Still Feeling Heavy-Eyed After Double Eyelid Surgery? Why You Should Check for Forehead Ptosis (Busan Forehead Lift)

Have questions? Chat with us on Naver TalkTalk!

Hello, this is Four Seasons Plastic Surgery Clinic.

Some people tell us that even though their double eyelid line turned out well,

their eyes still look heavy and stuffy.

In cases like this, we need to look one layer above the eyelids,

at the position of the brows and forehead together.

Here, we cover where the feeling of heavy eyes comes from,

how to check for forehead ptosis,

and what a Busan forehead lift involves.

We have summarized each one in order.

There isn't just one cause of eyes that feel heavy.

Even when the concern sounds the same, like 'my eyes look heavy,'

the area to examine depends on

what is covering the eyes.

There are three main categories to consider.

Brow and Forehead Ptosis

This happens when the brow sinks and

pushes the eyelid skin down from above.

In particular, when the outer tail of the brow drops,

the outer corner of the eye gets covered first, making the eyes look smaller and droopy.

The problem lies above the eyelids, at the brow and forehead.

Sagging Eyelid Skin

The brow height looks fine, but the eyelid skin itself has stretched

and drapes over the lashes.

Upper blepharoplasty, which removes the stretched skin,

may be an option to consider.

Weak Eye-Opening Strength

When the muscle that lifts the eyelid is weak,

the edge of the eyelid droops low

and covers the iris.

This is also commonly called blepharoptosis.

When the brows drop, the double eyelid crease gets hidden.

As we age, the tissues of the forehead and brows

gradually sink downward.

When the brows descend, the eyelid skin beneath them is pushed down as well,

covering the double eyelid line,

and the eyes end up looking smaller and heavier.

When you try to open your eyes wide, you tense up your forehead.

People often tell you that you always look tired because your eyelids droop.

When the eyes are covered, we unconsciously use our forehead muscles

to lift the brows and open our eyes.

Over time, this habit deepens the horizontal lines on the forehead,

and some people feel their forehead gets stiff by the afternoon.

This is why concerns about heavy eyes and forehead wrinkles

often come up together in the same person.

If only the eyelid skin is trimmed in this state,

the skin that was covering the eye shrinks, but the brows remain

in their dropped position.

In such cases, the eyes and brows end up too close together,

which can look unnatural.

When the space between the brows and eyes narrows, expressions tend to look

heavy or sharp.

So if your eyes still feel heavy after double eyelid surgery,

it's worth first checking where your brows are positioned

before looking at the eyelid line again.

Check in the mirror first!

The items below are not a diagnosis, but signs you can

check on your own before a consultation.

Relax your forehead and look straight at yourself in the mirror,

then check the following.

Your eyes feel heavier when you relax your forehead.

When you lift your brows gently with your fingertips, the double eyelid crease reappears.

When you open your eyes, horizontal forehead lines form first.

The outer corners of your eyes look especially covered.

Your brows look closer to your eyes than in older photos.

Having any of these does not mean

you need a Busan forehead lift.

Eye-opening strength, eyelid skin, and brow position are all evaluated together during consultation,

so please use self-checks only as a

reference. ^^

An endoscopic forehead lift is a surgery that restores the original position of the brows.

The Busan forehead lift raises the dropped forehead and brows

to a position closer to their original place and secures them there.

Rather than simply pulling the skin,

the procedure works on the muscles and supporting tissues that pull the forehead and brows downward,

reducing that pulling force and securing them so the lifted position is maintained.

During this process, the corrugator supercilii muscle, which creates vertical lines between the brows,

and the procerus muscle, which creates horizontal lines across the bridge of the nose,

are also addressed,

so we also consult on concerns about forehead, frown-line, and nose-bridge wrinkles.

Small incision inside the scalp - Three to five small incisions, about 1–2 cm each, are made in the scalp just inside the hairline.

Endoscopic dissection - While viewing the procedure on a screen through the endoscope, tissue is dissected from the forehead down to beneath the brows.

Muscle treatment and fixation - The muscles that create wrinkles are treated, and the drooping forehead and brows are lifted to the planned height and secured.

The area around the eyes contains many nerves and blood vessels, so even when using an endoscope,

how precisely the dissection is carried out is what matters most.

If you've already had double eyelid surgery

If you're considering a Busan forehead lift after double eyelid surgery,

there are a few more things to check first.

Previous surgical history - Knowing when and how you had surgery, and how much eyelid skin was removed, allows us to create a more detailed surgical plan.

Whether your eyes close comfortably - Raising the brows also pulls the eyelid skin upward. If a lot of skin was removed previously, we check eye closure while setting the lift height more carefully.

Whether multiple causes overlap - If brow ptosis is accompanied by weak eye-opening strength or remaining eyelid skin, we may plan eye-shape correction or upper blepharoplasty alongside the forehead lift.

Whether the double eyelid line itself is the issue - If the crease is the cause, such as when it is too high or has come loose, revision double eyelid surgery comes before a Busan forehead lift.

Frequently Asked Questions

Q. Do people in their 20s get a forehead lift too?

A. Brow position matters more than age. We consult with patients in their 20s whose brows naturally sit low, leaving little space between the brows and eyes, or who rely heavily on their forehead when opening their eyes.

The focus shifts slightly depending on age,

but whether surgery is recommended depends on the area that bothers you most

and how severe it is.

Q. Will there be a visible scar?

Consultations are available.

The focus shifts slightly depending on age,

but whether surgery is recommended depends on the area that bothers you most

Incisions are made inside the scalp, just within the hairline,

about 1–2 cm each, in 3–5 places.

Because the incisions are in an area hidden by hair,

scars are barely visible.

Q. If I get a forehead lift,

do I still need to get double eyelid surgery again?

If the main cause of the covered eyes is the brows,

simply returning the brows to their original position can sometimes

reveal the crease that had been hidden.

That said,

if excess eyelid skin remains, eye-opening strength is weak,

or the crease itself has a problem, double eyelid surgery

may need to be considered.

Q. How is it different from eye-shape correction?

Eye-shape correction adjusts the strength of the muscles that open the eyes

to change the height of the eyelid margin.

An endoscopic forehead lift

changes the position of the brows and forehead, which sit above that.

Q. Can't forehead wrinkles just be managed

with Botox?

Botox reduces muscle movement to soften wrinkles,

but it does not raise brows that have dropped.

For people who have been lifting their brows with their forehead muscles to open their eyes,

reducing forehead movement can actually make the eyes feel even heavier.