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2025.12.04

Natural Rejuvenation Achieved through a Subbrow Incision

幡手 亜梨子
Supervising Physician
Hatate, Ariko

As a plastic surgeon, I have gained extensive experience through numerous cases, cultivating precise techniques and a deep understanding of anatomy. Currently, I combine plastic surgery expertise with the latest techniques to provide aesthetic medicine addressing aging concerns like skin, contours, and sagging. "Natural beauty" isn't about doing nothing and leaving it to chance; it lies beyond the will to choose how you want to be. My experience as an idol during medical school made me realize the power appearance holds over the heart, and I focus on supporting patients in achieving "days where they can like themselves more." I also offer consultations in English and prioritize creating a comfortable environment for open discussion.

Hello, everyone!

Natural and elegant rejuvenationpropose,plastic surgeonMs. Aliceis.

↓I wrote an article like this before.

 

Brow Lift? Double Eyelid Surgery? Forehead Lift? The Right Treatment for Your Sagging Eyelids

https://biancaclinic.jp/blog/46480/

 

From your late 30s onward, many people suddenly start noticing things like: "My upper eyelids look heavier lately," "It's harder to apply eyeliner," or "I look sleepier in photos than I used to..."

However, many people express the desire to simply lighten the heavy feel, while fearing that altering the double eyelid line might look unnatural.

 

When I receive such inquiries, the options I present areBrow LiftIt is sometimes referred to as a brow lift.

An incision is made in a leaf-shaped pattern just below the eyebrow, and the sagging skin is excised.

If necessary, we may also add procedures to remove fat from that area (such as ROOF or orbital fat removal).

This allows for natural rejuvenation that feels like you've returned to before you ever felt sagging, without having to adjust the double eyelid line.

 

 

What is a brow lift? A “subtractive cosmetic procedure” ideal for those seeking natural-looking results.”

 

Brow lift surgery involves cutting away skin, so scarring is inevitable.

However, the scar is hidden beneath the eyebrow, and after suture removal, it can be easily covered with makeup or permanent makeup. It also fades significantly over time, making it less noticeable—another reason for its popularity.

"I want to lighten my heavy eyelids." "I want to rejuvenate while maintaining my own impression."

It's perfect for those who want subtle changes without being too aggressive.

 

People Suitable for and Unsuitable for Brow Lift Surgery

 

⭐︎People who are particularly suited for brow lift surgery

 

 ・Concerned about sagging from the brow line to the upper eyelid

 ・Thick eyelids tend to create a flat, featureless impression

 ・I don't want to change my double eyelid line/I want to keep my single eyelid

 ・Want to look younger within a natural range

 ・The distance between the eyes and eyebrows is not too close

 

It's perfect for those who dislike the look of having had plastic surgery.

 

×There are also cases where it is not suitable.

 

 ・I want to significantly change the width of my double eyelids

 ・Close distance between eyebrows and eyes

 ・The muscles responsible for opening the eyelids are also weakened, making this a type that is difficult to improve with skin excision alone.

 

Surgical Procedure Flow: A beautiful finish comes from “meticulous adjustments” and ”suturing technique.”

 

First, design the incision line along the lower edge of the eyebrow.

This step is actually crucial: while carefully observing the shape of the eyebrows, the thickness of the skin, and the overall balance of the eyelid, we adjust the amount removed to the nearest millimeter to ensure we don't take off too much.

If deemed necessary to reduce the sagging and heaviness the patient perceives, we will add ROOF resection or orbital fat removal.

 

The surgical procedure is as follows:

① Incision → ② Skin excision and muscle processing → ③ If necessary, access to the fat layer (ROOF or orbital fat)

It's a simple process, but the most important part is the quality of the stitching.

 

By carefully aligning the layers as you sew them together, the scar becomes less noticeable and gradually blends into the shadow of the eyebrow over time.

This is where a plastic surgeon's skills really shine!

Sutures are typically removed after about one week, and bruising and swelling usually subside completely within about one month.

The peak period for scars appearing red lasts 1 to 3 months, after which the color gradually fades to a whitish tone over the next 6 months to 1 year.

 

Brow Lift

Top: Preoperative

Below: One month post-surgery

 

How to Combine ROOF Resection and Orbital Fat Resection

 

Brow lift surgery is a procedure to remove sagging, but

Depending on age and the original characteristics of the eyelids, skin alone may not be sufficient to address the root cause of heaviness.

The cause is ROOF and orbital fat.

Both are "fat," but they exist in different layers.

 

ROOF Excision: The Truth Behind That “Puffy” Feeling in Your Eyelids

 

ROOF (retro-orbicularis oculi fat) is the superficial layer of fat beneath the orbicularis oculi muscle.

One reason why the surface of the eyelid appears thick.

especially

 ・The eyelid near the eyebrow feels heavy

 ・Flat and lacking depth

 ・If you often look sleepy in photos, it's often due to the volume of your ROOF.

 

Removing a small amount of ROOF tissue during a brow lift creates a slimming effect, making the eye area appear lighter and more defined.

However, overdoing it will cause it to sink, so using only the necessary amount is the golden rule.

That's where the technology comes into play.

 

Orbital Fat Removal: An Approach to Addressing the “Puffiness” Caused by Fat Protruding from Deep Within

 

Orbital fat is the fat that encircles the eyes, wrapping around them both above and below.

For people with protruding skin, no matter how much skin is removed, the weight remains.

 ・The area just above the double eyelid line is puffy and swollen.

 ・When you press down on the lower eyelid, the puffiness above is pushed forward.

This type is often caused by orbital fat.

 

Combining a brow lift with a small amount of fat removal can reduce puffiness and make the eyes appear more open.

This is also based on the bare minimum.

 

 

↑There is a plump bulge near the inner corner of the eye. This is the orbital fat.

 

Should I opt for a brow lift alone or combine it with fat removal?

 

The correct answer varies from person to person.

Even with the same “heaviness of the eyelids,”

 ・Is there excess skin?

・Is the surface ROOF thick?

 ・Is the orbital fat in the back strong?

 ・Is it that my eyelids don't open properly to begin with?

Because the approach changes completely.

 

During actual counseling sessions, we assess the client's symptoms and facial balance while considering...

"Where should I trim to look the most natural and beautiful?"

We will make decisions together.

 

Post-operative changes: Not overdone, yet reliably rejuvenating

 

After surgery,

The redness under the eyebrow will gradually fade over several months, changing from red → pink → a whitish color.

People with thick eyebrows are especially likely to go unnoticed, with some saying, "No one at work noticed at all."

 

Summary: For natural rejuvenation, a brow lift is an excellent option.

 

Brow lift surgery avoids that so-called ”plastic surgery look,”

"I want to rejuvenate without changing my original impression."

Aesthetic medicine that supports your desire to look your best.

Furthermore, by appropriately combining ROOF resection and orbital fat removal, we can address the “true cause” of eyelid heaviness.

 

tailored to the structure of your own eyelids,

Let's choose together how to achieve maximum results with minimal effort.

We also offer simulations, so please feel free to discuss your options during a consultation! We look forward to seeing you.

Author: Arisu Hatade

Board-Certified Plastic Surgeon / Cosmetic Surgeon

 After graduating from Kyushu University School of Medicine, he worked in plastic and reconstructive surgery and cosmetic surgery at university hospitals and affiliated facilities, obtaining board certification in plastic surgery.

 With extensive experience in a wide range of cases, from facial and trunk reconstructive surgery to cosmetic surgery, I prioritize achieving natural and beautiful results based on anatomical knowledge.

 Having worked as an idol during my student days, I possess a unique perspective that understands both “beauty for being seen” and “beauty as medicine.” This allows me to offer customized aesthetic medical treatments tailored to each individual patient.

 In my personal life, I love traveling and gourmet food, and I share information about beauty and lifestyle on Instagram.

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career

 Graduated from the School of Medicine, Kyushu University

 New Tokyo Hospital Initial Training

 Jichi Medical University Hospital, Department of Plastic Surgery

 Luce Clinic Employment

 Shin-Koyama Municipal Hospital Plastic Surgery Department Employee

 Teikyo University Hospital Department of Plastic Surgery

 JR Tokyo General Hospital Plastic Surgery and Reconstructive Surgery Department Employee

 Ariake Hifuka Clinic Employee

 

Professional Affiliations and Qualifications

 Board-Certified Specialist, Japanese Society of Plastic and Reconstructive Surgery

 

Field of expertise

 Cosmetic surgery (eyes, jawline, gynecological procedures, etc.)

 Injection Therapy (Hyaluronic Acid, Botox, Fat Grafting)

 Laser Skin Treatment

 Regenerative Medicine and Anti-Aging Care

 

SNS

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