Under-eye wrinkles # Lower blepharoplasty # Upper blepharoplasty # Brow lift # Brow lift scar # Upper-eye wrinkles # Drooping eyes # Middle-aged eye surgery # Under-brow lift # Middle-aged eye surgery # Aesthetic surgery # Blepharoplasty

Aesthetic surgery in your 50s # Surgery for drooping eyes # Surgery for sagging eyes # Blepharoplasty # Lower blepharoplasty # Entropion # Ptosis surgery # Best place for lower blepharoplasty # Lower blepharoplasty surgery # Lower blepharoplasty revision surgery # Upper blepharoplasty

Eye correction surgery # Ptosis correction # Revision lower blepharoplasty # Revision upper blepharoplasty # Duhan # Duhan Plastic Surgery Clinic # Director Shin Duhan # Lower blepharoplasty method # Lower blepharoplasty scar # Upper eyelid drooping

Drooping eyelids # Drooping upper eyelids # Removal of under-eye wrinkles # Under-eye wrinkle removal # Under-eye wrinkle removal surgery # Sunken forehead # Lower blepharoplasty under the eyes # Under-eye fat repositioning # Under-eye fat removal # Drooping eyes

Lower blepharoplasty recovery period # Upper and lower blepharoplasty # Under-eye fat removal surgery # Fat repositioning # Problems with under-eye fat repositioning # Under-eye fat grafting # Lower blepharoplasty procedure # Entropion # Lower blepharoplasty under the eyes

Lower blepharoplasty scar # Upper blepharoplasty surgery # Best place for lower blepharoplasty # Upper and lower blepharoplasty surgery # Lower blepharoplasty with under-eye fat repositioning # Lower blepharoplasty plastic surgery # Best hospital for lower blepharoplasty # Upper and lower blepharoplasty surgery

Upper blepharoplasty lift # Lower blepharoplasty laser # Upper blepharoplasty levator # Upper blepharoplasty # Upper blepharoplasty reviews # Ptosis plastic surgery # Double eyelid sagging # Ptosis surgery method # Best place for upper blepharoplasty surgery

Upper blepharoplasty method # Upper blepharoplasty recovery period # Lower blepharoplasty procedure # Ectropion surgery # Upper blepharoplasty in middle age # Upper eyelid ptosis # Correction of drooping eyes # Best place for upper blepharoplasty # Senile ptosis # Blepharoplasty

Lower blepharoplasty in middle age # Dermatochalasis # Sagging eyes in middle age # Upper blepharoplasty for middle-aged patients # Aesthetic surgery for drooping eyes # Under-eye wrinkle treatment # Surgery for drooping eyelids # Ptosis with double eyelids # Non-incisional upper blepharoplasty # 삼백안

Surgery for sunken eyes # Eyebrow lift # Double eyelids in older adults # Drooping eyelids # Lateral canthoplasty # Eyelid ptosis surgery # Middle-aged eye surgery # Best place for brow lift # Under-brow lift # Drooping eyelids

사백안 # Under-eye wrinkle surgery # Surgery for sagging eyes # Middle-aged eye surgery # Middle-aged ptosis # Ectropion # Under-eye sagging # Eyelid wrinkles # Eyelid ptosis # Post-op care after upper blepharoplasty # Brow drooping

Upper blepharoplasty in Apgujeong # Eye thread lifting # Double eyelid fat removal # Brow lift # Surgery for under-eye sagging # Eye wrinkle surgery # Middle-aged double eyelid surgery # Eye shape surgery # Double eyelid surgery in your 50s # Middle-aged double eyelids # Eye wrinkles

Drooping eyelids # Drooping eyes # Upper blepharoplasty for men # Surgery for drooping eyes # Fine under-eye wrinkles # Fat repositioning # Sagging-eye double eyelids # Surgery for drooping eyes # Under-brow lift # Eye and wrinkles # Eye sagging # Surgery for drooping eyes

Mini lower blepharoplasty # Lateral canthopexy # Middle-aged aesthetic surgery # Under-eye thread lifting # How to remove under-eye wrinkles # Under-eye wrinkle plastic surgery # Eye correction surgery # Surgery for sagging double eyelids # How to remove under-eye wrinkles

Lower Blepharoplasty - Under-eye Wrinkle Removal Surgery

As people age, the lower blepharoplasty (lower eyelid) that has sagged downward is

smoothed out in a natural-looking way

to make the under-eye area look brighter and younger

and to create an improved impression.

When the eyelids are sagging,

lower blepharoplasty can be used

to remove a certain amount of eyelid skin.

This is because sagging eyelid skin cannot simply be left in place during surgery.

An incision is made in the skin, and along the designed line,

an appropriate amount of skin is removed and the skin is closed.

During surgery, fat may also be removed together with the procedure

or repositioned

to correct the sunken area at the same time.

Indications for lower blepharoplasty (under-eye wrinkle removal surgery)

○ When the lower eyelid has many wrinkles

○ When wrinkles make the skin look saggy

○ When wrinkles make a person look older

○ When there are dark circles​

Lower blepharoplasty (under-eye wrinkle removal surgery) procedure

1. Before anesthesia, the design is marked with special ink directly below the eyelashes, and local anesthesia is administered under sedation.

​2. After local anesthesia, the skin is incised along the design line.​

3. Sufficient dissection is performed between the muscle layer and fat layer down to below the wrinkle line, lifting the muscle and skin.

If there is a lot of fat, the fat is pulled downward to fill the sunken area, and a fixation suture is performed to flatten it through fat repositioning.

Fat repositioning can only be applied when there is a significant amount of fat; it cannot be applied if there is little fat or if the under-eye area is already sunken.

4. The skin is pulled upward and outward with forceps so that the wrinkles are smoothed out, and the remaining skin is measured.

The amount to be removed is determined by designing according to the excess skin.

To prevent the skin from sagging again, it is fixed to the periosteum at the lateral canthus.

This is called lateral canthopexy.

5. An appropriate amount of skin is removed along the design line.

​6. After skin removal, the skin is meticulously sutured with fine thread.

Once the suturing is complete, the area is disinfected, a skin-colored bandage is applied, and the patient goes home.

The stitches are removed after 4 to 5 days.

​Examples of lower blepharoplasty (under-eye wrinkle removal surgery)

Post-op care instructions

① After surgery, use the cool pack provided by the hospital for cold compresses for 2 to 3 hours a day for 3 days. Cold compresses only need to be done for 3 days.

You may apply cold compresses continuously for 2 hours, or split them into 20 to 30-minute sessions.

Usually, it is easiest to do this before going to sleep.

② Visit the clinic 1 to 2 days after surgery to disinfect the surgical site.

③ Visit the clinic on day 4 or 5 after surgery to remove the stitches from the surgical site.

④ After the stitches are removed, you may wash your face and wear makeup, and you may also take showers, use a sauna, or visit a jjimjilbang.

⑤ Swelling after surgery varies from person to person, and it usually subsides to some extent in about 7 to 14 days.

⑥ Avoid alcohol and smoking for about one week after surgery.

⑦ Return to the clinic one month after surgery for a follow-up.

Correction by under-eye fat repositioning

Instead of removing the orbital fat under the eyes,

this method moves the fat to the area below the protrusion

and spreads it out.

This is a method intended to correct both the protruding area and the sunken area at the same time.

Although fat removal can address the protruding area,

it cannot also resolve the sunken area,

so this method was developed to compensate for that limitation.

Candidates for under-eye fat repositioning

This procedure is for cases where bulging orbital fat under the eyes is accompanied by sunken wrinkles.

Advantages of under-eye fat repositioning

○ Improvement of dark circles

○ Correction of puffy-looking eyelids

○ Prevention of a hollowed appearance that can occur after excessive under-eye fat removal

○ Correction of under-eye wrinkles along with restoration of a smoother eye area

○ No visible scars and a natural result

How under-eye fat repositioning is performed

The sagging fat pocket is removed through the conjunctiva, moved above the under-eye bone, and fixed so that it does not move.

Differences between lower blepharoplasty and under-eye fat repositioning

Lower blepharoplasty	Comparison	Under-eye fat repositioning
Skin incision under the eye	Surgical area	Inner conjunctiva of the eye
A slight incision mark remains.	Scar	Almost none
It disappears.	Under-eye aegyo-sal	Preserved or created
Yes	Wrinkle removal	No
Not possible	Whether patients with keloids can undergo surgery	Possible

Problems with under-eye fat repositioning

The problem is that it is difficult to achieve the desired result properly.

Because the surgery is performed through the conjunctiva, visibility is limited, so the operation may not be performed properly, and there are not many people who are truly ideal candidates for achieving good results through fat repositioning.

To use a simple example: if there is land with a pit, and the goal is to scoop soil from a hill to fill the pit and make the whole area flat, then if the hill is not very large, even after removing all of the hill’s soil, there may still not be enough, and after filling the pit, the hill can end up becoming a hollowed depression instead.

This means that when fat is not abundant and is forcibly pulled and repositioned, the protruding area may instead become sunken.

In another case, if the pit is larger than the hill, even after removing all of the hill’s soil to fill the pit, the depth of the pit is only slightly reduced and it still remains a pit.

This refers to cases where a small amount of fat is pulled and repositioned, but the sunken area is not corrected well and remains sunken.

In yet another case, if the hill is large and the pit is fully filled, but the hill only becomes slightly smaller and still remains a hill, this means that there is still too much fat bulging even after repositioning.

Four points of dissatisfaction with under-eye fat repositioning

① When the amount of fat is insufficient, the area where the fat protruded may become hollowed out after fat repositioning

② When the amount of fat is large, the original protruding area may still appear protruded even after fat repositioning

③ After fat repositioning, the original sunken area may instead appear protruded

④ When the amount of fat is small, even after fat repositioning, the original sunken area may not be filled properly and may still remain sunken and shaded

When performing fat repositioning, surgery must be done by carefully selecting the proper shape and indications in order to achieve satisfactory results, and fat repositioning in cases that are not indicated may end up being an ambiguous procedure that does neither well.

In addition, because more tissue must be dissected than in fat removal, swelling and bruising tend to be much more severe.

If the indications are not appropriate, fat removal can provide a more definite result than fat repositioning, and if needed after under-eye fat removal, micro-fat grafting can be performed to additionally fill the sunken area.

Under-eye fat repositioning is mostly unsatisfactory or awkward when applied carelessly to patients who do not actually have much orbital fat.

In addition, under-eye fat repositioning cannot be expected to improve under-eye discoloration very much, and it can only be performed for contour correction purposes.

However, creating the desired flat under-eye contour is extremely rare.

When other clinics recommend fat repositioning even for eyes with almost no under-eye fat protrusion, that should be considered carefully.

After under-eye fat repositioning, there are cases where the under-eye area becomes hollowed or protrudes rather than becoming flatter, and such cases may come to our clinic for correction; if the area is sunken, correction with micro-fat grafting is possible.

Upper Blepharoplasty - Drooping Upper Eyelids

As people age, the upper blepharoplasty (drooping upper eyelids) that has sagged downward is

changed into a more aesthetically pleasing appearance, helping restore youthfulness

and solving problems of eye fatigue and visual obstruction.

If the upper eyelid skin has sagged,

upper blepharoplasty should be performed to remove the excess skin.

The purpose is to cut away the loose skin

and create a more attractive double-eyelid line.

Upper blepharoplasty

has a broad meaning that includes double-eyelid surgery.

If there is an existing double-eyelid crease, the crease is preserved as is

while the sagging skin above the crease is removed.

For people without a double-eyelid crease, a natural-looking line is created.

Indications for upper blepharoplasty (drooping upper eyelids)

○ When the eyelids sag so much that the eyes feel tired

○ When the eyelids droop and cover the pupils, causing visual obstruction

○ When the drooping eyelids make a person look older

Upper blepharoplasty (drooping upper eyelids) procedure

1. Before surgery, the width of the skin to be removed is determined.

At this time, the amount of skin to remain is measured by pinching it, and before anesthesia, the skin of the upper eyelid is marked with special ink.

If the outer part of the eye is more sagging, the design extends about 5 to 10 mm beyond the outer canthus.

2. Local anesthesia is administered along the planned design line.

Because local anesthesia is performed under sedation, there is no pain during the anesthesia.

3. After anesthesia, an incision is made in the skin along the design line.

4. After the incision, the skin tissue inside the incision line is removed.

Sometimes the muscle layer is also removed.

5. If there is a lot of fat, orbital fat is also removed.

If the patient wants a double eyelid after fat removal, a three-point suture may be placed in about three locations to create the double-eyelid line.

​6. Finally, the skin is sutured.

To minimize scarring, the skin is sutured closely at 1 mm intervals.

After suturing is complete, the area is disinfected and the patient goes home.

The stitches are removed after 4 to 5 days.

Post-op care instructions

① After surgery, use the cool pack provided by the hospital for cold compresses for 2 to 3 hours a day for 3 days. Cold compresses only need to be done for 3 days.

​You may apply cold compresses continuously for 2 hours, or split them into 20 to 30-minute sessions.

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

②​ Visit the clinic 1 to 2 days after surgery to disinfect the surgical site.

③ Visit the clinic on day 4 or 5 after surgery to remove the stitches from the surgical site.

④ After the stitches are removed, you may wash your face and wear makeup, and you may also take showers, use a sauna, or visit a jjimjilbang.

⑤ Swelling after surgery varies from person to person, and it usually subsides to some extent in about 7 to 14 days.

⑥ Avoid alcohol and smoking for about one week after surgery.

⑦ Return to the clinic one month after surgery for a follow-up.

Examples of upper blepharoplasty (drooping upper eyelids)

Endotine lifting

This is a procedure mainly effective for sagging facial skin

or deep expression wrinkles.

Endotine is made of a dissolvable soft plastic material,

and because it has stronger lifting power than thread lifting,

it can correct various areas of the face.

It can be applied to areas that could not be treated with conventional thread lifting,

such as the forehead, brow lift, and cheek area,

while the duration of the effect is also long-lasting.

Endotine lifting for brow lift

As people age and reach their 30s and 40s, skin aging accelerates.

The eyelids sag and wrinkles appear on the forehead.

Wrinkles make a person look tired and lacking in energy, and wrinkles between the eyebrows create an angry impression, making the face look less pleasant.

Deep forehead wrinkles make the face look tight and older.

Endotine lifting is a surgery used for forehead wrinkles, sagging eyelids, eyebrows, and the midface, and because it is performed through an incision inside the scalp, surgical marks are barely visible.

Recovery is also quick, and return to daily life is fast.

The Endotine fixation plate is made of an absorbable material with a protruding tip that fixes and lifts the skin.

Because it is absorbable, it is absorbed by the body over time, so it is known as a relatively simple and comparatively safe procedure compared with other treatments.

Endotine received FDA approval in 2003, so its safety has already been verified,

and it is currently gaining great popularity, mainly in the United States.

The procedure is performed under sedation, and because an endoscope is used, the incision is small and there is less concern about pain and swelling.

​Indications for Endotine lifting

Advantages of Endotine lifting

Safe	Because it is performed under sedation, there is less concern about pain. Using an endoscope through a small incision in the scalp, scars are barely visible.
Convenient	It is a relatively simple surgery, and scars are minimal. Recovery is fast. Because recovery is quick, return to daily life is also fast.
Long-lasting and effective	Because the treatment is distributed in multiple directions, the effect is better than conventional surgical methods. The fixation plate is absorbed into the skin, and the effect remains long-lasting.

Types of Endotine for lifting

Endotine is a biocompatible wrinkle surgery material approved by the U.S. FDA.

It is currently used in 30 countries and has long been imported and approved in Korea, making it a widely used lifting material.

Unlike non-dissolving thread lifting, it dissolves after one year, so side effects or foreign-body reactions are rare,

and even after the Endotine dissolves, the lifting effect is maintained for about 5 to 10 years.

Endotine procedure method for brow lifting

① Because it is usually performed together with upper blepharoplasty, the tissue is dissected through the upper blepharoplasty incision to expose the brow bone.

② Dissection is performed above the eyebrow to prepare for lifting the eyebrow upward.

③ A fixation groove for Endotine is created in the brow bone using drilling.

④ After making the groove, the handpiece Endotine is attached and fixed into the groove.

⑤ The brow flap is placed over the inserted Endotine and hooked into place.

⑥ The incision is closed.

⑦ Taping is applied.

⑧ The stitches are removed after 4 to 5 days.​

Advantages of the Endotine procedure

① Minimal incision and no scars.

② Stronger pulling effect and longer-lasting results than thread lifting.

③ Unlike non-dissolving thread lifting, Endotine dissolves, so there is no foreign-body reaction.

④ Even after Endotine dissolves, the effect remains after the tissue has been repositioned.

⑤ Recovery to daily life is quick after the procedure.

Durability of Endotine lifting

The biggest advantage of Endotine is that, because it is a soft material, there is no foreign-body sensation,

and because it dissolves after one year, there are no side effects caused by foreign-body reactions.

It also has a strong lifting effect, and even after Endotine dissolves, the lifting effect remains.

The duration varies by person, but it is maintained for about 5 to 10 years.

Side effects of Endotine lifting

The effectiveness of Endotine is determined by the accuracy of dissection within the effective range and the degree of pulling.

The dissection must be performed accurately above the fascia and then firmly fixed to the fascia,

but if the fascia is dissected incorrectly, facial nerve damage can occur,

so it is better not to undergo the procedure from inexperienced providers or non-specialists in plastic surgery.

What are the risks of surgery?

Many people have undergone endoscopic Endotine surgery, and there have been no side effects at all.

Although extremely rare, if a problem does occur, it is relatively minor, and for side effects that arise individually, it is best to consult the attending physician.

If you fully understand and follow the individually provided instructions and recommendations before and after surgery, you can reduce any potential risks.

Features and advantages of Endotine lifting

Conventional surgical method	Comparison	Endotine lifting
Under 1 year	Duration	Over 5 years
10–25 cm	Incision size	2 cm
Required	Removal surgery	Not required
High risk	Nerve damage	Almost none
4 hours	Surgery time	40–50 minutes
Hair loss along the incision	Hair loss	Almost none
No volume and awkward	Facial change	Voluminous and natural

http://www.duhans.com

Duhan Plastic Surgery Clinic surgical procedure

① Before visiting, make a consultation appointment by phone or online in advance.

If you make a reservation in advance, the consultation will be more convenient.

② After making a reservation and visiting for consultation, if you decide to proceed with surgery, schedule the surgery date.

The surgery reservation can also be made later by phone or online.​

③ Preoperative precautions

Once the surgery date is confirmed, people taking steroids or anticoagulants (aspirin), etc. should temporarily stop taking the medication starting 7 days before surgery.

Please avoid drinking alcohol as much as possible the day before surgery.

Alcohol reduces the effect of local anesthesia, so anesthesia may not work well during surgery or may wear off quickly.

For women, avoid the menstrual period if possible.

This may not matter for minor surgery, but for larger surgery, bleeding during the operation may increase, so caution is needed.

④ On the day of surgery

• Arrive 30 minutes before the scheduled surgery time and receive an explanation of the precautions to be observed during surgery.

• Change into surgical clothing and receive an IV injection for preoperative preparation.

In the case of local anesthesia, an intravenous pain-free anesthetic is administered.

After the IV injection, you enter a sedated state for about 5 minutes, and for double-eyelid surgery or nose surgery patients, local anesthesia is applied to the surgical area while in this sedated state.

After 5 minutes, when you wake from the sedated state, anesthesia is complete.

The patient does not feel any pain during anesthesia.

• When the surgery is finished, an antibiotic and anti-inflammatory intramuscular injection is given, and the patient rests in the recovery room for about 30 minutes.

For double-eyelid or nose surgery, a cool pack will be applied for cold compresses.

• For patients who had surgery under general anesthesia, they rest in the recovery room for about 1 to 2 hours and go home once dizziness from the anesthetic has completely disappeared.

• When leaving, the attending surgeon provides postoperative instructions, schedules a follow-up date, gives a prescription, and the patient buys the medicine at a pharmacy and takes it.

⑤ Return on the scheduled date to check the postoperative progress and receive an examination.​

​http://www.duhans.com​