If Your Double Eyelid Line Has Become Hidden Over Time: Revision Surgery

Hello. I am Dr. Ahn Byeong-jun, director of An Byeong-jun Plastic Surgery.

Some people clearly had a beautiful eyelid line after surgery, but find several years later that the line is no longer visible.

This is especially common when the line was made small, as with a partial double eyelid. As the skin begins to sag over time, the line itself may become hidden beneath the sagging skin.

This does not mean that the previous surgery was unsuccessful. Rather, age-related changes in the skin have covered the line.

In such cases, the key to double eyelid revision surgery is not mechanically recreating the line, but removing the sagging skin.

When sagging skin covers the line

The smaller the double eyelid line, the more strongly it is affected by sagging skin.

As the eyelid skin loses elasticity and gradually descends with age, a low-lying line can become covered by the sagging skin above it, making the double eyelid increasingly indistinct.

Eventually, the line may become completely hidden, making the eyes appear to have no double eyelid.

Many people see this condition and think that the line has “come undone,” but it is not that the fixation of the line has loosened. The skin has simply covered it from above.

The solution should also differ depending on the cause.

Why removing the skin comes first in revision surgery

In this case, the line was designed at 7 mm, and 3 mm of sagging skin was removed.

If the line is simply recreated without removing the sagging skin, the same situation may recur before long.

Fixing the line after removing the skin can improve the likelihood that it will remain stable, since the weight of the sagging skin has been reduced.

Removing more skin is not necessarily better.

The principle is to carefully assess the amount of excess skin and remove only as much as necessary within a range that does not look unnatural when the eyes are closed.

Why the sunken eyelid was improved through fat repositioning

One additional procedure was performed in this case.

Fat remaining on the outer side of the eyelid was moved toward the center to fill the hollow area.

This involves repositioning fat that is already inside the eyelid, without harvesting fat separately.

Because no additional fat needs to be grafted from elsewhere, the procedure is less burdensome and can effectively improve a sunken appearance in a natural way.

When double eyelid revision surgery and fat repositioning are performed together, the line becomes more defined while the overall volume of the eyelid is restored in a balanced way.

The initial swelling after double eyelid revision surgery may subside more slowly than after the first surgery.

This is because the tissue has already been disturbed at least once, so recovery takes longer.

During the first one to two months after surgery, you may notice differences between the two sides, or the line may not yet be distinct.

Only after more time has passed, the skin has stabilized, and the fat-repositioning area has settled can you see the final definition of the eyes.

We recommend finding an experienced board-certified plastic surgeon and creating an eye design suited to you.

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