, for instance when outer-lid hooding is marked but a crease also needs to be defined. More often, one is done first and the other considered later if needed. Men seeking a subtle, low crease, or no visible change to the crease at all, sometimes prefer the sub-brow approach, described further on the eye aging in men page.
What does recovery look like?
Both are typically done under local anesthesia with optional sedation, and sutures are removed around day five to seven. Swelling after blepharoplasty tends to be more visible near the lashes for two to three weeks. After a sub-brow lift, swelling is closer to the brow and usually settles in one to two weeks. Scar lines can stay pink for a few months. Your surgeon will confirm your timeline.
What are the risks?
Upper blepharoplasty risks include asymmetry, a crease that is too high or too heavy, removal of too much skin causing difficulty closing the eye, dry eye and scarring. Sub-brow lift risks include visible scarring, slight change in brow shape, and residual hooding if the brow has descended. Individual results vary, and a detailed discussion is part of every consultation.
How Dr. Kim decides at consultation
Dr. Kim assesses skin thickness at different heights of the lid, how much skin hangs over the lashes, whether upper-lid fat bulges, where the brow rests, and how strongly each eye opens. He also asks what you like about your eyes now. The decision is based on your anatomy and what you want to keep, not on a standard formula. For international patients, a virtual consultation with clear photographs taken with the eyes open, closed and looking down can give a useful first impression, confirmed later in person.
Questions, answered
Frequently asked questions
Still wondering about something? Ask Dr. Kim directly — every consultation at Will Be is with the surgeon himself.
Which leaves a less noticeable scar?
Both scars are designed to be discreet. The blepharoplasty scar sits in the crease and is hidden when the eye is open. The sub-brow scar follows the brow's lower edge and blends with brow hairs. Scar visibility depends on skin type, healing tendency and aftercare. Most scars fade over several months.
Can a sub-brow lift remove eyelid fat?
Not in most cases. The sub-brow approach is designed to remove skin, not the fat that sits behind the orbital septum near the crease. If bulging upper-lid fat is a significant concern, the crease approach of upper blepharoplasty is usually more suitable, sometimes combined with a sub-brow lift.
I already have a double eyelid. Which should I choose?
If you like your existing crease and your main concern is skin folding over it, a sub-brow lift often preserves that crease well. If your crease has become hidden or uneven, upper blepharoplasty can refresh it. Dr. Kim will examine both and explain which fits your goals.
At what age do people consider these procedures?
There is no fixed age. Many patients consider them from their forties onward, when skin laxity begins to hood the eye, but anatomy matters more than age. Some younger people with naturally heavy lids also benefit. The decision is based on examination, not birth year.
Will my vision improve?
If excess skin was resting on your lashes or blocking the upper field of vision, many patients notice the eye feels lighter and the upper view clearer. However, these are primarily aesthetic procedures, and any functional assessment should be discussed with your surgeon at consultation.
One surgeon · Consultation to follow-up
Hooding changes gradually; the right correction should look just as gradual. Talk it through with Dr. Kim.
Consultations in Seoul and online. Dr. Kim Jun-young personally reviews every case.