sausage eyes # sausage eyes injection # sausage eyes revision surgery # sausage phenomenon # sausage eyes # sausage eyes revision surgery # thick double eyelids # thick double eyelids # lowering the double-eyelid line # protruding eyes

uneven eyes # severe ptosis # sausage double eyelids # double-eyelid scar # eye revision surgery clinic # Gangnam eye revision surgery clinic # Apgujeong eye revision surgery clinic # Sinsa eye revision surgery clinic # eyelid correction revision surgery

famous clinic for double-eyelid revision # double-eyelid revision clinic # Gangnam double-eyelid revision clinic # Apgujeong double-eyelid revision clinic # Sinsa double-eyelid revision clinic # revision double-eyelid surgery clinic # celebrity double eyelid surgery

incision # buried revision surgery # incision revision surgery # eye plastic surgery in your 40s # plastic surgery in your 40s # plastic surgery in your 50s # Gangnam eyelid correction # Gangnam eye plastic surgery # Apgujeong eye plastic surgery # Sinsa eye plastic surgery # Duhan # Duhan Plastic Surgery

Dr. Shin Duhan # Duhan double-eyelid revision # Gangnam eye plastic surgery clinic # Gangnam clinic good at eye plastic surgery # Gangnam eye revision surgery # Gangnam double eyelids # Gangnam double eyelid surgery # Gangnam double eyelid surgery # Gangnam ptosis

Apgujeong ptosis # Sinsa ptosis # age-related ptosis # senior double eyelids # senior double-eyelid surgery # eyelid correction methods # eyelid correction swelling # eyelid correction plastic surgery clinic # eyelid correction surgery

eyelid correction surgery # Gangnam eyelid correction surgery # Apgujeong eyelid correction surgery # Sinsa eyelid correction surgery # eyelid correction double-eyelid surgery # place good at eyelid correction # eyelid correction revision surgery # eyelid correction recommendation # buried suture method

buried eyelid method # eyelid surgery # correction of eye asymmetry # sleepy eyes # sleepy-looking eyes # Gangnam eye plastic surgery clinic # Apgujeong eye plastic surgery clinic # Sinsa eye plastic surgery clinic # famous place for eye plastic surgery # place good at eye plastic surgery

clinic good at eye plastic surgery # eye plastic surgery revision # eye surgery # types of eye surgery # double eyelids # double-eyelid surgery # ophthalmic plastic surgery # ophthalmic plastic surgery # eyelid surgery # ectropion # entropion # ptosis

ptosis test # ptosis correction # ptosis correction surgery # ptosis eyelid correction # ptosis clinic # ptosis plastic surgery clinic # ptosis surgery # Gangnam ptosis surgery # levator aponeurosis laxity

ptosis surgery methods # ptosis surgery clinic # place good at ptosis surgery # ptosis surgery # ptosis double eyelids # cause of ptosis # place good at ptosis # ptosis revision surgery

clinic good at ptosis # ptosis specialist # ptosis syndrome # ptosis symptoms # ptosis syndrome surgery # ptosis recommendation # ptosis pain # incision eyelid correction # incision double-eyelid surgery

sleepy eyes # surgery for sleepy eyes # surgery for sleepy eyes # eyelid correction for middle age # eye surgery for middle age # plastic surgery for middle age # double eyelids for middle age # double eyelid surgery for middle age # ptosis for middle age # severe ptosis # correction of uneven eyes # uneven eyes revision surgery

uneven-eye eyelid correction # uneven-eye plastic surgery # uneven eyes # correction of uneven eyes # drooping eyes # double-eyelid revision surgery # double eyelid revision surgery # double eyelid surgery # double-eyelid surgery # double-eyelid revision surgery # eye revision surgery # eye plastic surgery

Ptosis (sleepy-looking eyes)

�

If the eyes do not open clearly,

and always look sleepy, this is called ptosis.

It is broadly divided into congenital ptosis and acquired ptosis.

It is divided into true ptosis, in which the function of the levator palpebrae superioris muscle—the muscle that lifts the eyelid—has decreased, and pseudo-ptosis, which only appears as if it were simple ptosis.

The purpose of ptosis correction is to restore a large, clear eye shape, and ptosis correction surgery requires choosing the appropriate method and skilled technique depending on the severity of the condition.

Examples of ptosis

Types of ptosis (sleepy-looking eyes)

1. Congenital true ptosis

This occurs because the function of the levator palpebrae superioris muscle, which lifts the eyelid, is reduced. It may occur in both eyes or in one eye.

In cases of congenital ptosis, it is better to correct it early before the function of the levator palpebrae superioris deteriorates.

In true ptosis, even if double-eyelid surgery is performed, there is almost no effect of making the pupil appear larger, and ptosis correction must be performed additionally to increase the vertical size of the pupil.

2. Congenital pseudo-ptosis

There are cases where the eyes look sleepy even though the levator palpebrae superioris function has not decreased.

This is a phenomenon in which the eyelid droops and covers the pupil in eyes without double eyelids.

This is sometimes mistaken for ptosis, and even plastic surgery specialists may occasionally misjudge it as true ptosis, so caution is needed.

In congenital pseudo-ptosis, double-eyelid surgery alone can naturally make the eyes appear larger, so separate ptosis correction is not necessary.

In the case above, the patient wanted ptosis correction (eyelid correction) because the eyes looked sleepy, but when a temporary line was made with wire, the previously hidden pupil was revealed much more clearly, meaning there was no ptosis at all.

This is a typical case of pseudo-ptosis, and only simple double-eyelid surgery is needed.

Even so, there are clinics that recommend ptosis correction (eyelid correction) unnecessarily, so great caution is required.

3. Traumatic true ptosis

This occurs when the levator palpebrae superioris, the muscle that lifts the eyelid, is damaged due to improper surgery or trauma.

If the damaged levator palpebrae superioris is only partially injured, restoration is not difficult, but in cases of complete damage, restoration can be difficult if it is not repaired quickly because the levator palpebrae superioris may retract.

The damaged levator palpebrae superioris is found and repaired for correction.

4. Traumatic pseudo-ptosis

This refers to cases in which the function of the levator palpebrae superioris, which lifts the eyelid, is normal, but the function of the levator palpebrae superioris is interfered with by external factors, preventing the muscle from exerting proper force.

It often occurs due to scar adhesion when the double-eyelid line has been made too thick.

Correction is performed by fully incising, releasing the adhesion of the scar tissue below the double-eyelid line, and lowering the line.

5. Age-related true ptosis

As the levator palpebrae superioris, the muscle that lifts the eyelid, ages and its function gradually declines, the ability to open the eyes weakens and ptosis occurs.

It usually occurs after age 50, and in age-related cases, as with congenital ptosis, postoperative prognosis is often poor.

Surgery combines upper blepharoplasty, which removes skin, with ptosis correction.

6. Age-related pseudo-ptosis

As people age and the eyelids sag due to aging, the pupils can be covered, making it look as though the eyes are not opening fully, similar to ptosis.

In such cases, the eyelid skin should be temporarily lifted or a temporary double eyelid created to check the actual vertical height of the pupil.

A diagnosis of ptosis should not be made simply because the eyelid is covering the eye.

Since upper blepharoplasty, which removes eyelid skin, alone can make the eyes appear larger, ptosis correction is not necessary.

Causes of acquired ptosis

1. When the double-eyelid line has been made too high

2. When the eyes are habitually rubbed, causing scar tissue inside the eyelid that interferes with levator palpebrae superioris function

3. When levator palpebrae superioris function declines due to aging

4. When the levator palpebrae superioris is damaged by trauma

Differences between ptosis and a normal eye

■ When the eyes are naturally open and looking straight ahead

it is normal for the upper part of the black pupil to be slightly covered by about 1 to 2 mm.

If more of the black pupil is covered than that, ptosis should be suspected.

■ When the eyes are naturally open and looking straight ahead, the vertical height of the eye should be 8 mm or more to be normal.

If the vertical height is narrower than that, it is ptosis.

■ When shifting from the most downward gaze to the upward gaze, the eyelid movement range should be about 14 to 16 mm.

If it is less than that, it can be judged as true ptosis.

How ptosis is examined

The way ptosis is examined is to check the vertical height of the pupil while looking straight ahead.

For a normal person, the vertical height is between 8 and 9 mm, and in most cases, 8 mm or less is considered ptosis.

However, because each person’s eye shape and size are different, ptosis is not diagnosed using only exact numerical values.

A judgment is made based on whether the impression looks noticeably sleepy, and the diagnosis is made by comparing this with the measured values.

The function of the levator palpebrae superioris is also measured for assessment.

1. Measuring the palpebral fissure height of the eye (vertical eye opening)

2. Checking whether the appearance looks sleepy

3. Measuring the function of the levator palpebrae superioris (normal 14 to 16 mm)

Ptosis surgery methods

1. Levator palpebrae superioris shortening surgery

This method shortens the eyelid-lifting muscle (levator palpebrae superioris) by overlapping and suturing it about 4 to 8 mm, and is mainly applied in cases of mild ptosis.

Ptosis correction must always be performed through an incision, so a double-eyelid line will inevitably be created during the process. Therefore, people without double eyelids have no choice but to create at least a subtle double eyelid.

■ Surgical process for levator palpebrae superioris shortening surgery

1. Design is made and local anesthesia is administered.

2. An incision is made along the design line.

3. After the incision, the orbital septum is opened to expose the levator palpebrae superioris.

4. The levator palpebrae superioris is exposed and marked to the extent that it will be shortened, then the marked portion and the upper edge of the tarsal plate are tied together with thread.

5. Three buried sutures are placed to create the double-eyelid line.

6. The outer skin is sutured.

2. Levator palpebrae superioris resection

This method shortens the length of the eyelid-lifting muscle (levator palpebrae superioris) by resecting about 5 to 10 mm and suturing the resected end of the levator palpebrae superioris to the tarsal plate.

It is mainly applied in cases of moderate ptosis.

3. Frontalis suspension

This method is performed in cases of severe ptosis with levator palpebrae superioris function of 5 mm or less, when it is difficult to expect functional recovery through levator palpebrae superioris shortening surgery or resection.

The forehead’s frontalis muscle is advanced and tied to the tarsal plate of the eyelid so that the frontalis muscle takes over the function of the levator palpebrae superioris.

General anesthesia is required, and side effects such as severe vomiting can occur.

4. Müller muscle shortening surgery

Instead of levator palpebrae superioris shortening surgery, shortening surgery using the Müller muscle under the levator palpebrae superioris is sometimes performed.

The advantage of Müller muscle shortening surgery is that it can minimize vomiting, but the surgical prognosis is difficult to predict and recurrence is common.

Because access to the Müller muscle requires operating while damaging the levator palpebrae superioris, it is a procedure without special advantages.

Anatomically, many people have little or a very thin Müller muscle, and in such cases this surgery cannot be applied.

Before and after ptosis surgery

Ptosis means having an eye shape that always looks sleepy because the muscles that open the eyes are not strong enough.

If only one eye wants eyelid correction, surgery can be performed on just one side to match the other eye.

However, if the goal is to improve the scar on the double-eyelid line of both eyes, revision surgery can improve it depending on the amount of available skin.

Eyelid correction is a procedure in which, when ptosis is present, the muscle (levator palpebrae superioris) is tightened to shorten its length so that the eyes open wider.

This is called levator palpebrae superioris shortening surgery.

Ptosis correction surgery must be performed by making an incision, creating a new double eyelid, and directly tightening the muscle from the inside to correct it precisely.

If there is enough excess skin and the levator palpebrae superioris function is good, revision surgery is possible.

In cases of revision surgery, sufficient clinical experience and the surgeon’s technical skill must be supported.

Revision surgery is performed at many clinics, but in most cases the results are not very good.

Revision surgery is a procedure that can only be performed when a lot of experience and know-how have been accumulated, so it is not something anyone can do.

Please understand that there are not many people in our country who can consistently produce results that satisfy patients through revision surgery.

Only by accurately understanding where and how the first surgery went wrong, and how it should be improved, can good results be achieved.

During consultation, the surgery is planned only after various examinations and tests are carried out to predict the postoperative result, and it is performed only if there is a sufficient chance of improvement after surgery.

The purpose of revision surgery is largely twofold.

Restoring a large, clear eye shape and restoring a natural double-eyelid line.

After revision surgery, the double-eyelid line is made thinner and more natural.

The surgery takes about 2 to 3 hours, recovery takes about a week, and stitches are usually removed about a week after surgery.

Postoperative care tips

1. Apply a cold compress using the cool pack provided by the clinic.

Do this for 2 hours a day for 3 days.

The cold compress can be done continuously for 2 hours or split into 20 to 30 minute sessions.

It is usually convenient to do it before going to sleep.

2. Use the prescribed artificial tears and eye drops to prevent dry eyes.

3. Postoperative visits are usually twice: the day after surgery and on the day the stitches are removed.

Stitches are removed on day 3 or 4.

4. Makeup and face washing are possible after the stitches are removed.

Until the stitches are removed, wash the face with a wet towel.

5. Since no bandage is applied to the surgical area, daily life is possible.

6. Swelling after surgery varies from person to person, but in most cases it goes down significantly in about 7 days, and the period until it settles completely is about 1 to 3 months.

7. Lagophthalmos, where the eyes do not close fully, varies depending on the severity of the ptosis and the extent to which the levator palpebrae superioris was shortened, but in most cases it can take from 15 days to over 6 months.

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

Correction of a thick double-eyelid line

The existing high line should be flattened or removed by incision,

and a new line should be designed at an appropriate level to create the fold.

However, the height of the new line varies from person to person,

and it is important to find and design the most natural height for each person,

taking into account the amount of excess skin and the size of the eyes.

Sausage eyes

This refers to a swollen-looking phenomenon in which the area below the double-eyelid line bulges like a pouch, making it look as if the surgery was done only a few days ago.

Causes of sausage eyes

1. When the line has been made too high

2. When the skin and orbicularis oculi muscle are thick

3. When the buried suture for the double-eyelid line is tied below the height of the incision line

4. When the suture area loosens and the double-eyelid line is pushed downward

Surgery methods for sausage eyes

1. Sausage phenomenon after full-incision surgery

In most cases, only full-incision surgery is possible, and some of the orbicularis oculi muscle below the incision line must be partially removed to reduce muscle thickness. The sagging skin is pulled upward, tightened, and fixed in place.

2. Sausage phenomenon after buried-suture surgery

When the sausage phenomenon occurs after buried-suture surgery, it is a phenomenon caused by the line being designed too high, so that after surgery the line partially sags. In that case, the partially loosened line is pulled upward and firmly tightened again.

This is corrected with partial-incision surgery or full-incision surgery.

If there is a sausage phenomenon, it can be corrected through double-eyelid revision surgery.

If there is enough excess skin, revision surgery is fully possible.

The purpose of revision surgery is largely twofold.

Restoring a large, clear eye shape and restoring a natural double-eyelid line.

After revision surgery, the double-eyelid line is made thinner and more natural.

A thick sausage phenomenon occurs when the skin is thick and the line has been designed too high, causing the skin to slide downward.

During surgery, the existing scar line must be removed and a new line created below it.

Some of the orbicularis oculi muscle beneath the skin, which causes the sausage-like appearance, must be partially removed to make it thinner.

If ptosis is present, revision surgery will also make the eyes open wider and correct the sleepy-looking eyes.

The surgery takes about 2 to 3 hours, recovery takes about a week, and stitches are usually removed about a week after surgery.

Success requirements for double-eyelid revision surgery

http://www.doublefold.co.kr

For revision surgery, more than anyone else, you yourself must first understand the cause of why the double-eyelid surgery went wrong. It is not easy to undergo revision surgery without recognizing the cause of the problem.
Only when you understand the cause of the problem and the doctor in charge also identifies the cause can the patient and doctor proceed with surgery based on trust.
To understand the cause of a failed double-eyelid surgery, it is essential to receive a detailed consultation from a highly experienced plastic surgery specialist whenever possible.

1. You must be treated by a board-certified plastic surgeon.

You should check whether the operating surgeon holds a board certification in plastic surgery before undergoing surgery.

There are many clinics that only have a plastic surgery signboard, while in reality they are run by non-specialists.

It is important to understand this well and avoid having surgery performed by a non-specialist.

2. The surgeon must have extensive experience in double-eyelid revision surgery.

Even among board-certified plastic surgeons, specialties differ slightly.

If you are considering double-eyelid revision surgery, a specialist who focuses on double-eyelid revision surgery may achieve better results. Double-eyelid revision surgery is one of the more difficult procedures in plastic surgery.

Having surgery performed by a specialist with solid know-how and accumulated experience in double-eyelid revision surgery can help restore a more beautiful and natural eye shape.

3. Double-eyelid revision surgery should not be taken lightly.

If double-eyelid revision surgery is thought of too casually, the chance of failing again is very high.

Compared with the first surgery, double-eyelid revision surgery is a much more demanding and difficult, top-level procedure in plastic surgery.

Careful consideration before deciding on surgery is recommended.

4. The cause of failure in double-eyelid revision surgery must be accurately identified.

The patient must understand the cause of the first surgery’s failure.

Through consultation, you must be able to clearly understand why the initial surgery was wrong and through what process the double-eyelid revision surgery will be carried out, so that you can proceed with surgery in trust and achieve good results.

5. The surgery time should not be too short.

Double-eyelid surgery usually takes about 30 minutes to 1 hour.

Full-incision double-eyelid revision surgery is not a procedure that can be completed in a short time.

Unlike the first double-eyelid surgery, revision surgery proceeds from releasing the original double eyelid, to separating scar tissue, rearranging the tissue, and performing delicate layered suturing.

Therefore, the surgery time inevitably becomes longer, and good results come only when every step is carried out according to principle and procedure.

6. The eyes should open well immediately after double-eyelid revision surgery.

Most patients have large double-eyelid lines and sleepy-looking pseudo-ptosis.

The goal of double-eyelid revision surgery is to make the double-eyelid line as thin as possible and to allow sleepy eyes to open clearly.

If the surgery is smoothly and successfully performed, in most cases the eyes should open clearly as soon as the surgery is finished; that is a successful operation.

If the immediate postoperative appearance is not awkward, it is usually the case that the swelling will subside later and the result will look natural.

7. Right after double-eyelid revision surgery, the thick front line should be reduced.

The highlight of double-eyelid revision surgery is naturally converting a severe out-fold line into an in-fold.

From immediately after surgery, the inner line corresponding to the first button must be properly formed so that the outer line connects naturally and shows a good prognosis.

If the line remains thick even immediately after surgery and the inner line is not properly narrowed, it cannot be considered a good prognostic result.

8. There should be some lagophthalmos for a period after double-eyelid revision surgery.

A surgery in which the eyes close perfectly immediately after surgery is considered an incorrect surgery.

In most double-eyelid revision cases, there is not enough excess skin.

When surgery is performed in this state, for the eyes to close well, the skin must stretch from somewhere, and in most cases the skin stretches below the incision line.

If that happens, the double-eyelid line becomes larger again.

During the adaptation period, the skin above the incision line gradually stretches, and after some time the eyes close naturally.

If there was not enough excess skin, recovery from lagophthalmos is slower; conversely, if there is enough excess skin, recovery is faster.

9. After double-eyelid revision surgery, stitches should be removed a little later.

Usually stitches are removed in two sessions, on day 4 and day 7, depending on the amount of excess skin.

Unlike the first double-eyelid surgery, where all stitches are removed around 3 to 4 days after surgery, in double-eyelid revision surgery the last stitch is removed around day 7.

If stitches are removed too early after double-eyelid revision surgery, the scar may widen and the tissues above the incision line may be pulled upward again, resulting in a surgery that is no better than having done nothing.

Because revision surgery involves suturing with insufficient tissue, the stitches must hold the tissues in place until they settle into their new position.

If the stitches disappear before the tissues have settled, the tissues that have not yet settled may be pulled upward again, leading to a failed surgery.

http://www.doublefold.co.kr