Douhan Plastic Surgery - Revision Double Eyelid Surgery: Outline Revision

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Basic Principles and Concepts of Double Eyelid Surgery

People often mistakenly think that double eyelid surgery is a procedure that simply creates a double eyelid line.

Its purpose is not just to make a double eyelid line.

The goal of double eyelid surgery is to make the eyes look larger and brighter so that the overall impression becomes both intelligent and beautiful.

A surgery that is performed only to create a double eyelid line can sometimes create an unattractive impression.

The ultimate goal of double eyelid surgery is to create a natural and beautiful eye shape.

Basic Principles and Concepts of Double Eyelid Surgery

People often mistakenly think that double eyelid surgery is a procedure that simply creates a double eyelid line.

Its purpose is not just to make a double eyelid line.

The goal of double eyelid surgery is to make the eyes look larger and brighter so that the overall impression becomes both intelligent and beautiful.

A surgery that is performed only to create a double eyelid line can sometimes create an unattractive impression.

The ultimate goal of double eyelid surgery is to create a natural and beautiful eye shape.

Revision Double Eyelid Surgery

This refers to surgery that revises the double eyelid line and restores it to its original natural and refreshed appearance when the line is too large, uneven, or has come undone.

Indications for Revision Double Eyelid Surgery

♥ When the double eyelid line is too large

♥ When the double eyelid line has come undone

♥ When the lines are asymmetrical

♥ When the eyes feel tired after double eyelid surgery

♥ When there is a thick sausage-like appearance below the incision line

♥ When the impression looks worse after double eyelid surgery

♥ When you want to restore beautiful, natural-looking eyes

Types of Double Eyelid Surgery Methods

Full incision method	The full incision method is used when the skin is loose.
Partial incision method	This is used when the skin is not loose, regardless of skin thickness, in younger patients.
Buried suture method	This is used when the skin is not loose, in younger patients with thin skin and little fat.

Full Incision Method

The full incision method is mainly used for older patients with loose skin.

It allows removal of loose skin, and when there is thick fat or muscle, it also allows removal of fat and muscle.

♥ Advantages of the full incision method

① This method is used when the skin is loose and there is a lot of excess tissue.

② The double eyelid line can be designed to be clear and refined.

③ Unnecessary orbicularis muscle and fat can be removed.

④ The double eyelids are less likely to come undone.

⑤ If ptosis is present, ptosis correction can also be performed.

♥ Disadvantages of the full incision method

① A long scar remains.

② Swelling and bruising last longer than with the buried suture or partial incision methods.

③ If the line is unsatisfactory, revision is difficult.

Partial Incision Method

The partial incision method is a technique that compensates for the drawbacks of the buried suture method.

It is a method of creating a double eyelid by making only three incisions of about 2 mm along the planned double eyelid line.

It is a method that combines the advantages of both incision and buried suture methods, with less chance of coming undone than the incisional method and almost no scar like the buried suture method.

This is the technique mainly used at Douhan Plastic Surgery's double eyelid clinic.

♥ Advantages of the partial incision method

① The surgery takes about 30 minutes, and you can return to daily life immediately; washing your face and applying makeup are possible starting the next day.

② There is almost no swelling or bruising.

③ Orbital fat can also be removed, and there is no need to remove stitches.

④ A natural double eyelid line can be achieved in a short time, and it does not look like you had surgery.

⑤ It is less likely to come undone than the incisional method.

⑥ There is almost no scar.

Buried Suture Method

This method involves making a tiny incision in the skin and burying the sutures.

It is mainly used for young people with thin skin.

However, it is not a very desirable method because the line is more likely to change shape or come undone, and fat removal cannot be performed.

♥ Advantages of the buried suture method

① The surgery takes 30 minutes, and you can return to daily life immediately; washing your face and applying makeup are possible starting the next day.

② A natural double eyelid line can be achieved in a short time, and the surgery is barely noticeable.

③ There is almost no scar.

♥ Disadvantages of the buried suture method

① It can easily come undone when the skin is thick.

② Over time, the line can loosen or become deformed.

③ Fat removal is not possible.

④ If internal bleeding occurs, there is no channel for swelling to drain, so swelling and bruising are often severe.

⑤ Because the sutures are fixed above the tarsal plate, it is difficult to adjust the thickness of the line.

⑥ In cases such as the single-knot continuous-knot method, the amount of buried suture material is large, so swelling may not subside well.

Which surgical method is appropriate for you?

The choice depends on the shape and condition of the eyes, as well as the surrounding circumstances.

For young people whose skin is not very loose,

the partial incision method is used in most cases,

For older patients, if the skin is significantly loose,

it is better to perform the surgery with the incision method.

Dr. Shin Du Han

Comparison of Common Double Eyelid Surgery Methods

Please refer to the surgical methods below~

	Incision method	Buried suture method	Partial incision method (Quick double eyelid)
Indications	Used when the skin of the upper eyelid is significantly loose	Used when the skin is not sagging, is thin, and there is not much eyelid fat	Used for eyelids that are not sagging
Advantages	* Loose skin can be removed.* The line does not come undone easily.* Unnecessary fat can be removed.* Ptosis correction is possible.	* Less scarring.* Swelling goes down quickly.	* Almost no scar remains.* Swelling is minimal and subsides quickly.* The line does not come undone easily.* Orbital fat can be removed at the same time.
Disadvantages	* A scar from the incision remains. * Swelling lasts a long time.	* Cannot be used when the skin is loose.* The line is likely to come undone or become thin.* Orbital fat cannot be removed.	* Cannot be used when the skin is loose.

When there are wrinkles below the line

If there are multiple lines below the double eyelid line, the double eyelid looks messy.

A beautiful line should be small and precisely formed as a single line, but if there are many fine wrinkles in addition to the double eyelid crease, the eyes can look older and the overall impression can appear less favorable.

In such cases, correction should be done with the partial incision method, or if that is not feasible, a certain amount of skin should be removed using the full incision method.

When the line is not clear and appears faint

A double eyelid line should be reasonably clear to look beautiful.

If the line becomes loose and faint, it looks like a wrinkle rather than a refined line, giving an unfavorable impression.

In such cases, it should be changed back to a clear line.

When the line is too deep and dark

It also looks awkward if the double eyelid line appears too deep or too dark.

This can be caused by loose skin or depression in the incision area.

The line should be clear, but a double eyelid line that looks too deep is also considered an unattractive double eyelid.

When the outfold line extends excessively beyond the inner corner of the eye

An overly pronounced outfold double eyelid line often feels artificial and awkward.

An infold line that disappears in the middle because of an epicanthal fold is also awkward, but an outfold line that stretches past the inner corner of the eye creates a strong impression and is therefore considered an unattractive double eyelid.

When the double eyelid line is not smooth and has uneven curves

A beautiful double eyelid should have a smooth curved line.

The most ideal line is one where the inner line is small and becomes wider toward the outer side, continuing without irregularity.

However, a curved line that is wide on the inside, becomes small in the middle, and then widens again on the outside is one of the awkward types of lines.

Problems with an overly pronounced outfold line

It must be reduced to an outfold or changed to an infold, and this is the most difficult technique among revision surgeries.

To reduce the line, the inner line must be properly reduced.

When the line is thick and the inner line is also very wide, it becomes an outfold.

Reducing an outfold to an infold is necessary in order to create an overall natural line.

One of the most difficult techniques in revision surgery is turning an outfold into an infold.

If the line cannot be properly reduced to an infold, the desired line cannot be created correctly.

Problems When Excessive Epicanthoplasty Has Been Performed

Excessive epicanthoplasty limits the ability to change the line into an infold or a natural line.

Because of unnecessary excessive epicanthoplasty, a severe outfold line may occur, or overexposure of the mucosa and eyes that appear too close together may result.

In cases of excessive epicanthoplasty, the first step is to make the line as much like an infold as possible, and if that is still insufficient, epicanthoplasty restoration should be performed after 6 months.

Problems When There Is Insufficient Skin and Rabbit Eye Syndrome Occurs

If there is not enough skin, it may not be possible to reduce the line as much as desired, or rabbit eye syndrome may worsen.

If, after multiple revision surgeries or due to excessive skin removal during surgery, the eyes cannot close properly, they need to be corrected so that they can close again. However, if there is no tissue reserve, correction of rabbit eye syndrome is practically impossible.

The rabbit eye syndrome should be left as is, and only the thickness of the line should be adjusted.

Reducing a thick line when there is insufficient skin is a very difficult surgery that can only be done by maximally stretching and repositioning the tissue.

Candidates for Revision Double Eyelid Surgery

When the inner line is thicker than the outer line

The most ideal double eyelid line is one that naturally widens from the inner corner of the eye toward the outer corner.

However, if the inner line is wider than the outer line,

this is an abnormal shape and becomes a candidate for correction.

The causes include unnecessary epicanthoplasty, an incorrect design line, and excessive skin removal. The correction method involves creating a new design, smoothing the existing scar line, making the inner line as close as possible to an infold line, and correcting it so that the line naturally widens from the inner to the outer side.

http://www.doublefold.co.kr

Revision Double Eyelid Surgery Methods

Thick outfold line - revision to infold line

An outfold refers to a line where the inner line remains visible all the way to the end.

A thin outfold line may suit some people depending on the individual, but

in severe outfold cases, it causes an awkward eye shape,

so it should be corrected to an infold line.

The surgery to change an outfold line into an infold line is

the core of revision double eyelid surgery and the peak of the surgeon's skill.

If the inner line cannot be properly adjusted as desired,

the overall line becomes awkward, and it is difficult to achieve the desired result.

When there is no extra skin or the scar is severe,

changing an outfold line into an infold line is

the most difficult procedure among revision double eyelid surgery methods.

Causes of Outfolds

▷ When the double eyelid line is designed too high overall

▷ When the inner design line is set too high

▷ When unnecessary or excessive epicanthoplasty has been performed

▷ Excessive skin removal

Revision method for a thick outfold line - infold line

In most cases, it can be done with full incision.

It may also be possible with the buried suture method or partial incision method, but only when the adhesions are weak and the line has partially come undone.

When the adhesions are strong or the scar line is pronounced, correction with the buried suture or partial incision method is almost impossible.

The method involves, through a full incision, precisely dissecting between the orbital fat and the levator palpebrae superioris muscle, then repositioning the inner orbital fat and also dissecting and smoothing the inner scar line.

This is a procedure that requires highly advanced skill and extensive experience.

http://www.doublefold.co.kr

Examples of revision from a thick outfold line to an infold line

The reason revision surgery is difficult is that changing an outfold to an infold is the hardest part.

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

Please note that there are not many surgeons in Korea who can always deliver results that satisfy the patient after revision surgery.

Only by accurately understanding what went wrong in the first surgery and how it should be improved can a good result be achieved.

At our clinic, during consultation we perform various examinations and tests to predict the outcome after surgery, and we only proceed when there is a sufficient possibility of improvement after surgery.

The biggest key to revision surgery is the amount of extra skin, and the position and darkness of the scar line.

The goal is to restore a larger, more open eye shape and a natural double eyelid line.

After revision surgery, the double eyelid line becomes thinner and more natural.

Revision double eyelid surgery occupies a significant share of plastic surgery procedures.

Since double eyelid surgery (eye plastic surgery) is one of the most commonly performed procedures in plastic surgery, there is inevitably a high potential for various problems.

Because surgeries are performed not only by board-certified plastic surgeons but also by non-specialists, concerns about complications are bound to grow.

Sadly, these problems are also a matter of the medical system itself.

It is wrong to refer patients for treatment to someone who does not hold a specialist certificate,

and each specialty does not clearly have its own firm boundaries,

which is partly why other specialties overlap.

For example, double eyelid surgery is performed in ophthalmology,

and nasal augmentation surgery is performed in otolaryngology.

In principle, plastic surgery should be performed by plastic surgery specialists.

If plastic surgery is performed at a plastic surgery clinic by a board-certified plastic surgeon, complications from surgery will be much lower.

Because of the many cosmetic surgeries performed by unqualified doctors,

many victims continue to appear,

and patients who experience complications from cosmetic surgery lose trust in the first surgeon,

and are forced to seek another plastic surgeon to undergo corrective surgery, which is painful and distressing.

The first thing to consider is not the cost before getting cosmetic surgery,

but whether the doctor you plan to see holds a board certification in plastic surgery, and you should have the surgery only after confirming this.

Most people mistakenly assume that if a clinic has a plastic surgery signboard, the doctor is automatically a board-certified plastic surgeon,

and the number of people experiencing dissatisfaction or complications after surgery keeps increasing.

For people who need revision surgery, it is painful to correct an unattractive double eyelid again,

and from the specialist's perspective, it can sometimes also be difficult and disappointing.

Although it is the specialist's role to perform revision surgery, there are also times when the surgeon truly does not want to operate.

This is because the condition of the patient's eyes is sometimes so severe that it feels impossible to touch.

Rather than needing revision surgery, it is more important not to create a situation that requires revision surgery in the first place.