[Duhan Plastic Surgery Eye Surgery] - [First Double Eyelid Surgery]

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Attractive double eyelids

There is no fixed standard for what makes an attractive and beautiful double eyelid line, but

let's look at what is generally considered

an attractive double eyelid line.

A beautiful double eyelid that looks natural

and does not look surgically altered can be considered an attractive double eyelid.

1. A double eyelid line that is too large is not good.

In general, when the line is large, the expression often becomes awkward in most cases.

Depending on one's aesthetic sense, a large and distinct line can give an artificial and awkward impression.

The most beautiful and ideal double eyelid line is one that is just slightly visible, about 1–2 mm, when the eyes are open. That can be considered the most attractive double eyelid line.

2. The double eyelid line should extend clearly to the inner corner of the eye.

Asian eyes may in some cases have an epicanthal fold (inner canthal fold), and if this is overlooked during surgery, the inner eye line may disappear, creating a feeling of heaviness.

Whenever possible, it is better to make the line visible all the way to the inner corner of the eye. If the line does not form properly because of the epicanthal fold, epicanthoplasty should be performed. If there is no epicanthal fold, the design should be done well so that the line does not break in the inner part.

3. The surgical marks should not be visible.

The biggest drawback of incision-based surgery is scarring.

How much scarring remains depends on the surgeon's skill and individual constitutional factors.

Scarring is relatively more common in people with thicker skin and orbicularis oculi muscle.

Once a scar forms, there is no way to remove it completely, though in severe cases scar revision surgery can be performed to make the scar less noticeable.

Therefore, during the first surgery, it is important to minimize scarring by removing an appropriate amount of skin and performing precise suturing.

4. The eyelid should look thin.

Causes of eyelids appearing puffy include thick skin or orbicularis oculi muscle, or excessive orbital fat or preaponeurotic fat.

It is better to address these issues during double eyelid surgery whenever possible.

The most common cause is excessive orbital fat.

This can be reduced by removing orbital fat during double eyelid surgery.

Another method is to partially remove the orbicularis oculi muscle layer under the skin if it is thick. The orbicularis oculi muscle below the incision line can be partially removed, while the muscle above the incision line is difficult to remove.

5. If an epicanthal fold is present, it is better to remove it.

In some Asian patients, an epicanthal fold (inner canthal fold) causes the skin at the inner corner of the eye to cover the eyeball and create a cramped appearance. Removing it can increase the horizontal width of the eye and make it look more open, allowing the double eyelid line to appear clearly toward the inner side as well.

However, surgery must be performed carefully with the eye shape in mind to avoid unsatisfactory results.

If the distance between the eyes does not appear wide and there is almost no epicanthal fold at the inner corner, performing epicanthoplasty may instead make the eyes look too close together or make the gaze appear sharper as a side effect. Therefore, epicanthoplasty should only be performed when it is indicated after an accurate physical examination.

6. If ptosis is present, it should be corrected at the same time.

Ptosis refers to a sleepy-looking eye in which the upper eyelid droops and covers the pupil because the function of the levator palpebrae superioris is weakened. If this is overlooked during surgery, the double eyelid line may not turn out beautifully.

Before double eyelid surgery, the eyes should look larger and more refreshed for the double eyelids to also look beautiful.

Depending on the degree of ptosis, if it is judged that ptosis correction is also needed, it is better to correct ptosis at the same time using the incision method.

Beautiful quick double eyelids

The quick double eyelid procedure

is a surgery with minimal incision and minimal swelling, allowing

immediate return to daily life after surgery.

Our quick double eyelid procedure

is performed with a minimally incisional partial incision method,

so skin suturing is not required, daily activities are possible,

there is almost no swelling immediately after surgery,

and it is characterized by a natural result.

It also has the advantage of being less likely to come undone.

The 4 principles of double eyelid surgery

Swelling should occur as little as possible

The quick double eyelid procedure is one of the methods that causes less swelling than any other method.

The line should not come undone

By removing orbicularis oculi muscle and orbital fat, the line is hardly likely to come undone.

Scarring should be minimal

With a 2 mm minimal incision, scarring is almost nonexistent.

The line should be natural

By creating the line in advance while the patient is seated, the most natural line is found and then the surgery is performed.

Why quick double eyelids do not swell

Swelling occurs when exudate generated by surgery accumulates within the tissue.

The reason quick double eyelids hardly swell is that through the micro-incision, the swelling-causing tissue such as orbicularis oculi muscle and fatty tissue is removed, and the exudate produced by the surgery is immediately drained through the micro-incision, leaving little room for swelling to develop.

For example, it is similar to how a bruise without an open wound swells, while a cut wound barely swells.

A bruise without an open wound swells because exudate is generated inside but cannot drain and accumulates, whereas a cut wound does not swell because the exudate drains out immediately.

Degree of swelling after quick double eyelid surgery

The degree of swelling varies from person to person, but in general there is not much swelling even immediately after surgery,

and it is fine to go about daily life right away.

The degree of swelling varies from person to person, but in general there is not much swelling even immediately after surgery, and it is fine to go about daily life right away.

The quick double eyelid surgical process

♥ Step 1 ~ 2: Design the double eyelid line -> Determine the 3 incision points

1. Design the desired double eyelid line. The design is made according to the height and shape the patient wants, or the surgeon determines the most suitable line and designs it. The line height is usually designed between 5 and 8 mm from the eyelashes, and the direction of the design line changes depending on whether it will be an out-fold or an in-fold.
2. Mark the three incision points with design ink. The locations are lightly marked at the inner, middle, and outer parts.

♥ Step 3 ~ 4: Administer local anesthetic -> 2 mm minimal incision

3. Under sedation anesthesia, after sleeping for about 5 minutes, local anesthetic is injected into the three marked areas. The local anesthetic is administered in minimal amounts so as not to cause swelling as much as possible.
4. Make a very small incision of about 2 mm at the three marked sites. If the incision is made too large, more scarring will remain, so the surgery is performed with the smallest possible incision to leave almost no scar.

♥ Step 5 ~ 6: Removal of orbicularis oculi muscle -> Exposure of orbital fat

5. Through the incision, the orbicularis oculi muscle is first pulled out and removed with scissors. The orbicularis oculi muscle is the muscle layer covering the eyelid and is tissue that interferes with double eyelid formation, so it must be removed to prevent the double eyelid line from coming undone. Along with removing the orbicularis oculi muscle, the preaponeurotic fat beneath the muscle layer is also removed.

6. When there is a lot of orbital fat, it is pulled out and exposed through the outer incision site. Fat removal is mainly done from the outer side.

♥ Step 7 ~ 8: Removal of orbital fat -> Cauterization of orbital fat

7. Hold the fat with a hemostatic forceps and cut the base of the protruding fat with a scalpel. Excessive removal of fat can cause hollowing of the eyelid, so it is better to remove only as much as has protruded.
8. After fat excision, use an electrocautery device to control bleeding so that no bleeding occurs. If hemostasis is not properly achieved, orbital bleeding can occur, worsening bruising and swelling, so good hemostasis is important.

♥ Step 9 ~ 10: Process of creating the double eyelid line -> Embedding the suture

9. Through the three incision sites, a very thin dissolvable thread is used to connect the levator palpebrae superioris and the skin to create the double eyelid line.
10. After burying the thread, the surgery ends after applying eye ointment. Washing the face and wearing makeup are possible starting the next day. Use the cooling pack provided by the hospital for cold compresses for 3 days. If cold compresses are applied for more than 3 days, swelling will not go down any further, so it is best to do it only for exactly 3 days.

Postoperative care after quick double eyelid surgery (partial incision method)

1. Apply cold compresses with the cooling pack provided by the hospital.

Do this for 3 days, 2 hours a day.

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

Usually, it is convenient to do it before going to sleep.

2. For follow-up visits after surgery, come back once the day after surgery to disinfect the surgical site and observe the recovery.

3. Makeup and face washing are possible starting the next day.

4. Swelling after surgery varies by person, and in general it almost subsides after about 7 days, but the period for it to settle completely takes 1 to 3 months.

Before and after photos of quick double eyelid surgery

Differences between quick double eyelid surgery (partial incision method) and the buried suture method

​	Quick double eyelid surgery (partial incision method)	Buried suture method
Use of thread	Dissolvable thread	Non-dissolvable thread
Degree of incision	About 2 mm, 3 incisions	About 2 mm, 3 incisions
Postoperative swelling	Mild	Mild
Degree of looseness	Almost never comes undone	A high rate of loosening or thinning
Clarity of the line	Maintains the clarity of an incision method	Often comes undone or is not distinct
Fat removal	Possible	Impossible
Removal of sutures	Not necessary. Can be removed if desired	Impossible or very difficult
Scar formation	Almost none	Almost none

Examples of partial incision surgery at Duhan Plastic Surgery

A quick double eyelid refers to the partial incision double eyelid method performed at our clinic.

Our clinic creates double eyelids using the partial incision method (quick double eyelids) instead of the pure buried suture method.

The difference is that the buried suture method has the drawback of easily coming undone,

so to compensate for this, we perform the procedure using the partial incision method.

The buried suture method does not remove fat or muscle under the skin,

and because the thread is buried,

exudate that causes swelling cannot drain out and remains trapped,

which leads to more swelling and bruising and makes the line come undone.

In contrast, the partial incision method removes muscle and fat,

thereby removing the primary swelling-causing tissue,

and because exudate drains out immediately through the incision,

there is much less swelling and bruising, and the line is less likely to come undone.

By making the partial incision only about 2 mm, we have distinguished it from other partial incision methods.

Our clinic’s partial incision method (quick double eyelids) uses a method in which very small incisions of about 2 mm are made at each site,

making it natural like the buried suture method and allowing immediate return to daily life,

with almost no scar remaining.

If there is a lot of fat, fat removal is also possible.

It also has the advantage of not coming undone easily like an incision method.

Anesthesia is pain-free, so there is no pain at all.

The surgery takes about 30 to 40 minutes.

There is no need to remove sutures after surgery, and daily life is possible immediately.

No separate recovery period is needed, and going straight back to work is also possible.

http://www.duhans.com

http://www.duhans.com