In fact, not everyone with a hidden eyelid crease or drooping eyelids is suited to double eyelid surgery. In some cases the problem may not come from the eyelid crease itself, but from low brows, drooping outer brows, a narrow space between the brows and the eyes, or upper eyelid skin that hangs down and covers the existing crease so that it can no longer be seen. This article explains what can cause droopy eyelids, downturned eyes and hidden eyelid creases, and which cases need an assessment with a surgeon before deciding between double eyelid surgery and an endoscopic brow lift.

What Causes Droopy Eyelids, Downturned Eyes and Hidden Eyelid Creases?

Problems around the eyes, such as droopy eyelids, downturned eyes, hidden eyelid creases or an existing crease that looks smaller, can have several causes and do not come from the eyelid crease alone. An assessment looks at the brow position, the eyelid skin, the eyelid crease and the overall shape of the face together.

1. Genetics

Some people are born with small or hidden eyelid creases, a fairly narrow space between the brows and the eyes, or low brows, because of genetics. This makes the area between the brows and the eyelid crease look smaller than usual.

In this group, having double eyelid surgery without also assessing the brow position may make the eyelid crease look narrower, because double eyelid surgery may remove some eyelid skin, which can make the space between the brows and the crease look smaller. For this reason, have a surgeon assess you so that the procedure chosen suits you as an individual.

2. Droopy Eyelid Skin Covering the Eyelid Crease

When the upper eyelid skin droops, it covers the existing eyelid crease, so less of the crease can be seen or it looks like a hidden crease. Signs you may notice include:

• less of your existing eyelid crease is visible
• the eyelid creases on each side look uneven
• your eyes look tired and dull
• your face looks tired overall, even when you have had enough rest
• your face looks older

However, in this case have a surgeon assess whether the skin covering the crease comes from the eyelid skin itself or from a lower brow position.

3. Low or Drooping Outer Brows Make the Eye Area Look Narrower

When the brows or the outer brows drop as you get older, the upper eyelid skin may drop too. This makes the space between the brows and the eyes look smaller, less of the existing eyelid crease can be seen, or the outer corners of the eyes look downturned.

Many people may think the problem is the eyelid crease, but in some cases the cause may be brows that sit lower. If the cause is assessed wrongly and double eyelid surgery is chosen straight away, the eyelid crease may end up looking narrower than before.

4. Raising Your Brows Often, Which Leads to Forehead Lines

As you get older, the eyelid skin can droop down over the eyes and make it harder to see clearly, so you raise your brows often to open your eyes and see better. This habit makes forehead lines more visible. If you have droopy eyelids, a hidden eyelid crease, low brows and forehead lines, have a surgeon assess the whole eye area rather than only the eyelid crease.

5. Ageing and Changes in Skin Elasticity

As you get older, the skin around the eyes and on the forehead becomes less elastic. This makes the upper eyelid skin droop down, or makes the space between the brows and the eyes narrower than before.

Which Problems Should Be Assessed for an Endoscopic Brow Lift?

An endoscopic brow lift may be one of the options a surgeon considers when the main problem is related to the position of the brows or outer brows, or to eyelid skin that is pressed down from above.

Downturned Eyes and Drooping Outer Brows Can Make the Face Look Sad

Downturned eyes may be related to drooping outer brows, because when the outer brows sit lower, the outer corners of the eyes drop too. This can make the eyes look sad or tired, or make the face look dull overall.

In some people, the existing eyelid crease may still be there, but the outer corner is covered more by the upper eyelid skin. This makes the outer part of the crease less clear and can make the face look older.

Hidden Eyelid Creases, or Creases Covered by Eyelid Skin so That They Look Hidden

Some people do not have a problem with the eyelid crease itself. The upper eyelid skin simply comes down and covers it, so less of the crease can be seen or it looks like a hidden double eyelid crease.

In this case, the assessment looks at whether the skin covering the crease comes directly from the upper eyelid or from a lower brow position, because the approach differs from person to person.

Narrow Brows, or a Narrower Space Between the Brows and the Eyes

If the space between your brows and eyes is narrow or looks narrower, have a surgeon assess you in detail before double eyelid surgery. If the main problem comes from low brows or drooping outer brows, double eyelid surgery may not always meet your needs. In some cases, lifting more eyelid skin when the space between the brows and the existing crease is already narrow may make the crease look narrower. Have a surgeon assess your brow position together with your eyelid crease before choosing a procedure.

How Does Double Eyelid Surgery Differ From an Endoscopic Brow Lift?

Double eyelid surgery suits people who have no eyelid crease, or a crease that is not clear, because of genetics or weak eyelid muscles from birth, so surgery is needed to create a clearer crease. A brow lift suits people who already have an eyelid crease that cannot be seen clearly, because it is covered by eyelid skin or because narrow brows make the crease look hidden.

How Does S45 Clinic Assess You Before Planning an Endoscopic Brow Lift?

Before planning an endoscopic brow lift, our surgeons at S45 Clinic assess the area around your eyes in detail, including the position of the brows and outer brows, the eyelid skin, the eyelid crease and the space between the brows and the eyes, to consider an approach that matches your concerns, as follows.

Assessing the Position of the Brows and Outer Brows

The surgeon looks at the height of your brows and outer brows and any difference between the two sides, to assess whether low or drooping outer brows are making the eyelid crease less clear, letting the eyelid skin cover the crease or making the outer corners of the eyes look downturned.

Assessing the Eyelid Skin and Existing Eyelid Crease

The surgeon assesses how much the eyelid skin droops and whether you already have an eyelid crease, and considers whether the skin covering the crease comes from low brows or from droopy eyelid skin, so that treatment can be planned to suit you.

Assessing the Space Between the Brows and the Eyes

If your brows are narrow or the space between your brows and eyes looks narrower, the surgeon assesses the brow position, eyelid skin and existing eyelid crease together before considering double eyelid surgery, because in some cases it may make the crease area look narrower than before. If the problem is related to the brow position, the surgeon may consider an endoscopic brow lift, depending on what suits each person.

If you have low brows, drooping outer brows, droopy eyelids, downturned eyes or hidden double eyelid creases that make your face look sad or older, you can book a consultation for an assessment with our surgeons at S45 Clinic here.

<p>The post What Causes Droopy Eyelids, Downturned Eyes and Hidden Eyelid Creases? first appeared on s45 clinic.</p>

Many people think double eyelid surgery, which creates a second fold in the upper lid, is the only way to fix this. In fact, the problem may not come from the eyelid crease alone. It may be caused by a low brow or drooping upper eyelid skin pressing down on your existing crease, so the crease is hard to see.

If this concerns you and you are looking for a suitable option, endoscopic brow and forehead lift at S45 Clinic is one approach that can help your existing crease show more clearly, cut down your make-up routine and give you a fresher look while you still look like yourself. The incisions are not made on the face itself, and recovery is relatively short.

Why Is Using Double Eyelid Tape Every Day Not a Long-Term Solution?

If you have hooded eyes, using tape may be an easy option in the short term. But over the long term, pulling the eyelid skin again and again may have unexpected effects, such as:

• irritation and inflammation of the eyelid skin
• drooping upper eyelid skin earlier than usual, because the skin is pulled and taped every day
• embarrassment if the tape comes off during the day, or visible edges when you close your eyes
• a longer make-up routine

Why Do Hooded Eyes and Drooping Upper Eyelid Skin Make You Look Stern and Older Than Your Age?

Hooded eyes together with drooping upper eyelid skin do not only affect how your eyes look. They also affect your whole face and how other people see you, for example:

• Sad, tired-looking eyes: you look sleepy and tired, even when you have had enough rest.
• An unintentionally stern face: a low brow pressing down makes the face look tense all the time.
• Looking older than your age: upper eyelid skin that droops over the eyes is one of the signs of skin ageing.
• A less approachable look: a space between the brow and the eye that is too narrow may make you look expressionless, aloof or hard to approach.

Warning Signs That You May Need a Brow Lift Rather Than Surgery to Create a Second Eyelid Fold

Double eyelid surgery, which creates a second fold in the lid, may often not solve the problem if the cause lies in the level of the brow and the skin above the eye. Check these signs to see whether this applies to you:

• Hooded eyes: you already have an eyelid crease, but the skin above it droops down and hides it.
• A drooping outer corner and drooping upper eyelid skin: the skin at the outer corner of the eye droops, making your eyes look sad and your face look older than your age.
• A narrow space between the brow and the eye: this makes you look stern, aloof or hard to approach.
• Raising your brows all the time: to make your eyes look bigger, which leads to lines on the forehead.

Endoscopic brow lift helps widen the space between the brow and the eye, which can help your eyelid crease look clearer and your eyes look rounder, bigger and brighter.

Choosing the Right Material for Endoscopic Brow Lift

The choice of material for brow lift is another important factor in getting a balanced result. The surgeon assesses your skin condition and how much your skin has sagged. S45 Clinic offers 3 types of material:

Suture (A Medical Material That Does Not Dissolve)

Suitable for people aged 25 to 35 who are starting to have mild to moderate sagging. It helps lift and tighten specific areas. Results may last about 5 to 8 years, depending on each person.

Endofict (A Medical Material That Dissolves)

Suitable for people aged 30 to 45. It is a small anchor with tiny barbs that helps spread the pulling force over a wider area and lift sagging skin and muscle. Results may last about 5 to 10 years, depending on each person.

Endotine (A Material That Dissolves)

Suitable for all skin types, especially people with thick skin aged 35 to 65. Endotine is a medical device designed to hold the skin and spread the pulling force over a wide area. The material dissolves by itself within 6 to 12 months. Results may last about 10 to 15 years, depending on each person.

Feel More Confident With Endoscopic Brow Lift at S45 Clinic

If you have hooded eyes or an unclear eyelid crease and rely on eyelid tape every day to create a second fold, a “brow lift” can help open up the area around your eyes so it looks clearer.

In this case, the brow lift was done together with a midface lift to make the facial structure more balanced, using an endoscopic technique with a high-resolution view. This helps the surgeon see scar tissue, blood vessels and nerves clearly at every step. The result was not only a clearer eyelid crease but also a fresher-looking face, including:

• small incisions hidden along the hairline, so the scars are usually hard to see
• a lower chance of swelling and bruising in some cases, with a relatively short recovery for many people
• less drooping upper eyelid skin and less hooding over the crease
• a raised brow and a lifted midface, for a fresher-looking face

Frequently Asked Questions About Correcting Hooded Eyes

Summary

Hooded eyes and drooping upper eyelid skin are not always treated with double eyelid surgery. Choosing a suitable approach, such as endoscopic brow and forehead lift, can help you get a softer, brighter and fresher look. Results depend on each person.

“Reveal the beauty within you” Reveal your hidden beauty

To book a consultation about your eyelid concerns and have your face assessed by an experienced surgeon at S45 Clinic, contact us through the channels below.

<p>The post Hooded Eyes and an Unclear Eyelid Crease, Correcting Them With Endoscopic Brow Lift first appeared on s45 clinic.</p>

What Is Brow Ptosis? Signs That Make the Face Look Older

Brow ptosis (drooping brows) is when the brows sit lower than usual. In general, a suitable brow position is about 1.5cm to 2cm above the edge of the eye socket.

If the brows drop, whether at the inner end, at the tail or unevenly, the face can look less fresh, the eyes can look sad and the face can look stern without meaning to.

Brow ptosis is also often seen together with drooping outer eye corners and sagging upper eyelids, which can make the eyelid crease look narrower and the eyes look tired. Many people think double eyelid surgery alone can fix this, but when the main cause is a lowered brow position, an endoscopic brow lift and facelift with Endotine may give a more balanced result. If you have drooping brows or drooping outer eye corners, you can book a consultation with a surgeon at S45 Clinic, who will assess the problem in detail case by case and plan care that fits your goals and your facial structure.

What Is Endoscopic Brow Lift and Facelift Surgery?

Endoscopic brow lift and facelift surgery lifts the skin and muscles of the forehead and brows, also known as an upper facelift, to move them to a more suitable position. It helps the face look fresher and reduces drooping brows, drooping outer eye corners and forehead lines.

The surgeon inserts an endoscope (a thin camera) through small incisions in the hairline to magnify the internal structures, so the details can be seen more clearly on a screen, which makes the surgery more precise. An endoscopic brow lift and facelift is therefore another option to reposition the brows and lift the face so its proportions and overall look appear more youthful.

Types of Endoscopic Brow Lift and Facelift, and How the Materials Differ

In a brow lift and facelift with the endoscopic technique, apart from the surgical technique itself, another factor that affects the result is the ‘material used to hold the lift’, which affects how firmly the tissue is held, how long the result lasts and how well it suits each person’s skin.

In general, an endoscopic brow lift and facelift can use 3 types of material. The surgeon assesses your facial structure, the degree of sagging and your goals to choose the most suitable approach for each case.

1. Suture (non-absorbable medical material): a material for the facelift and brow lift suited to people aged 25 to 35 with mild to moderate sagging. It holds specific points well, with results that can last 5 to 8 years, depending on each person.
2. Endofict (absorbable medical material): a material for the facelift and brow lift suited to people aged 30 to 45. It is a small anchor with tiny prongs that holds and spreads the lifting force over a wide area and helps stretch skin and muscle well. Results can last 5 to 10 years.
3. Endotine (absorbable medical material): suitable for all skin types, especially thick skin, for people aged 35 to 65. Endotine is a device designed for medical use to hold the skin and spread the lifting force over a wide area. The material absorbs on its own within 6 to 12 months, and results can last 10 to 15 years.

Why Choose an Endoscopic Brow Lift?

An endoscopic brow lift and facelift helps lift the brows and makes the face look more balanced. Its key features are:

• Long-term results

Results of an endoscopic brow lift and facelift can last 10 to 15 years, depending on several factors, such as your health and how carefully you follow aftercare advice.

• Small incisions

The incisions are only 1.5cm to 2cm long and are hidden in the hairline.

• No overnight hospital stay

You can usually go home straight after the procedure without staying in hospital. Recovery time depends on each person.

• A result that suits your face

It helps bring the brows to a suitable position so the face looks fresher, and you can still make facial expressions as usual.

An endoscopic brow lift and facelift is therefore one option for people who want to reposition their brows to suit their face. The choice of treatment should be made after an assessment by a surgeon, to lower risks and meet each person’s goals.

Brow Lift vs Thread Lift, How Do They Differ?

An endoscopic brow lift and facelift and a thread lift both help lift the face and correct drooping brows, but they differ in how they are done, the degree of change and how long the result lasts. The right choice depends on each person’s problem and goals.

Endoscopic Brow Lift and Facelift

This lifts the skin and muscles of the forehead and brows to address the problem in a suitable way:

• results can last 10 to 15 years
• lifts both the brows and the forehead, helping to lift the face so it looks fresher
• helps reduce sagging upper eyelids
• better proportion between the eyelid crease and the brows
• small incisions hidden in the hairline

Thread Lift

A procedure that lifts the skin without surgery, but it has limits to consider:

• results last about 8 to 12 months
• suited to lifting at the skin level
• needs repeat sessions to maintain the result
• not suitable for people with clearly sagging upper eyelids or drooping outer eye corners
• may cause irritation or inflammation in some cases
• in some cases, may cause scar tissue or uneven skin

If you want to address sagging upper eyelids and drooping outer eye corners and lift the face, an endoscopic brow lift and facelift with Endotine is one option, with results intended to last in the long term.

Summary

Drooping brows, drooping outer eye corners and sagging upper eyelids are among the main reasons the face looks less fresh and older. They can be addressed with an endoscopic brow lift and facelift, which repositions the brows to a suitable level, with the advantage of small incisions hidden along the hairline. If you have drooping brows, drooping outer eye corners or sagging upper eyelids and are looking for options, you can book a consultation at S45 Clinic for an assessment and a treatment plan that suits you.

<p>The post Types of Brow Lift and Facelift With the Endoscopic Technique, and How the Materials Differ first appeared on s45 clinic.</p>

More Than 20 Years of Emotional Scars, and a Major Change

More than 20 years ago, Khun Daeng was in a serious car accident. The car glass struck her face and pierced through her nose to the eye socket, causing loss of sight in 1 eye and severe disfigurement. All this time, she endured bullying and people seeing her face as frightening. Out of deep love, her only daughter Sobam set herself the goal of entering beauty pageants to raise money for her mother’s treatment and give her mother her face back, and she finally succeeded.

A Challenging Facial Restoration Case

Khun Daeng’s case was a highly challenging structural rhinoplasty and facial reconstruction case that our team took on in 2026, because the right side of her face was severely damaged, her eye had dropped out of position, and repeated infections had destroyed tissue.

This treatment needed assessment and surgery by experienced surgeons, led by Dr. Ty (นายแพทย์กิตติศักดิ์ วงค์เทียนชัย, ว.35602) at S45 Clinic experienced in open rhinoplasty and structural correction, and Dr. Tao (นพ.นครินทร์ จรัสวิริยะกุล) at S45 Clinic, experienced in facial reshaping with the endoscopic technique.

The Medical Techniques Used for Khun Daeng

This surgery was not only for appearance but to rebuild a badly damaged facial structure, with these key steps:

• Rebuilding the nose structure: open rhinoplasty with rib cartilage was used to build a completely new, strong nasal structure
• Repositioning the upper face: the surgeon performed a brow lift and facelift with the endoscopic technique to correct sagging skin and muscle and lift the eye, which had dropped out of position, to a more balanced position
• Filling and softening lines: fat grafting was used to reshape the temples, under the eyes and the eyelids to fill deep grooves caused by the injury, together with liposuction along the jawline and scar revision to smooth the scars

Restoring Confidence and a New Smile at S45 Clinic

The result of the surgery has helped Khun Daeng move past the pain, let go of the stigma she carried and live with confidence again. This case reflects the standards and experience of the surgeons at S45 Clinic and their attention to every detail of each patient.

If you have problems with your facial structure, a misshapen nose, or a previous surgery that did not go as planned, do not give up hope. You can book a consultation with our experienced surgeons at S45 Clinic. We assess and plan treatment case by case, with care focused on lowering risk. Message us to book a consultation.

Frequently Asked Questions About Facial Structure Correction

<p>The post Facial Reconstruction Surgery, How Sobam Helped Her Mother Move on From a Misshapen Face first appeared on s45 clinic.</p>