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Cause of revision failure
Cause of reoperation fail
If you had double eyelid revision surgery but did not get the result you wanted,
there can be several reasons.
Main signs that appear after revision failure
① Surgery was performed to make a large line smaller, but the line hardly decreased or remained the same.
② Swelling does not go down easily and looks awkward. (sausage effect)
③ Opening the eyes feels uncomfortable and the eyelids feel heavy.
④ There is a pulling sensation when opening the eyes, and they feel dry and stiff.
⑤ The line is severely asymmetric.
⑥ The eyelashes remain turned outward and do not recover.
⑦ Opening the eyes feels uncomfortable, but the eyes close well.
⑧ The scar line at the incision site is too dark.
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 4](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/819e2eb4ddc6efc3a081e16379bda5d6ab94cdd29d9c65a745f8ec74eeaafd5c.jpg)
Cause of revision failure
The biggest cause of failure is the patient’s own tendency to think of double eyelid revision surgery as something simple.
After a failed double eyelid surgery, the thought of “I can just fix it again” is what leads to failure in double eyelid revision surgery.
In order to undergo revision surgery, you must understand the cause of the original mistake better than anyone else, so that another failure does not occur.
The items below are analyses of the causes of revision failure, based on examinations for revision surgery after patients visited our clinic following failed revision procedures at other hospitals.
- 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 revision surgery to reduce the line while, at the same time, performing a surgery that enlarges the inner line in the opposite direction.
Unnecessary epicanthoplasty can cause various problems.
Epicanthoplasty should only be applied when necessary in eyes with an epicanthal fold, and unnecessary epicanthoplasty can cause several side effects such as excessive exposure of the inner mucosa, a severe out-fold line, eyes that appear too close together, or a harsher eye shape.
You should be careful because unnecessary epicanthoplasty often ends up ruining the impression instead.
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 5](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/f2227133accaf54e0649507ff7cd4e457602e215623e23251e8ca33926bed5a9.jpg)
- When scar tissue is not thoroughly dissected during revision surgery
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 6](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/5f6d5626a304255c79e7c6c887adc4f96ccce5da76f8c3505fae5152aba37bbf.jpg)
During revision surgery, the existing scar tissue must be removed or thoroughly dissected to release adhesions between the tissues that have stuck together.
Otherwise, tissue repositioning cannot be achieved.
If the adhesions are not released and the muscle and fat layers are not thoroughly dissected through tissue separation, tissue repositioning becomes impossible and it is difficult to narrow the double eyelid line.
If you close the incision without proper dissection, not only will the double eyelid line not narrow at all, but an outward turning of the eyelashes may occur.
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 7](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/a36764b6ab85e8fa02edfc9ec9e94e01f89ffaaf5274440e9c5a45e0fad02ed7.jpg)
- When orbital fat repositioning is not performed
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 8](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/0751ae855860224d487b97145e4520af0dc56e17982a8ebf8e79539cea18d8d7.jpg)
If fat needs to be repositioned but this is neglected, the dissected tissue will stick together again, the eyes will not open widely, and a triple eyelid may even form.
Along with the dissection of scar tissue, orbital fat repositioning is one of the important surgical steps that acts like lubricant to prevent the tissues from sticking together.
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 9](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/22d5e63369f30ccf99dbf74388bc74851282af92f34b904beaf6b57ee51fe30e.jpg)
- When fat is not repositioned at the inner canthus
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If orbital fat is not repositioned to the inner canthus, scar tissue forms on the inner side of the eye and interferes with opening the eyes widely.
Scar tissue should not form on the inner side of the eye.
The inner side of the eye plays an important role in allowing the eyes to open widely, so if excessive scar tissue develops in this area, it becomes impossible to open the eyes widely.
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- When ptosis correction (eye-opening correction) is not performed
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 12](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/e969065b12f6b8e993ef0826dc34c9ff7ba11b3e8f14c977bd2d1f5fc7f150d3.jpg)
In the case of sleepy-looking eyes, eye-opening correction must be done to make the eyes open wider.
Usually, levator muscle shortening is performed. The levator palpebrae superioris (the muscle that lifts the eyelid) is an important structure that opens the eyes, and most patients undergoing revision surgery usually have a weakened eyelid elevator muscle.
It is important to perform levator muscle shortening (sixth step) to make the eyes open wider.
If this is not performed, the existing sleepy-looking eyes will not be corrected, reducing the effect of the revision surgery.
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 13](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/df48c44629aebbbbe7742edab775926a6c647e2499c9590d31c0dece4c34be78.jpg)
- When the stitches are removed too early
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 14](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/bb5216330f57c8f8e08d7c265f495aeb417f7e59cfed2fcfe2fe3194dd900eb2.jpg)
The reason stitches are removed later in revision surgery is that most revision patients do not have much extra skin, and because tissue has been repositioned, the tissues need to be held in place by the tension of the stitches in order to secure them firmly.
The repositioned tissues tend to return to their original state, like a spring, so they must be held in place by the stitches. But if the stitches are removed before the tissues have stabilized in their newly repositioned location, the tissues may return to their original position and lead to poor surgical results.
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 15](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/615a1782737bfcdf436e23ec07557192cc716c58126222f09e657890d29bec36.jpg)
- When fat grafting and double eyelid revision are performed at the same time for a hollow eyelid
Some hospitals perform fat grafting and double eyelid revision at the same time when the eyelid is sunken and revision is needed, but this should not be done.
Fat grafting should be performed first, and double eyelid revision is possible 3 to 6 months later.
For revision surgery, tissues must be dissected. Fat grafting cannot be done into the dissected tissue, and if fat grafting and revision surgery are performed at the same time, it is like sprinkling fat into an empty, dissected space. The fat will not properly take, and the result will be a ruined double eyelid line.
Therefore, performing both surgeries at the same time is not appropriate.
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 16](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/b5c6923561102bde8c5a5a9af2447cdade55f4296fac4f5d20ee23f9ce219f0d.jpg)
Problems that occur when fat grafting and double eyelid revision are done together
- When 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.
- If an incision is made for double eyelid surgery immediately after fat grafting, the grafted fat will spill out through the incision site.
In revision surgery, the surgeon must dissect and enter between the orbital fat layer and the levator muscle layer, but fat is grafted into that area.
- Conversely, if fat is directly grafted into the orbital fat layer after the incision, it cannot be done with sufficient precision and delicacy, so proper take may not occur later, or problems such as an uneven shape may arise.
Process of double eyelid revision when the eyelid is sunken
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 17](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/e18c0586586d333b657854a4907e479e9945b81395c19657d5e5a93249872a9e.jpg)
A sunken eyelid causes the double eyelid line to be pulled upward and become distorted, and wrinkles often appear as people age.
In this condition, the correct order is to first correct the eyelid hollowing with fat grafting.
When the eyelid is sunken, double eyelid revision usually does not produce a beautiful line even if surgery is performed.
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 18](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/367627fdcb675c13afae0b35eb139290666b28fe82ff3818064dd93e6e794bc8.jpg)
After micro fat grafting using micro needles, the sunken eyelid is corrected.
Compared with the initial result, the width of the line is reduced, but fine wrinkles remain on the line and the inner line is thick, so it does not look natural.
The line must be naturally corrected through revision surgery, and surgery is planned 3 months after fat grafting, once it has fully taken.
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 19](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/72090ba7af65e2e55c1d6410cddf4d39c17c336ec2bea688391b1d1fee67258d.jpg)
Three months after fat grafting, double eyelid revision is performed to restore a natural line.
A natural double eyelid is narrower on the inner side and gradually becomes wider toward the outer side.
As in the example above, the sunken eyelid must first be corrected with fat grafting, then the appearance after it has fully settled should be checked 3 months later, and revision surgery should be planned according to that shape. Only then can the surgery be accurate and good results be obtained.
http://www.doublefold.co.kr
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The double eyelid style that suits me
My suitable doublefold line
Since everyone’s eye shape is different,
surgery should be performed with a design tailored to the individual.
What is a double eyelid style that suits me?
Through a preoperative consultation, the surgeon must determine which line suits the patient.
Because each person’s eye shape and size are different, it is important to create a double eyelid line that suits the individual.
In-fold double eyelid
An in-fold double eyelid refers to a double eyelid line that disappears toward the inner side of the eye.
This type is created in eyes with a short horizontal width or eyes with an epicanthal fold at the inner canthus.
Therefore, if the line is made too much in an in-fold style, it may sometimes be designed closer to an out-fold style, but an artificial line can easily look awkward.
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 22](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/4406abe2541c23efb08a6ea53ad76e4ba473a59fe98ebfc7aa38e9c67d6ff0d2.jpg)
Out-fold double eyelid
An out-fold double eyelid refers to a double eyelid line that remains visible all the way to the inner corner of the eye.
This type is created in eyes without an epicanthal fold and with a long horizontal eye shape.
It is also more likely to result in an out-fold double eyelid when the line is designed to be large during surgery.
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 23](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/45419232b83605a3744269d229bcfab31d62e527000637dc1f465d49b918b522.jpg)
Hidden double eyelid
This refers to a double eyelid with a small line that is barely visible when looking straight ahead.
Usually, this style suits people with thicker skin or larger eyes.
It is suitable when a natural line that does not stand out is desired.
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 24](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/d97ed02d83c52d3bfd824797b1dd02e2d9056816f5d3368bc46eef1530256a05.jpg)
Visible double eyelid
This refers to a double eyelid with a large line that is clearly visible when looking straight ahead.
In most cases, double eyelids that are too prominently visible are not considered desirable by today’s standards.
An excessively large double eyelid line can also create problems that lead to revision surgery.
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 25](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/17f42f6d704be2d003938413cad2f8b51ca516c338ad185e82df2afedbd2b59d.jpg)
http://www.doublefold.co.kr
![[Duhan Plastic Surgery Double Eyelid Revision] - [Causes of Revision Failure, the Double Eyelid Style That Suits Me] image 26](https://pub-9f2bb3498faf4d1d8714b41df24753e3.r2.dev/content/clinics/archive/f98b721498/naver_blog/gimlet1124/assets/by_hash/9fb35bd2ca137a3abf726eedd251cf86d4db1b7fee9ebe312d62d5d277a16c43.jpg)
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Advantages and pride of the Duhan Plastic Surgery Double Eyelid Revision Clinic
- Experienced medical staff and stability
Director Shin Duhan, who has focused on more than one double eyelid revision case per day and thousands of cases, works as a team with experienced nurses.
- 1:1 customized surgical plan
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 performing epicanthoplasty or canthoplasty at the same time as double eyelid surgery has steadily increased.
If epicanthoplasty or canthoplasty is appropriate for the eyes and is performed together with double eyelid revision, the effect is doubled.
The height of the double eyelid line and the line shape (in-line, in-out line, out-line, etc.) are reflected according to the patient’s preference, and the current trend in double eyelid lines is “naturalness.”
- Double eyelid revision without side effects
People who undergo double eyelid surgery worry whether the line will come undone or whether scars will remain.
Side effects are reduced through Director Shin Duhan’s analysis and the ability to accurately create the line exactly as analyzed.
In addition, delicate incision and suturing reduce worries about asymmetry.
- Results that are hard to imitate
There are many hospitals that perform double eyelid revision, but even if the surgery name and method are the same, the results are not necessarily the same.
With more than 20 years of extensive experience, we provide the optimal beautiful line for each individual patient.
Double eyelid surgery may often be thought of as a simple procedure, but revision surgery is considerably more difficult.
Double eyelid revision includes a delicate process of newly designing the line and completely separating and dissecting the previously adhered double eyelid tissue.
Through this careful dissection process, there are no later side effects such as an uneven line or adhesion causing the line to roll upward.
With skill in neatly organizing not only the skin layer but also all tissues in the fat and muscle layers one by one, we can produce results that are hard to imitate even in extremely difficult revision cases.
- Double eyelid revision and eye-opening correction at the same time
At the Duhan Plastic Surgery Double Eyelid Revision Clinic, eye-opening correction is included in double eyelid surgery, helping correct sleepy eyes or dull-looking eyes where the pupil is obscured.
By tying and shortening the levator muscle that opens the eyes, we control how much of the pupil is visible and make the eyes look clearer.
- Research, lectures, and educational activities on double eyelid revision
The most trustworthy answers come from abundant clinical experience.
Double eyelid revision is like a luxury item perfected through years of experience.
Through this accumulated experience, we also carry out research and educational activities.
- Increase in consultations for revision surgery
As newly established hospitals that spring up like mushrooms after rain perform double eyelid surgery indiscriminately, requests for revision surgery are also increasing, which is truly unfortunate.
If revision surgery is performed repeatedly and ends in failure, the amount of extra skin decreases, making future revision even more difficult and extreme.
Double eyelid surgery is important not only for the first choice, but also when considering revision surgery, it should be approached carefully as if it were the last opportunity.
- Craftsmanship for a complete and beautiful face
A doctor who performs double eyelid surgery among cosmetic surgeons must have a sense similar to that of both a doctor and a designer.
If one insists only on a uniformly preferred double eyelid line without understanding what a beautiful line is, a perfect line suited to each individual patient cannot be created.
If there is no eye for it, or even if there is, no skill to reproduce it, a masterpiece cannot be made.
We do our best down to the last stitch to provide beauty and satisfaction to each and every person.
- Honest surgery with sincerity
We recommend surgery when it is expected to achieve more than 80% satisfaction, but we do not proceed with unnecessary surgery even if requested.
We aim to be a hospital that provides honest treatment through skill and results.
- A trustworthy premium hospital
There is a reason why a craftsman’s work is expensive.
It is because they create works that are that beautiful and valuable.
The Duhan Plastic Surgery Double Eyelid Revision Clinic takes pride in and is confident about its surgery.
Proper surgery will become a turning point that gives you confidence for the rest of your life.
Rather than a hospital that offers a low price and recommends surgery, or one where several directors take turns performing procedures, we will be a hospital that delivers satisfying results even at a higher price.
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