ptosis #eye correction #double eyelid surgery #double eyelid #epicanthoplasty #double eyelid surgery #double eyelid surgery #lateral canthoplasty #natural adhesion double eyelid #double eyelid revision surgery #ptosis surgery #how to make eyes bigger #double eyelid

#double eyelid revision surgery #lateral canthoplasty #uneven eyes #double eyelid revision surgery #upper canthoplasty #epicanthoplasty reversal #double eyelid swelling #eye plastic surgery #uneven eyes surgery #hidden double eyelid #eye revision surgery #double eyelid revision surgery #uneven eye correction

#double eyelid surgery #double eyelid correction surgery #ptosis correction #eye correction surgery #double eyelid outer line #eye surgery #ptosis revision surgery #best place for eye plastic surgery #double eyelid surgery #ptosis eye correction

#epicanthoplasty revision #sausage eyes #puffy eyes #inner epicanthoplasty #double eyelid line #types of eye revision surgery #eye plastic surgery clinic #sausage eyes revision surgery #types of double eyelids #uneven eyes double eyelid surgery #double eyelid #eye correction surgery

#best place for double eyelid surgery #surgery to release double eyelids #hospital good at double eyelid revision surgery #best place for eye revision surgery #best place for eye revision surgery in Gangnam #best place for eye revision surgery in Apgujeong #best place for eye revision surgery in Sinsa

#Duhan #Duhan Plastic Surgery #Dr. Shin Duhan #epicanthoplasty revision surgery #eye correction revision surgery #thick double eyelid #remove double eyelids #hidden double eyelid surgery #Gangnam double eyelid surgery #best place for double eyelid surgery

#best place for double eyelid surgery in Gangnam #best place for double eyelid surgery in Apgujeong #best place for double eyelid surgery in Sinsa #sausage double eyelid #incision double eyelid #Gangnam eye plastic surgery #Apgujeong eye plastic surgery #Sinsa eye plastic surgery

#double eyelid #postoperative care after double eyelid surgery #surgery to make eyes bigger #effect of double eyelid revision surgery #lateral canthoplasty revision surgery #in-out line double eyelid #release eye correction #entropion #famous hospital for eye revision surgery

#famous hospital for eye revision surgery in Gangnam #famous hospital for eye revision surgery in Apgujeong #famous hospital for eye revision surgery in Sinsa #drooping eyes #symptoms of ptosis #double eyelid outer line #hospital specializing in double eyelid revision surgery

#incision revision surgery #lowering the double eyelid line #double eyelid revision hospital #Gangnam double eyelid revision hospital #Apgujeong double eyelid revision hospital #eye revision plastic surgery clinic #Gangnam eye revision plastic surgery clinic #double eyelid

#buried suture revision surgery #Apgujeong eye revision plastic surgery clinic #Sinsa eye revision plastic surgery clinic #buried suture revision surgery #incision double eyelid #buried suture double eyelid surgery #eye correction method #hidden double eyelid #hidden double eyelid

#Gangnam double eyelid revision hospital #Apgujeong double eyelid revision hospital #Sinsa double eyelid revision hospital #double eyelid line #natural adhesion swelling #best place for double eyelid surgery #buried suture revision #incision eye correction

#double buried sutures #types of double eyelids #lateral canthoplasty reversal #double eyelid scar #double eyelid scar tissue #uneven double eyelids #eye revision hospital #Gangnam eye revision hospital #Apgujeong eye revision hospital #Gangnam eye revision

#Apgujeong eye revision #Sinsa eye revision #Sinsa eye revision hospital #out line double eyelid #lateral canthoplasty reconstruction #natural adhesion revision surgery #Seoul double eyelid #uneven eyes double eyelid surgery #epicanthoplasty for Mongolian folds

#double eyelid clinic #natural adhesion eye correction #double eyelid surgery scar #double eyelid #best place for double eyelid revision surgery #best place for double eyelid revision surgery in Gangnam #best place for double eyelid revision surgery in Apgujeong #double eyelid

#best place for double eyelid revision surgery in Sinsa #double line removal #famous hospital for double eyelid surgery #famous hospital for double eyelid surgery in Gangnam #famous hospital for double eyelid surgery in Apgujeong #famous hospital for double eyelid surgery in Sinsa

#hospital good at double eyelid revision surgery #hospital good at double eyelid revision surgery in Gangnam #hospital good at double eyelid revision surgery in Apgujeong #hospital good at double eyelid revision surgery in Sinsa #double eyelid in Gangnam #double eyelid at Gangnam Station

#surgery to make eyes larger #double eyelid surgery #incision double eyelid surgery failed #partial incision eye correction #epicanthoplasty reconstruction surgery #asymmetric double eyelids #loose double eyelids #thin outer line #partial incision double eyelid

#double eyelid plastic surgery clinic #Gangnam double eyelid plastic surgery clinic #Apgujeong double eyelid plastic surgery clinic #Sinsa double eyelid plastic surgery clinic #small eye plastic surgery #eye correction surgery method #Gangnam eye plastic surgery clinic #famous place for eye plastic surgery

#famous place for eye plastic surgery in Gangnam #famous place for eye plastic surgery in Apgujeong #famous place for eye plastic surgery in Sinsa #lateral canthoplasty revision surgery #Seoul double eyelid #buried suture double eyelid #best hospital for eye revision surgery #double eyelid recommendation

#Gangnam double eyelid recommendation #Apgujeong double eyelid recommendation #Sinsa double eyelid recommendation #in-out line double eyelid #Gangnam eye correction #Apgujeong eye correction #Sinsa eye correction #non-incisional eye correction surgery #epicanthoplasty and lateral canthoplasty

#famous place for double eyelid revision surgery #famous place for double eyelid revision surgery in Gangnam #famous place for double eyelid revision surgery in Apgujeong #famous place for double eyelid revision surgery in Sinsa #famous hospital for double eyelid revision surgery #epicanthoplasty double eyelid surgery

#famous hospital for double eyelid revision surgery in Gangnam #famous hospital for double eyelid revision surgery in Apgujeong #famous hospital for double eyelid revision surgery in Sinsa #ptosis hospital #ptosis hospital in Gangnam #ptosis hospital in Apgujeong

What are the indications for double eyelid revision surgery?

1. When the double eyelid line is too large

2. When the double eyelid line has loosened

3. When the line is asymmetric

4. When the eyes feel tired after double eyelid surgery

5. When there is a thick sausage-like appearance in the area below the incision line

6. When your impression looks worse after double eyelid surgery

7. When you want to restore beautiful, natural-looking eyes

What is double eyelid revision surgery?

When the double eyelid line is too large, uneven, or has loosened, this refers to surgery that revises the double eyelid line and restores the original natural yet refreshed double eyelid shape.

What is the purpose of double eyelid surgery?

Double eyelid surgery is not simply intended to create a double eyelid line.

The purpose of double eyelid surgery is to make the eyes look bigger and more refreshed, and to create bright eyes and a refined eye shape.

Surgery performed only to create a double eyelid line can easily lead to undesired results.

The same applies to the purpose of double eyelid revision surgery.

Its purpose is to correct the eye shape to look bigger, more refreshed, and more natural.

Characteristics of Duhan Plastic Surgery’s double eyelid revision clinic

1. We have accumulated over 20 years of extensive experience and know-how in double eyelid revision surgery.

2. We have a systematic system for revision surgery.

3. Through preoperative consultation, we perform various examinations and tests to predict the postoperative results.

4. We only perform surgery when the examinations and tests show that there is sufficient room for improvement.

If we determine that the patient cannot achieve the desired result, our policy is not to attempt surgery.

5. By identifying the problems with the previous surgery through examination, we provide a thorough and clear explanation and propose the surgical method that will give the best result.

6. We explain the surgical process and the postoperative course clearly so that patients fully understand them, and we do not omit explanations of possible postoperative side effects.

7. We provide thorough postoperative care after surgery.

We closely observe the postoperative course to confirm that recovery is progressing properly.

8. Our clinic makes every effort and continues its research so that people who want double eyelid revision surgery will no longer need to visit another hospital.

Types of examinations and tests during consultation for double eyelid revision surgery

The most important test for determining whether revision surgery is possible is the amount of excess skin.

Because revision surgery requires removing at least some of the scar tissue before performing the operation, the amount of excess skin is an important indicator for predicting the prognosis of surgery.

If there is no excess skin, surgery may not be possible.

If surgery is performed aggressively when there is insufficient excess skin, the results will be poor and lagophthalmos, where the eyes cannot close properly, will worsen. Therefore, this is the most important examination that must be done before revision surgery.

The second most important test for determining whether revision surgery is possible is the levator function test.

When ptosis is severe, how much levator function remains is a crucial factor.

The levator muscle is the muscle that lifts the eyelid upward.

The extent to which this muscle is functioning determines whether successful revision surgery can be predicted.

In patients with ptosis, if levator function is significantly reduced, surgery may not be possible.

As a rule, surgery should not be performed when levator function has fallen below a certain threshold.

Other examinations and tests

• Measurement of eyelid skin thickness

• Examination for the presence of lash eversion

• Examination of scar tissue and the degree of adhesion along the existing double eyelid line

• Selection of the method that can produce excellent treatment effects and maximize satisfaction

• Measurement of the height and symmetry of the existing double eyelid line (scar line)

• Measurement of the amount and presence of orbital fat, and the thickness and presence of the orbicularis oculi muscle

• Measurement of the degree of ptosis by assessing the vertical eye opening when looking naturally straight ahead at eye level

• Measurement of the horizontal eye length and the distance between the eyes (to determine the presence of an epicanthal fold)

• Assessment of the presence of strabismus

Surgical planning based on the above test results

1. Setting the height and design shape of the new double eyelid line

2. Setting the width of skin (scar) excision

3. Setting the width of levator shortening

4. Determining whether orbicularis oculi muscle excision is needed

Based on the above test results, we predict the postoperative outcome and the likelihood of surgical success.

We recommend surgery only when it is judged to be possible.

If surgery is not possible, we explain why, or explain how far surgery can realistically improve the condition.

Correction of a thick line

Problems with a thick double eyelid line

A double eyelid with an excessively thick line looks artificial, awkward, and gives the impression that the surgery was done not long ago.

It also often causes ptosis that makes the eyes look sleepy.

Causes of a thick double eyelid line

When the initial surgery was designed too high

The average natural double eyelid height for Korean people is around 6–8 mm.

However, because each person’s eyes differ in size and shape, the height of the double eyelid line must also be adjusted accordingly.

The design criterion should always be to temporarily create a line while the patient is seated and first find the line that best suits their eye shape.

However, when designing in the lying-down position, it is difficult to find a suitable line, and because the design is based on the tarsal plate, there is a high chance of creating a large double eyelid line.

When the skin is thick

Even if the line is set at the same height as other people’s, thick skin can make the line look thick and awkward.

In cases of thick skin, the line often needs to be set slightly lower than average.

When ptosis is present

When there is ptosis with sleepy-looking eyes, the line can appear larger even if it is at the same height as other people’s.

This is because the eyes do not open fully.

In cases of ptosis, the line should be set lower, or ptosis correction should be performed at the same time.

Protruding eyes

When the eyes protrude, the line height should be set slightly lower than in normal cases.

This is because eyeball protrusion can make the line appear larger.

It is important to temporarily create a line while seated to find the most natural line for one’s own eye shape.

Sunken eyelids

When the eyes are sunken, the double eyelid line is pulled upward and becomes higher.

This happens because as the eyes become sunken, the skin pulls the line upward.

In such cases, the line should be set lower than normal, or fat grafting should be performed first before double eyelid surgery so that the eyes are restored to a normal shape. Then, double eyelid surgery should be performed several months later to create a satisfactory double eyelid.

Why it is difficult to reduce the double eyelid line using a general method

In the case of a high line, the height of the incision line is often more than 8 mm from the eyelashes.

This is usually reduced to about a 5–6 mm line, and for this, it is common to excise about 2–3 mm of skin, including the existing scar line.

You must understand what happens when the skin is excised and simply sutured.

If only excision and suturing are performed, the skin below the excision line is pulled upward and adheres to the skin above the excision line, resulting again in a large line of more than 8 mm, and the surgery will fail 100%.

Therefore, the key to surgery is to pull the skin above the excision line downward.

For this, tissue rearrangement must occur, and to rearrange the tissue, the area between the levator muscle and the orbital fat must be dissected precisely so that tissue rearrangement can occur and the line can be reduced.

How to reduce a thick double eyelid line

Method using a full incision technique

1. Remove the scar tissue.

2. Dissect precisely between the levator muscle and the orbital fat so that tissue rearrangement can occur.

3. After dissection, advance fat to prevent adhesion of scar tissue.

4. To prevent the skin below the excision line from being pulled upward, firmly fix the skin below the excision line to the tarsal plate.

5. Perform levator shortening so that the eyes open a little more widely.

The more the eyes open, the more the double eyelid line can be reduced.

6. Finish tissue rearrangement by performing firm layered suturing through the tissue, and prevent the tissue from being pulled upward.

7. Remove the stitches a little later so that the scar does not widen and the rearranged tissue can stabilize.

Examples of correcting a thick double eyelid line with the full incision method

Method using micro fat grafting

This is applied only when the upper eyelid is sunken.

Micro fat grafting requires highly skilled technique and know-how.

The anatomical structure of the eyelid must be understood precisely.

Therefore, eyelid fat grafting can only be performed properly by someone with extensive experience in double eyelid revision surgery.

It is a highly advanced procedure that must also consider correcting the awkward double eyelid line along with the sunken eyelid.

It is better not to receive the procedure from someone with insufficient experience or from a non-board-certified plastic surgeon.

1. Sedation and local anesthesia are performed.

2. Fat is finely collected from the abdomen using a syringe.

3. The collected fat is centrifuged and purified.

4. The purified fat then undergoes another oil removal process.

5. Tunneling is performed at the procedure site to secure space for transplantation.

6. Precise grafting is performed into the orbital fat layer of the sunken eyelid.

7. The procedure is finished by adjusting the contour of the eyelid and the height of the double eyelid line through molding and retunneling.

Examples of correcting a thick line and sunken eyelid with micro fat grafting

Method using partial incision

In cases of a naturally occurring double eyelid or a thick line that developed after buried-suture surgery, if the degree of adhesion is assessed, there are cases where correction is possible without necessarily using the full incision method.

If a temporary line is created during the examination and the line is formed naturally while the existing line disappears, correction is possible with the partial incision method as well.

Extreme revision surgery to correct a thick line

This is surgery to restore normal eye shape through revision surgery in extremely severe cases or in situations where further surgery is judged to be difficult.

It is surgery that brings an eye shape that is in very poor condition, making normal restoration difficult or nearly impossible, closer to normal.

The goal of extreme revision surgery is to restore eyes with severe revision history, filler-like foreign substances injected into the eyelids, or bulky fat grafts causing marked unevenness and adhesion, as well as severe ptosis, back to a normal eye shape.

Examples of extremely damaged double eyelids

Differences between extreme revision surgery and general revision surgery

In general revision surgery, depending on the condition, some surgical steps may be simple or omitted. However, in extreme eye (double eyelid) revision surgery, if there is not enough excess skin or if the existing scar line is too high and dark, making revision almost impossible, subcutaneous dissection is performed instead of scar excision, and a new line is created below it.

This refers to the concentration of all revision surgery techniques for restoring a natural and beautiful double eyelid by fully utilizing all available techniques, such as multiple tissue dissection and repositioning to release scar adhesions, insertion of micro fat tissue, levator shortening, and dissection and excision of the orbicularis oculi muscle below the incision line.

Plan for extreme revision surgery

1. If there is insufficient tissue or skin, measure the limit of how much can be stretched and then stretch it.

2. If levator function is almost absent, calculate the limit of how much can be lifted.

3. If the skin is very thick, create a plan to thin the tissue by excising the orbicularis oculi muscle.

4. If scar adhesion is very severe and cannot be released, plan micro fat grafting after scar dissection.

5. If the sausage-like appearance is severe, plan to remove it through incision-line dissection and partial excision of the orbicularis oculi muscle.

6. If the scar line is very high, plan to flatten it instead of excising the scar line.

7. In the case of a very dark and sunken scar line that cannot be excised, plan to fill the sunken area.

8. If lash eversion is severe, plan to correct the eversion by dissecting beneath the lash roots.

Before-and-after results of extreme revision surgery

Even very difficult and severe revision cases can produce good results if surgery is performed according to principles with a sufficient plan.

However, surgery is not possible in every case.

If there is too little excess skin or if scar adhesion is very severe, there are limits to surgery, and in some cases surgery may not be possible at all.

If, based on the preoperative examination, revision surgery is judged to be difficult, our principle is not to formulate a surgical plan at all.

Correction of asymmetric lines

A double eyelid with a large difference between the two lines looks awkward and gives a poor impression.

In cases of asymmetric double eyelid lines, the rule is to correct the line you dislike based on the line you like.

If neither side is satisfactory, both sides must be corrected.

The causes of asymmetry vary.

There are also several methods for correction.

Causes of asymmetry

1. When the heights of the double eyelid lines are different

2. When one eye has ptosis

3. When one double eyelid line has loosened

4. When the skin on one side is loose

5. When there is insufficient orbital fat and the eyelid becomes sunken, pulling the line upward

6. When the line is pulled upward due to scar adhesion

How to correct asymmetric lines

When the line height differs after buried-suture surgery

If the original surgery was done with a buried-suture method, the chance of loosening remains high even if it is redone with the same method.

A new line is created at the desired position using the partial incision method.

As the new line forms, the existing double eyelid line naturally flattens and disappears.

However, if the existing line is too prominent, it cannot be corrected with the partial incision method and may require correction with the full incision method.

When the line height differs after full incision surgery

1. When the smaller line is enlarged to match the larger line

If one side is lower and the smaller line needs to be made larger, a new double eyelid is created above the existing line.

This is generally corrected with the partial incision method, but if the existing scar line is dark, it is corrected with the full incision method.

2. When the larger line is reduced to match the smaller line

To reduce a large line created by the full incision method, it is corrected again with the full incision method.

The existing scar line is excised and removed, and a new double eyelid line is created to match the opposite side.

To reduce the large line, the tissue is dissected and fully repositioned.

How to correct when one side has ptosis

Surgery is performed to help the ptotic eye open more widely.

Using the full incision method, levator shortening is performed by pulling the levator muscle and tying it to the tarsal plate.

When one side’s double eyelid line has loosened

If one side’s line has loosened, the loosened side is corrected using the partial incision method or the full incision method.

If the skin is very thick or the scar is not severe, the principle is to correct it first with the partial incision method; if it still loosens, it is corrected with the full incision method.

When the skin on one side is loose

If the line height is the same but asymmetry occurs because of skin sagging, the sagging side is corrected by excising the loose skin using the full incision method.

When both sides are asymmetric and both lines look awkward

If the left and right sides are asymmetric and both lines are unattractive and awkward, both sides must undergo revision surgery.

The lines are designed at the same height, the existing scar lines are removed, the tissue is fully repositioned, and new lines are created.

When one eyelid becomes sunken and the line is pulled upward, causing asymmetry

When the eye socket fat is insufficient and the eyelid becomes sunken, the line is pulled upward and becomes larger.

In such cases, the asymmetry can be corrected simply with micro fat grafting without revision surgery.

Micro fat grafting is a simple procedure in which fat is injected with a syringe.

Correction of a loosened line

• When there is a lot of pre-tarsal fat

• When the orbicularis oculi muscle is thick

• When scar tissue has not formed properly

• Lack of experience or skill on the part of the surgeon

• Choosing the wrong surgical method

• Habitually rubbing the eyes

There are many reasons why the line loosens, but one reason is that the orbicularis oculi muscle and fat that interfere with double eyelid formation were not properly removed. Another reason is that scar tissue beneath the skin, which is essential for double eyelid formation, does not form properly due to constitutional factors.

How to correct it with the full incision method

If a line created by the incision method loosens, it can sometimes be corrected with the partial incision method.

If the goal is to correct both the scar line and the line height at the same time, the full incision method is used.

How to correct it with the partial incision method

If a line loosens after buried-suture surgery, the chance of it loosening again is high even if it is corrected with the buried-suture method again, so correction with the partial incision method is the rule.

If it loosens again even after the partial incision method, it is corrected with the full incision method.

How to correct it with micro fat grafting

When the eyelid becomes sunken and the line is pulled upward and loosened, the loosened line can be corrected together with the sunken eyelid through micro fat grafting.

However, this applies only when the cause of loosening is solely due to eyelid sunkenness.

The main purpose of the procedure is to correct the sunken eyelid, and correcting the double eyelid line is a secondary goal.

If the line does not naturally recover even after the eyelid is restored, revision surgery must be performed.

Causes of double eyelid revision surgery failure

If double eyelid revision surgery was performed but the result was undesired

There are various causes.

Main phenomena seen after failed double eyelid revision surgery

◆ Surgery was performed to make a large line smaller, but the line barely changed or remained the same.

◆ Swelling does not go down easily and looks awkward. - sausage appearance

◆ It feels uncomfortable to open the eyes, and the eyelids feel heavy.

◆ There is a pulling sensation and stiffness when opening the eyes.

◆ The line is severely asymmetric.

◆ The eyelashes remain everted and do not recover.

◆ It is uncomfortable to open the eyes, but the eyes close well.

◆ The scar line at the incision site is too dark.

Causes of double eyelid revision failure

The biggest cause of failure is the patient thinking of double eyelid revision surgery too lightly.

After a failed double eyelid surgery, the thought that “it can just be corrected again” leads to failure in revision surgery.

To undergo revision surgery, the patient themselves must understand why the original surgery went wrong more than anyone else; otherwise, failure can happen again.

The following content analyzes the causes of failure in cases where revision surgery was performed at another hospital, failed, and then the patient came to our hospital for revision, with various examinations used to identify the reasons for failure.

1. When revision surgery is performed together with epicanthoplasty

Some hospitals perform revision surgery to reduce the double eyelid line together with epicanthoplasty.

Epicanthoplasty tends to make the inner (medial canthal) line thicker.

It does not make sense to perform surgery to reduce the line while simultaneously performing surgery that makes the inner line larger.

Unnecessary epicanthoplasty can cause various problems.

Epicanthoplasty should only be applied when needed in eyes with an epicanthal fold, and unnecessary epicanthoplasty can lead to various side effects such as excessive exposure of the inner mucosa, severe out-fold lines, eyes that appear too close together, or eyes that look harsh.

Be careful, because unnecessary epicanthoplasty often ruins the impression rather than improving it.

2. When scar tissue is not clearly dissected during revision surgery

During revision surgery, the existing scar must be removed or clearly dissected to release the adhesions between the stuck tissues.

Otherwise, tissue repositioning cannot occur.

If the muscle and fat layers are not clearly dissected while releasing adhesions, tissue repositioning becomes impossible and it becomes difficult to narrow the double eyelid line.

If suturing is done without proper dissection, the double eyelid line will not narrow at all, and instead the skin below the incision line will be pulled upward, causing lash eversion.

3. When orbital fat is not repositioned

If fat needs to be repositioned but is neglected, the dissected tissue will stick again, the eyes will not open widely, and in some cases a triple eyelid may even form.

Along with dissection of scar tissue, repositioning orbital fat is one of the important surgical steps that acts like lubrication to prevent tissues from sticking again.

4. When fat is not repositioned at the inner canthus (inner corner of the eye)

If orbital fat is not repositioned to the inner canthus, scar tissue forms at the inner corner and interferes with opening the eyes widely.

Scar tissue should not form at the inner corner.

The inner corner of the eye plays an important role in helping the eyes open widely, and if excessive scar tissue forms in this area, the eyes cannot be opened widely and a natural line cannot be created.

5. When ptosis correction (eye correction) is not performed

In sleepy-looking eyes, eye correction must be performed so the eyes can open widely.

Usually levator shortening is performed, and the levator muscle (the muscle that lifts the eyelid) is an important structure that opens the eyes. Most patients undergoing double eyelid revision surgery have weakened eyelid-lifting muscles.

It is important to perform levator shortening (step 6) to make the eyes open widely.

If this is not done, the existing sleepy-looking eye shape will not be corrected, reducing the effect of double eyelid revision surgery.

6. When the stitches are removed too early

The reason stitches are removed late during revision surgery is that most revision patients have very little excess skin, and because tissue repositioning has been done, the tissues need to be held firmly in place by the strength of the sutures.

Since repositioned tissues tend to return to their original state like a spring, they must be held by the sutures. If the sutures are removed before the tissues have stabilized in their new position, the tissues will return to their original location and lead to a poor surgical outcome.

7. When fat grafting and double eyelid revision surgery are performed at the same time in cases where the eyelid has sunken

Some hospitals perform fat grafting and double eyelid revision surgery at the same time when the eyelid is sunken and revision surgery is needed, but this should not be done.

First, fat grafting is performed, and double eyelid revision surgery is possible only 3 to 6 months later.

During revision surgery, tissue must be dissected, but fat cannot be grafted into dissected tissue.

If fat grafting and revision surgery are done at the same time, it is like scattering fat into an open dissected space, so the fat does not take properly and only the double eyelid line is damaged.

Therefore, performing the two surgeries at the same time is not reasonable.

8. Problems that occur when fat grafting and double eyelid revision surgery are done together

① If fat grafting is performed, swelling makes it almost impossible to accurately judge or adjust the double eyelid line.

As a result, the desired line is not created, leading to dissatisfaction with the surgery.

② If the incision for double eyelid surgery is made immediately after fat grafting, the transplanted fat will spill out through the incision site.

During revision surgery, the surgeon must dissect and enter between the orbital fat layer and the levator muscle layer, but fat has been grafted into that area.

③ Conversely, if fat is directly grafted into the orbital fat layer after incision, the grafting cannot be precise and delicate, so the fat may not take properly later, or irregular contours and other unsatisfactory results may occur.

Process of double eyelid revision surgery when the eyelid is sunken

A sunken eyelid causes the double eyelid line to be pulled upward and become distorted.

As people age, wrinkle lines often appear.

In such a condition, the proper order is to first correct the eyelid sunkenness with fat grafting.

When the eyelid is sunken, the double eyelid line usually does not look good even after revision surgery.

After micro fat grafting using micro needles, the sunken eyelid is corrected.

Compared with the original line, the width of the line has also decreased, but fine wrinkles remain in the line and the inner line is thick, so it does not look natural.

The line must be naturally corrected through revision surgery, and revision is planned 3 months later, after the fat has fully taken.

Three months after fat grafting, double eyelid revision surgery is performed to restore a natural line.

A natural double eyelid is narrow on the inside and gradually becomes wider toward the outside.

→ As in the example above, the sunken eyelid must first be corrected with fat grafting, and after 3 months, once it has fully settled, the appearance should be checked and revision surgery should be planned according to that shape. Only then can the surgery be accurate and produce good results.

When the condition is very difficult or surgery is challenging during consultation

After coming in for consultation and examination, there are cases where the surgeon feels that the eye shape is very difficult or is not confident that a satisfactory result can be achieved.

In such cases, it may not be possible to give an answer with full confidence, but answering that it is difficult can also lower trust in the clinic or lead to the doctor being misunderstood as lacking skill.

From the surgeon’s perspective, if they wish to provide an honest and principled consultation, they must accurately assess the patient’s condition and explain what is difficult and why the outcome may not be good. Some patients accept this, but many receive it negatively.

If a patient is swayed by exaggerated consultation and proceeds with surgery, the situation can become even more bleak.

From the patient’s perspective, it is very important that the consultation is not exaggerated and that they can distinguish a principled surgeon.

There are various possible prognoses for revision surgery.

Some people think that if they meet a highly skilled doctor for revision surgery, they will definitely get a good result.

This is a very dangerous way of thinking.

Even with a skilled doctor, there are cases where surgery can improve the condition, cases where it cannot improve, and cases where the result may be insufficient.

Before surgery, patients should keep these three possibilities in mind and have a consultation to confirm whether surgery is possible, how much improvement can realistically be achieved if it is possible, or whether it is impossible, and make a realistic judgment.

When revision surgery is difficult or impossible

There are many cases in which revision surgery is impossible or difficult.

Examples include cases with insufficient excess skin, cases where the scar line is too dark to release adhesions, cases where the skin and muscle are excessively thick, cases where repeated revision surgery has made the tissue hard and thick, cases of severe sausage-like appearance that is likely to recur even after surgery, and cases of severe ptosis.

When surgery is very complicated and difficult, patients must understand the limitations themselves, but some people do not want to accept those limitations.

Undergoing surgery with only vague hope will only lead the patient into a deeper pit.

You must carefully assess the limitations and prognosis of your current condition before deciding on surgery.

The double eyelid that suits me

Before surgery, you need to determine which line suits your own face through a medical consultation.

Because each person’s eye shape and size are different, it is important to create a double eyelid line that suits you.

In-fold double eyelid

An in-fold double eyelid is one in which the double eyelid line disappears toward the inner part of the eye.

This is often created in eyes with a short horizontal length or eyes with an epicanthal fold at the inner canthus.

Therefore, in cases where the line is made too much into an in-fold, it may be designed artificially closer to an out-fold, but artificial lines can easily look awkward.

Out-fold double eyelid

An out-fold double eyelid is one in which the double eyelid line remains visible all the way to the inner end of the eye.

This type of double eyelid is created in eyes without an epicanthal fold and with a long horizontal eye length.

It is also more likely to be created when the line is designed to be large.

Hidden double eyelid

This refers to a double eyelid with a small line that is barely visible when looking straight ahead.

In general, this type of hidden double eyelid suits people with thick skin or large eyes.

It is suitable when a natural line that does not look obvious is desired.

Visible double eyelid

This refers to a double eyelid with a large line that is clearly visible when looking straight ahead.

In many cases, a double eyelid that appears too obvious is not considered desirable by current standards.

Excessively large double eyelid lines can also create the need for revision surgery.

Finding the right line for me

Before surgery, it is important to use a wire tool called I-Form to create a temporary line in order to find the line that suits you best.

The goal is first to make a temporary line, then find the line you like and the line that forms most naturally.

If the desired line is found and marked in that position before surgery, you can obtain almost the exact line you wanted.

Pre- and post-operative care for double eyelid revision surgery

Preoperative care tips

1. Before surgery, you should have enough consultation to understand for yourself the causes of the failed double eyelid surgery and the surgical process.

2. Do not consume alcohol the day before surgery.

Alcohol can reduce the effect of anesthetic drugs, which may cause problems with anesthesia during surgery.

3. If possible, avoid surgery during menstruation.

If there is a lot of bleeding during surgery, it can interfere with the procedure and cause significant bruising.

Postoperative care tips

In general, the visit schedule after surgery is the day after surgery and one week later, for a total of two visits.

• Day 1 after surgery: The surgical site is disinfected at the hospital, you receive a shot to reduce swelling, and your progress is checked.

• Day 4 after surgery: Your progress is checked and the continuous sutures are removed.

• Day 7 after surgery: Your progress is checked to see whether the surgery went well or whether there are any problems, and the remaining stitches are removed.

• One month after surgery: The double eyelid line is checked to see whether it is settling in properly.

What to do at home yourself

• Cold compress

Use the cool pack provided by the hospital for cold compresses.

Do this for 2 hours a day for 3 days only.

The cold compress time can be done continuously for 2 hours, or divided into 20–30 minute sessions.

Usually, it is convenient to do it before sleeping.

• Disinfection and eye drops

Disinfect the surgical site with the prescribed medication.

Disinfection is done by yourself until the stitches are removed.

To prevent dry eyes, use the artificial tears and eye drops prescribed by the hospital.

• Scar management

Apply the prescribed eye ointment to the surgical site for about one month.

The scar-prevention ointment helps reduce scarring and calm redness, so apply it about twice a day for 3–4 weeks.

• Makeup and face washing

These are allowed one week after the stitches are removed.

Until then, wash your face with a wet towel.

Postoperative swelling

There are individual differences, and in most cases swelling subsides to some extent in 7–14 days, but the period for it to settle completely is between 1 and 3 months.

When levator shortening is performed during revision surgery, lagophthalmos, in which the eyes temporarily close less fully, may occur.

Depending on the degree of ptosis and the amount of levator shortening, it varies, but in most cases it takes around 15 days, and in very rare cases it can take more than 6 months.

Lagophthalmos management

Source input

When levator shortening is performed to help the eyes open widely, temporary lagophthalmos, where the eyes do not close fully, may occur. Depending on the degree of ptosis and the extent of levator shortening, it can last from about 15 days to more than 6 months in rare cases.

On average, it progresses for about 2 to 3 months and then the eyes close naturally again.

During this period, artificial tears (eye drops) prescribed by the hospital are used to prevent dry eyes.

http://www.duhans.com

http://www.doublefold.co.kr

Advantages and pride of Duhan Plastic Surgery’s double eyelid revision clinic

1. Experienced medical staff and safety

Dr. Shin Duhan, who has focused on more than a thousand cases of double eyelid revision surgery, more than one case per day,

works as a team with experienced nurses.

2. 1:1 customized surgical planning

Based on each individual’s double eyelid condition, we consider gender,

overall facial harmony, and the patient’s wishes.

The rate of correction from out-line to in-line and the number of procedures combining epicanthoplasty or lateral canthoplasty with double eyelid surgery continue to increase.

If combined with double eyelid revision surgery in eyes where epicanthoplasty or lateral canthoplasty is appropriate, the effect is doubled.

The height and shape of the double eyelid line (in-line, in-out line, out-line, etc.)

reflect the patient’s preferences, and the current trend in double eyelid lines is “naturalness.”

3. Double eyelid revision surgery without side effects

People considering double eyelid surgery worry whether the line will loosen or whether scars will remain.

Side effects are reduced through Dr. Shin Duhan’s analysis and the ability to precisely perform the line as analyzed.

In addition, delicate incision and suturing reduce concerns about asymmetry.

4. Results that are hard to imitate

Although there are many hospitals that perform double eyelid revision surgery,

having the same surgery name and method does not mean the results will be the same.

With over 20 years of rich experience, we provide the optimal beautiful line for each patient.

Double eyelid surgery is often thought of as a simple procedure, but revision surgery is quite difficult.

Double eyelid revision surgery includes a meticulous process of newly designing the line and completely separating and dissecting the previously adhered double eyelid tissue.

With careful dissection, there are no later side effects such as the line becoming irregular

or being adhered and curling upward.

By carefully organizing not only the skin layer but also all the tissues in the fat and muscle layers one by one,

even extreme revision surgery can produce results that are hard to imitate.

5. Double eyelid revision surgery and eye correction at the same time

At our clinic, eye correction surgery is included in double eyelid surgery,

so we correct sleepy eyes or eyes where the pupil is obscured and appears dull.

By tying and shortening the levator muscle that opens the eyes, we adjust how much of the pupil is visible,

making the eye shape clearer.

6. Research, lectures, and educational activities related to double eyelid revision surgery

The most reliable answers come from extensive clinical experience.

Double eyelid revision surgery is like a premium product perfected through years of experience.

We continue research and educational activities based on this accumulated experience.

7. Increasing consultations for revision surgery

As new hospitals spring up everywhere and perform double eyelid surgery indiscriminately,

requests for revision surgery are also increasing, which is truly unfortunate.

If revision surgery is performed multiple times and fails,

the excess skin decreases, making later revision surgeries even more difficult and extreme.

Double eyelid surgery is important as a first choice,

and when considering revision surgery, it should be approached carefully with the thought that it may be the last.

8. Craftsmanship for a highly refined and beautiful face

Among plastic surgeries, a doctor who performs double eyelid surgery must be a doctor while also

possessing a sense like that of a designer.

If one insists only on a uniform double eyelid line that one personally prefers,

a line that perfectly suits each patient will not emerge.

If you do not have an eye for beauty, or even if you do, lack the skill to reproduce it, no masterpiece will come out.

We do our best down to the last stitch to provide beauty and satisfaction to each and every patient.

9. Honest surgery with sincerity

We recommend surgery if it is likely to achieve more than 80% satisfaction,

but we do not perform unnecessary surgery even if requested.

We aim to be a hospital that provides honest treatment based on skill and results.

10. A trustworthy premium hospital

There is a reason why a master’s work is expensive.

It is because it creates something beautiful and valuable.

Our clinic has confidence and pride in its surgery.

Proper surgery will become an opportunity to gain confidence for the rest of one’s life.

Rather than a hospital that suggests surgery at a low price,

or a hospital where several doctors rotate through the surgery,

we will be a hospital that is more expensive but delivers satisfying results.