Sub-Brow Lift (Below-Brow Excision) in Seoul

What is a sub-brow lift?

A sub-brow lift, also called a below-brow excision or infrabrow excision, removes a crescent of skin, and sometimes a little muscle, from just beneath the eyebrow. The incision runs along the lower border of the brow hairs. When the wound is closed, the heavy skin of the upper lid is drawn upward, which reduces hooding and brings the lid crease and lashes back into view.

It is sometimes described as a brow lift, but it does not move the brow itself upward in any significant way. Its effect is on the upper eyelid skin below the brow, lifted from a different direction than conventional eyelid surgery.

Why take skin from below the brow instead of the eyelid?

Upper eyelid skin is not uniform. Close to the lashes it is very thin and delicate, which helps a natural crease fold softly. Near the brow it becomes thicker. In conventional upper blepharoplasty, skin is removed at the crease, so the thicker skin from higher up is brought down toward the lashes. In some people, especially those with thick skin, this can make the crease look heavy, bulky or unnatural.

A sub-brow lift removes skin from the thick part instead, leaving the thin, delicate lid skin and your existing crease intact. This is why the result can look so natural: the eyelid itself has not been reshaped. The approach also allows more lift toward the outer part of the lid, where hooding typically starts with age.

How the brow and upper lid change with age

The eyebrow and the upper eyelid behave as a single unit. With age, the soft tissues around the outer brow tend to descend first, because the forehead muscle that lifts the brows, the frontalis, has less influence at the outer tail. Skin loosens, and the fat pad that sits beneath the brow, sometimes called the ROOF (retro-orbicularis oculi fat), can drop slightly onto the lid. Together, these changes produce the outer hooding that makes eyes look triangular, tired or sad, even when the inner part of the lid looks almost unchanged.

Because the heaviness starts at the outer third, an approach that lifts from just below the brow often matches the pattern of ageing more closely than removing a uniform strip of skin at the crease. If your concern is droopy eyebrows themselves, however, the brow may need to be addressed directly.

A useful option after previous eyelid surgery

People who have had upper eyelid surgery in the past sometimes develop hooding again years later. Removing more skin at the crease can be risky at that point, because the remaining lid skin may be limited and the crease has already been shaped by scar. A sub-brow lift can relieve the heaviness without disturbing the existing fold or taking more of the thin lid skin. For more complex problems with a previous crease itself, see revision double eyelid surgery.

Who is a good candidate?

• Upper-lid hooding, particularly toward the outer corner
• Thick upper-eyelid skin
• A natural double eyelid crease you would like to keep
• A brow in a reasonable position, not significantly low
• A wish to avoid a visibly "new" crease
• Full, dense eyebrows, or a brow tattoo, that can help conceal the scar

It may not be suitable if your eyebrows are already very low, in which case an endoscopic forehead and brow lift may be more effective; if your brows are very sparse or thin, making the scar harder to hide; if you want a new or higher double eyelid crease; or if the lid margin itself is low, when ptosis correction is needed. It also may not suit a person whose brow has a very high arch, because pulling skin up can accentuate it.

How Dr. Kim approaches design at Will Be

At Will Be, Dr. Kim Jun-young personally sees you through consultation, design, surgery and follow-up. He assesses brow position and shape, the thickness of your lid skin, where the hooding is greatest, the character of your existing crease, and the density of your brows. He also considers how a lifted outer lid will change the overall look of your eye, which should remain in character with your face.

The design follows the lower margin of your brow so that the scar sits at the border of the brow hairs. The width of skin removed is measured carefully: enough to lift, not so much that the brow is pulled down or the closure is under tension, which can widen the scar.

How is the procedure performed?

1. Marking along the lower brow margin while you sit upright, with the crescent of skin to be removed measured at several points.
2. Anesthesia. Local anesthesia, often with IV sedation.
3. Beveled incision. The incision is angled parallel to the hair follicles so that brow hairs can grow through the scar, helping it blend.
4. Excision. The marked skin and, when appropriate, a thin strip of orbicularis oculi muscle are removed.
5. Deep support. The deeper layer may be anchored to the tissue over the bone (periosteum) to reduce tension on the skin and improve longevity.
6. Layered closure. Deep sutures carry tension, and fine skin sutures are placed so the surface heals under minimal stress.

Anesthesia and surgery time

A sub-brow lift typically takes about an hour for both sides under local anesthesia, often with light sedation. It is a day procedure. If combined with other surgery, total time is longer.

How long does recovery take?

Eyelid swelling is often less than after crease-level surgery, because the lid itself is not incised. See scar care after facial surgery.

Risks and how they are minimised

Risks include a visible or widened scar, particularly in people with sparse brows; temporary numbness of the forehead or brow area; asymmetry; a lowered brow if too much skin is removed; accentuation of the brow arch; residual hooding; bruising, bleeding and infection. Individual results vary.

These risks are reduced by careful selection, measured excision, beveling to protect hair follicles, deep anchoring and tension-free layered closure, followed by diligent scar care. Follow-up with the same surgeon lets any concern be addressed early, and any areas of numbness usually recover gradually over weeks to months.

Sub-brow lift compared with other options

A sub-brow lift sits between eyelid surgery and forehead lifting. Compared with upper blepharoplasty, it preserves the natural crease and thin lid skin but leaves a scar at the brow margin. Compared with an endoscopic brow lift, it does not raise the brow itself but involves a smaller operation and shorter recovery. For detail, see upper blepharoplasty vs sub-brow lift and sub-brow lift vs endoscopic brow lift.

Combining with other procedures

A sub-brow lift may be combined with a double eyelid or ptosis procedure when both hooding and lid shape need attention, or with lower-lid surgery. It can also be performed years after a previous eyelid operation, when re-operating at the crease would risk removing too much lid skin. That makes it a useful option in some revision situations.

Preparing and caring for the area

Before surgery, pause medicines and supplements that increase bruising as advised, and avoid brow tinting or tattoo work in the preceding weeks unless your surgeon agrees. Afterwards, keep your head elevated, use cold compresses for 48 hours, keep the incision clean, and avoid heavy exercise, saunas and alcohol for about two weeks. Silicone gel and sun protection after suture removal help the scar mature quietly.

Staying in Korea as an international patient

Plan about 7 days in Seoul, allowing for consultation, surgery, suture removal around day 5–7 and a final check. The scar may still be pink when you travel; brow makeup can usually cover it once your surgeon confirms healing. Photo follow-up from home helps track the scar as it matures. Pack a hat and a high-protection sunscreen, because protecting the healing brow line from strong sun for the first few months helps the scar fade toward your natural skin tone.