[Duhan Plastic Surgery] Revision Double Eyelid Surgery - [Double Eyelid Surgery]

#Double eyelids #Double eyelid surgery method #Recommended eye plastic surgery clinic #Inner double eyelids #Eye double eyelid surgery #Lowering the double eyelid line #Double eyelid removal for men #Men without double eyelids #Multiple double eyelid folds #Double eyelid pinning

#Suture loosening #Upper and lower blepharoplasty #Men’s eye plastic surgery #Eye plastic surgery clinic #Double eyelid surgery for elementary school students #Eyelid fat #Double eyelid clinic #Natural-looking double eyelids #Hospital for double eyelid surgery #Dog-like eye shape

#In-out line double eyelids #Undetectable double eyelid surgery #Best place for double eyelids #Eye double eyelid surgery #Double eyelid plastic surgery #Out-line suture method #Best place for double eyelid surgery #Double eyelid plastic surgery clinic #Double fold surgery #Eye plastic surgery

#Gangnam eye surgery #Seoul double eyelid surgery #Double fold surgery #Before and after double eyelid surgery #Famous hospital for double eyelid surgery #Seoul double eyelid surgery #Gangnam double eyelid surgery #Best hospital for double eyelid surgery #Seoul double eyelids

#One-sided double eyelid #Removing double eyelids #Gangnam double eyelids #Partial incision eye correction #Double eyelid line #Double eyelid correction #Outer-fold surgery #Famous eye plastic surgery clinic #Suture double eyelid method #Small eyes in men

#Eye correction inner corner surgery #Double eyelid partial incision #Double eyelids #Inner double eyelid surgery #Recommended double eyelid surgery #Double eyelid swelling #Eye double eyelids #Revision after incision double eyelid surgery #Gangnam double eyelids #Drooping eyelids

#Eye plastic surgery clinic #Gangnam double eyelid surgery #Best hospital for double eyelid surgery #Double eyelid plastic surgery clinic #Best place for double eyelid surgery #Small eye plastic surgery #Best place for double eyelids #Seoul double eyelid surgery #Double fold surgery

#Recommended double eyelid surgery #One-sided double eyelid surgery #Elderly double eyelid surgery #Outer-line double eyelid surgery #Recommended double eyelid surgery #Outer-line double eyelids #Eye double eyelids #Best hospital for double eyelid surgery #Women’s eye plastic surgery

#Women’s eye plastic surgery #Revision outer-line double eyelid surgery #Outer-line double eyelid surgery #Double eyelid pinning #Double eyelid clinic #Duhan #Duhan Plastic Surgery #Duhan Eye Plastic Surgery #Duhan Revision Double Eyelid Surgery #Gangnam double eyelid clinic

#Apgujeong double eyelid clinic #Removing double eyelids #Double fold #Swelling-free double eyelid surgery #Before and after double eyelid surgery #Best hospital for double eyelid surgery #Seoul double eyelids #Double eyelid correction #Outer-line double eyelid surgery

#Outer-line double eyelids #Eye double folds #Thick double eyelids #Men’s eye and nose plastic surgery #Drooping eye corners #Double fold surgery #Double fold #Student double eyelid surgery #Making double eyelids #Double eyelid line #Revision double eyelid surgery

#Outer-line double eyelids #Celebrity revision double eyelid surgery #Celebrity eye plastic surgery #Celebrity double eyelid surgery #Best place for double eyelid surgery in Seoul #Partial incision double eyelid surgery #Best place for double fold surgery #Double fold pinning #Asymmetric double eyelid surgery #Revision surgery

#Natural double eyelid surgery #Non-incisional double eyelid surgery #Outer-line double folds #Outer-line double eyelids #Outer-line double folds #Famous place for double eyelid surgery #Sinsa Station double eyelid surgery #Double eyelid correction #Before and after double eyelid surgery #Double eyelid surgery

#Sleep anesthesia for double eyelid surgery #Sinsa Station double eyelid surgery #Types of double eyelid surgery #Outer-line double eyelid surgery #Outer-line revision surgery #In-line double eyelids #In-line double folds #In-line double fold #Celebrity double eyelids

#One-sided double eyelid #Double fold surgery #Double eyelid procedure #Double eyelids #Eye plastic surgery #Double fold surgery #Best place for double eyelid surgery #Double eyelid surgery #Eye plastic surgery clinic #Eye correction #Celebrity double eyelids

#Eye surgery #Best place for double eyelid surgery #Best place for double eyelid surgery in Gangnam #Best place for double eyelid surgery at Apgujeong #Best place for double eyelid surgery near Sinsa #Best place for eye plastic surgery #Revision double eyelid surgery #In-out line #Types of double eyelids

#Fat grafting to the upper eyelid #Eyelid fat removal surgery #Eyelid fat grafting #Eye asymmetry #Uneven eyes #Eyelid ptosis surgery #Multiple eyelid folds #Drooping eyes #Eyelid wrinkles #Sagging eyes #In-out line

Correction of the double eyelid line in sunken eyelids

When the eyelids are hollowed out, they may sometimes be corrected not through revision surgery but by correcting the eye shape and double eyelids with fat grafting.

Micro fat grafting to correct the double eyelid line

When the upper eyelid is hollowed and the double eyelid line looks unnatural, in some cases it can be corrected sufficiently with micro fat grafting alone, without the need for an incision.

If surgery is performed on a hollowed double eyelid state, the double eyelid line may not be formed properly, and even after surgery, unsatisfactory results are likely because of the hollowed contour.

If there is a hollowed eyelid, the priority is to first correct the sunken area with fat grafting and adjust the shape of the double eyelid at the same time.

Effects of correcting the double eyelid line with micro fat grafting to the upper eyelid

▶ Correction of a thick double eyelid line

▶ Correction of a loosened double eyelid line

▶ Correction of an asymmetric double eyelid line

▶ Correction of a triple double eyelid line

▶ Correction of multiple wrinkle lines

▶ Restoration of a lost double eyelid line

Anatomy of orbital fat in the upper eyelid

The role of orbital fat in the upper eyelid

◈ It gives the eyelid contour a fuller and softer look.

◈ It protects the eyeball from external impact.

◈ It acts like a lubricant so that the levator palpebrae superioris muscle, which opens the eyelid, can move smoothly.

Benefits of micro fat grafting to the upper eyelid

Aesthetic aspect	Functional aspect
Restoration of a softer and younger-looking eye shape by correcting the sunken area	It helps the levator palpebrae superioris muscle, which opens the eye, move smoothly and reduces eyelid fatigue.
Correction of an unnatural double eyelid line	​

Placement of micro fat grafting in the upper eyelid

The goal of micro fat grafting to the upper eyelid is to satisfy both aesthetic and functional purposes.

For this, it is very important to graft an appropriate amount of fat in the correct location.

The most accurate grafting site is where the orbital fat is located, and the newly grafted fat should blend with the existing fat in this area to achieve good results.

However, if it is grafted incorrectly into the orbicularis muscle layer, the eyelid can become uneven and, rather than looking lighter, the eyelid may feel heavier and opening the eyes may become more uncomfortable.

Therefore, fat grafting to the upper eyelid must be performed delicately and with precise anatomical knowledge to achieve the desired result.

Micro fat grafting procedure for an attractive eye shape

1. Fat is collected from areas where the patient has a lot of fat accumulation, such as the lower abdomen, waist, or thighs.

For wrinkle correction, not much fat is needed, so collecting it from the lower abdomen is preferable.

• Since local anesthesia (painless sleep anesthesia) is used, there is no pain at all.

• Fat is collected into a syringe using a thin liposuction cannula.

2. The collected fat is placed in a centrifuge to remove impurities such as local anesthetic, serum, and red blood cells.

The purpose of centrifugation is to remove impurities from the fat, increase its concentration, and improve the fat’s survival rate.

3. The fat that has been centrifuged undergoes a second concentration process to remove water and oil.

By removing water and oil, concentrated fat that is nearly 100% pure is obtained.

4. The purified fat is transferred into a thin 1cc syringe and grafted into the desired area.

The fat is transferred again into a thin 1cc syringe and grafted into the desired area.

Our clinic’s independently developed microneedle (micro grafting cannula) is used.

The microneedle is a special grafting cannula used only at our clinic, allowing ultra-precise grafting.

For grafting, a subcutaneous tunnel must be created in advance before grafting so that it can be placed accurately in the wrinkle area and effectively correct the wrinkle.

The micro fat grafting cannula is inserted into the planned line of the eyelid and grafted precisely.

It must be grafted into the orbital fat layer to create a smooth contour and a high survival rate.

After fat grafting, daily life is possible immediately, and washing the face and applying makeup are allowed from the next day.

Example of correcting a thick double eyelid line with micro fat grafting

This is applied only when the upper eyelid is hollowed out. Micro fat grafting requires very advanced skill and know-how, and the anatomical structure of the eyelid must be accurately understood.

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

Because it is a highly difficult procedure that must consider both the correction of the hollowed eyelid and the unnatural double eyelid line, it is better not to undergo the procedure from someone with insufficient experience or from a non-specialist in plastic surgery.

Example of correcting an asymmetric double eyelid line with micro fat grafting

When the orbital fat is insufficient and the eyelid becomes hollowed, the line is pulled upward and becomes larger.

In such cases, it 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.

Example of correcting a loosened double eyelid line with micro fat grafting

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

However, this applies only when the cause of the loosening is solely the hollowing of the eyelid.

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

If the line does not naturally restore even after the eyelid has been restored, revision surgery is necessary.

Example of correcting a triple double eyelid line with micro fat grafting

When the eyelid becomes hollowed, the skin is pulled upward, causing the line to become larger or creating a triple double eyelid.

Sometimes multiple layers of folds can also form.

In such cases, micro fat grafting can also correct the problem simply.

Two-dimensional plane fat grafting to the upper eyelid

Fat grafting to the upper eyelid must be done as two-dimensional plane fat grafting.

If fat is grafted under the skin, problems such as a heavy eyelid and uneven skin can occur.

To avoid these side effects, the fat must be grafted precisely between the orbicularis muscle and the levator palpebrae superioris muscle, which requires precise anatomical knowledge and a lot of experience.

Only when the fat is grafted in the correct location can it be considered a complete graft in both functional and aesthetic terms.

Recovery period after micro fat grafting to the upper eyelid

Usually, normal activity is possible immediately.

Some swelling and bruising may occur, but the bruising is mild enough to be covered with makeup, so it does not cause major issues in daily life.

However, swelling and bruising vary from person to person, so not every case is the same. On average, severe swelling and bruising do not occur, and after about a week it usually looks natural.

Number of sessions for micro fat grafting to the upper eyelid

Eyelid fat grafting tends to have a higher survival rate than in other areas.

If one session is performed, or at most two, satisfactory results can usually be obtained.

The interval between sessions is from 3 to 10 months, and when repeating the procedure, the fat that was stored at the time of the first grafting is thawed and used.

However, in many cases, if the patient is satisfied after one session, a second session is not necessary.

Since the survival rate of fat varies by person, the decision on whether to do a second session should be made after at least 3 months.

Survival and survival rate of fat grafting

The survival rate of fat cells differs by area of the face.

The higher the survival rate, the fewer the procedures needed and the greater the effect.

For example, a survival rate of 80% means that 80% of the total grafted fat survives and 20% is absorbed and disappears.

Therefore, a higher survival rate leads to better results.

The area with the lowest survival rate is the lips, and the area with the highest survival rate is around the eyes.

The average survival rate after fat grafting is 50%.

In other words, after grafting 100 units of fat, only 50% remains after a few months.

The better the blood circulation, the higher the survival rate of fat. Since the area around the eyes has the best blood circulation on the face, fat grafting there has a higher survival rate than in other areas.

Therefore, around the eyes, even one procedure can produce lasting effects.

However, since repeat procedures are sometimes necessary, it is better to think of fat grafting as usually requiring about two sessions.

Second procedure and fat collection

When fat is collected from the lower abdomen or thighs, enough fat is harvested for grafting, and the remaining fat is not discarded but stored sterilely in a freezer.

The stored fat can be kept for about 10 months, so if you visit within a year, you can receive an additional procedure without another harvest.

Whether the fat is stored and used later or harvested and used immediately, the result is the same.

Lasting effect of upper eyelid fat grafting

After fat grafting, until about 3 to 6 months, the fat is gradually absorbed and the volume decreases.

After that, if the fat fully survives and no further absorption occurs, the remaining fat stays permanently.

The surviving fat does not melt away and disappear on its own.

If body weight decreases overall in the future, the grafted area may be affected, but if body weight remains the same, the volume of the grafted area changes very little.

Therefore, the surviving fat remains part of one’s own tissue for life.

That does not mean, however, that the shape itself will remain unchanged for life.

As people age, the skeleton changes, wrinkles form on the eyelids, the skin sags, and body weight may decrease, so the shape of the fat-grafted area will also not remain exactly the same.

Before aging progresses significantly, the effect is long-lasting.

That is why the term “semi-permanent” is used.

Side effects of upper eyelid fat grafting

The side effects are only minor swelling and bruising.

Other side effects can be considered virtually nonexistent.

Because the procedure uses the patient’s own fat rather than a foreign substance, there is no foreign-body reaction or inflammation.

Also, once the fat survives, it is no longer absorbed and becomes the patient’s own tissue.

In some cases, people experience side effects after procedures done at clinics with somewhat limited fat grafting experience, but this is a matter of the practitioner’s technique.

If the fat is grafted into the orbicularis muscle layer rather than the orbital fat layer, the eyelid may feel heavier and become uneven; if too much fat is injected, the eyelid may swell and interfere with daily life; if too much fat is injected, ptosis may occur and the eyes may not open well; or if much of the fat is absorbed, the patient may not see any effect.

Because results differ by clinic, it is better not to undergo the procedure from a non-specialist in plastic surgery who lacks some experience in fat grafting.

Other procedures besides fat grafting

At present, there is no other method for correcting upper eyelid hollowing besides fat grafting.

In some cases, an incision is made in the upper eyelid as if performing double eyelid surgery and a lump of fat is grafted, but this comes with the burden of needing an incision, and grafting a lump of fat can cause the eyelid to feel heavy.

Also, various filler materials used in plastic surgery such as Restylane, Athecol, and Juvederm are widely commercialized and used, but if commercial fillers are injected into the upper eyelid, the eyelid may become stiff and opening the eyes may become uncomfortable, and inflammation can occur.

Therefore, micro fat grafting using the patient’s own tissue is a safe and effective method.

http://www.doublefold.co.kr

Full incision method

For correcting ptosis with a thick line, the full incision method is possible.

The full incision revision process is very complicated and requires extensive experience, advanced skill, and know-how.

It usually takes about 2 to 3 hours and proceeds through a total of 10 steps. If even one step is omitted, the result may fall below expectations.

Therefore, no matter how long it takes, all steps must be carefully checked and performed with attention to achieve good results.

Two goals of full incision surgery

The goals for correcting a thick line and ptosis are largely twofold.

1. Reducing the thick, unattractive double eyelid line and making it into a natural, thin inner double eyelid

2. Making the sleepy, drowsy-looking eyes open more widely and clearly so they look larger and more refreshed

With these two goals, revision double eyelid surgery proceeds as described below.

STEP 01 - Design the planned incision line, including the existing incision scar tissue.

Before surgery, the design is made to create a new double eyelid line below the scar line and determine the excision width up to the scar line.

The width to be excised is measured from the new double eyelid line to the existing scar line.

For example, if the existing scar line is 10 mm above the eyelashes and the new double eyelid line is set at 7 mm, the excision width will be 3 mm.

The standard is determined based on the width at the center.

The new double eyelid line is decided by considering how much to reduce the line and how much excess skin is available.

The average line height in revision surgery is around 5 to 7 mm.

STEP 02 - Cut away the skin and scar tissue.

Scar tissue is excised along the design line.

The incision is made precisely with a scalpel, and then the tissue is removed with surgical scissors.

The lower edge of the excised area becomes the new double eyelid line, and the upper edge must be naturally pulled downward after tissue dissection so that it can be sutured.

STEP 03 - Dissect the orbicularis muscle, orbital fat, and skin that are adhered to the levator muscle.

Since the skin above the incision line must be pulled downward, the firm scar tissue that is stuck together must be released.

Scar tissue dissection proceeds by separating the space between the orbital fat layer and the levator palpebrae superioris muscle, and in some cases the area between the muscle and fat is also dissected for fat advancement.

Through this dissection process, tissues can be advanced and repositioned downward, which is important as preparation for achieving a natural double eyelid line.

STEP 04 - If there is contraction of the orbicularis muscle, the muscle is incised or removed to release the contraction.

If the adhesion of scar tissue is very severe, in rare cases a vertical 1 to 2 mm incision may be made in the orbicularis muscle to release the contraction.

STEP 05 - To prevent re-adhesion, the orbital fat is repositioned to the incision line.

Advancing the orbital fat is a step taken to prevent the tissues from re-adhering.

If the fat is not repositioned, the tissues will stick together again, which can lead to ptosis and a sleepy, drowsy-looking eye.

In some cases, a triple double eyelid may occur, which can damage the eyelid line.

Another effect of repositioning the orbital fat is that, when the eyelid is hollowed, some correction of the hollowing can be achieved. In some cases, if the hollowing would otherwise require fat grafting later, the surgery itself may improve it enough that fat grafting is no longer needed.

STEP 06 - Shorten the levator palpebrae superioris muscle to strengthen its function.

Levator shortening is one method for correcting ptosis.

It is simple and effective, and has the advantage of correcting the problem with almost no tissue damage.

Instead of cutting the levator palpebrae superioris muscle, it is simply advanced and fixed to the tarsal plate.

In revision surgery, the effects of levator shortening are twofold: it makes the eyes open wider so they look clearer and more refreshed, and by opening the eyes more widely, it also reduces the double eyelid line.

STEP 07 - After incising the orbicularis muscle at the inner corner of the eye, orbital fat is inserted between the muscles to prevent re-adhesion.

In addition to advancing the fat, fat is inserted into the inner corner of the eye to prevent adhesion of the orbicularis muscle.

The inner part of the eye is the area where scar tissue adhesions most commonly occur. Adhesion in this area makes the eyes look sleepy and difficult to open, causing discomfort when opening the eyes.

To prevent this, orbital fat that can act as a lubricant is placed between the orbicularis muscle and the tarsal plate and fixed with sutures.

STEP 08 - During suturing, layered suturing ensures that the repositioned structures do not shift.

The suturing method for revision surgery is not simple.

The purpose of suturing is to close the open wound and create the double eyelid line.

Therefore, to obtain the double eyelid line that was designed initially, the skin below the incision line must not be pulled upward.

To do that, the skin below the incision line must be firmly fixed to the tarsal plate, and sutures must also be placed so that the advanced fat does not get pulled upward.

In addition, the orbicularis muscle and skin above the incision line must all be passed through by the sutures and firmly closed with layered suturing in order to achieve the desired double eyelid line.

STEP 09 - To prevent hematoma and inflammation, a small amount of anti-swelling agent (hyaluronidase) is administered to the surgical site.

Hyaluronidase, an anti-swelling agent, is a medication that disperses water and can quickly reduce swelling as soon as it is administered.

However, if used in excessive amounts, it can instead cause more bruising, so it is used selectively only to reduce swelling.

STEP 10 - Suture removal is left relatively long, from 7 to 14 days depending on the patient’s condition.

Stitches are removed in two stages, on day 4 and day 7.

The reason for removing the stitches late is that in revision surgery there is usually not enough excess skin, and because the procedure involves advancing all tissues, the suture line is under a lot of tension.

Therefore, if the stitches are removed on day 3 or 4, the tense suture line may open, the scar line may widen and become more noticeable, and the tissue may gradually be pulled upward, which can also enlarge the double eyelid line.

So, until the tissue stabilizes, the stitches need to hold the tissue in place, which is why it is better to leave them in longer.

Many clinics remove the stitches early out of concern that stitch marks may remain, but that applies to the first double eyelid surgery.

It does not apply to revision surgery.

To minimize stitch marks, most of the stitches are removed on day 4, leaving only about 3 or 4 stitches, and those are removed on day 7. This helps minimize stitch marks and scar widening while also reducing deformation of the double eyelid line.

To reduce early inflammation and swelling quickly, steroid medication is administered for about 2 days.

After surgery, artificial tears are used for about 1 month to prevent dry eye.

http://www.doublefold.co.kr

Partial incision method

The partial incision method is a surgical method used to restore a wrinkle line to its original clear line when it becomes smaller, loosens, or becomes blurry.

It is also a method that can make a small double eyelid line slightly larger.

STEP 01 - Design the desired double eyelid line.

Usually, the design is often made along the existing scar line.

Sometimes it is designed to match the height and shape the patient wants, or the surgeon may determine the most suitable line and design it accordingly.

The direction of the design line also changes depending on whether an outer fold or inner fold is desired.

STEP 02 - Mark the incision positions at three points with design ink.

The locations are lightly marked on the inner, middle, and outer parts.

STEP 03 - Under sleep anesthesia, while the patient is asleep for about 5 minutes, local anesthetic is injected into the three marked areas.

The local anesthetic is administered in the minimum amount possible to avoid swelling as much as possible.

STEP 04 - Make very small incisions of about 2 mm at the three marked areas.

If the incision is made too large, too much scar tissue will remain, so the surgery is done with the smallest possible incision to leave almost no scar.

STEP 05 - Through the incision, first pull the orbicularis muscle and remove it with scissors.

The orbicularis muscle is the muscle layer covering the eyelid and is tissue that interferes with the formation of a double eyelid, so it must be removed to prevent the line from loosening.

Along with removing the orbicularis muscle, the pre-tarsal fat beneath the muscle layer is also removed.

STEP 06 - If there is a lot of orbital fat, pull it out through the outer incision and expose it.

Fat removal is mainly done from the outer side.

STEP 07 - Hold the fat with a hemostat and cut the stalk of the protruding fat with a scalpel.

Excessive removal of fat can cause the eyelid to become hollow, so it is better to remove only as much as protrudes.

STEP 08 - After removing the fat, use electrocautery to stop bleeding so that no bleeding occurs.

If hemostasis is not done properly, orbital hemorrhage can occur and bruising and swelling will become severe, so proper hemostasis is important.

STEP 09 - Through the three incision sites, use very thin dissolvable sutures to connect the levator palpebrae superioris muscle and the skin to create the double eyelid line.

STEP 10 - After burying the sutures and applying eye ointment, the surgery is complete.

Washing the face and applying makeup are possible from the next day.

Use the cool pack provided by the clinic for cold compresses for 3 days.

If cold compresses are continued for more than 3 days, the swelling may not subside further, so it is best to do them for exactly 3 days.

http://www.doublefold.co.kr

We have extensive clinical experience, know-how, and successful cases numbering in the tens of thousands. ^^

http://www.duhans.com