As upper-eyelid skin sags with age, the crease gets covered and the eyes can look heavy. The two main options are upper blepharoplasty, which removes skin near the crease, and the sub-brow lift, which removes skin just below the eyebrow.
| Aspect | Upper blepharoplasty | Sub-brow lift |
|---|
|---|---|---|
| Incision site | Near the eyelid crease | Just below the eyebrow |
|---|---|---|
| Skin removed | The relatively thin skin below | The relatively thick skin above |
| Effect on the crease | Can be newly created or adjusted | The existing line is largely kept |
| Typically considered for | Thin skin with mild sagging | Thick skin with clear outer-corner sagging |
Why the eyelid can look thicker after upper blepharoplasty
Removing a lot of the thin skin below can bring the thicker skin above down close to the crease.
What is a sub-brow lift?
An incision just below the eyebrow reduces the thick skin above so that the thin eyelid skin below rises naturally. It is worth considering especially when sagging at the outer corner is pronounced or you want to keep your existing crease.
Is it true that eyes look narrower after a sub-brow lift?
As you no longer need to keep raising your eyebrows, they settle into a natural position, which can make the gap between eyebrow and lashes feel narrower. The eye itself has not become smaller.
Can all the sagging skin be removed?
No. Removing too much can leave the eye unable to close fully or make it dry, so there is a limit to how much can be safely removed.
A simple guide to choosing
- Upper blepharoplasty: thin skin, not much to remove, sagging concentrated near the crease
- Sub-brow lift: thick, heavy skin with pronounced sagging at the outer corner
- Also consider a forehead lift: when the eyebrows themselves have descended considerably
The question is not which operation is better, but choosing the incision site based on where the sagging skin sits and how thick it is, on brow height, and on the crease shape you want.