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Duhan Plastic Surgery Clinic · 두한성형외과 DUHANISM · March 9, 2020
Uneven double eyelids #unfolded double eyelids #tired-looking eyes #asymmetric double eyelids #double eyelid surgery #double eyelid surgery #double eyelid surgery #eye correction #...
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This page is an English translation of a Korean Naver Blog archive entry. For exact wording and source context, verify against the Korean archive original and the original Naver post.
Clinic: Duhan Plastic Surgery Clinic
Original post date: March 9, 2020
Translated at: April 25, 2026 at 8:32 AM
Medical note: This translation does not guarantee medical accuracy or suitability for treatment decisions.
Guide to double eyelid revision surgery
Double eyelid revision surgery refers to a procedure that corrects the double eyelid line and restores it to its original natural and clear shape when the line is too large, uneven, or has come loose.
Indications for double eyelid revision surgery
○ Double eyelid lines that are too large
○ Feeling tired-looking eyes after double eyelid surgery
○ When the overall impression looks worse after double eyelid surgery�a0
○ When the eyes look half-closed after double eyelid surgery
○ When the lines are asymmetric
○ When the line has loosened
○ When you want to restore beautiful, natural-looking eyes
Purpose of general double eyelid surgery
Double eyelid surgery is not simply performed to create a double eyelid line.
The purpose of double eyelid surgery is to make the eyes look larger and clearer and to create bright-looking eyes and a refined eye shape.
Surgery performed only to make a double eyelid line can easily lead to undesirable results.
The purpose of double eyelid revision surgery is the same.
It aims to correct the eye shape so that it becomes larger, clearer, and more natural.
Features of our clinic
① We have accumulated more than 20 years of extensive clinical experience and know-how in double eyelid revision surgery.
② We have a systematic system for double eyelid revision surgery.
③ Through preoperative consultations, we perform various examinations and tests to predict the postoperative result.
④ We perform surgery only when the tests indicate that there is sufficient room for improvement.
If we determine that the result the patient wants cannot be achieved, our rule is not to attempt surgery.
⑤ Through testing, we identify the problems with the previous surgery, provide sufficient and clear explanations, and suggest the best surgical method for the best outcome.
⑥ We explain the surgical process and recovery clearly so that patients fully understand them, and we do not omit explanations about possible side effects that may occur after surgery.
⑦ We provide thorough post-operative care.
We closely monitor the postoperative course and check whether recovery is proceeding properly.
⑧ We make our best efforts and continue our research so that patients who want double eyelid revision surgery can make our clinic the last hospital they need to visit.
Types of examinations and tests during double eyelid revision consultations
The most important test for determining whether double eyelid revision surgery is possible is the amount of excess skin.
Because double eyelid revision surgery must be performed after removing at least some of the scar tissue, excess skin is an important indicator for estimating the prognosis of the surgery.
If there is no excess skin, surgery may not be possible.
If surgery is performed excessively in a state where there is insufficient excess skin, the results will not be good, and lagophthalmos, in which the eyes cannot close properly, will worsen. Therefore, this is the most important test that must be done before revision surgery.
The second important test for revision surgery is the levator muscle function test.
In cases of severe ptosis, how much levator function remains is the key issue.
The levator muscle refers to the muscle that lifts the eyelid upward.
A certain level of function in this muscle is necessary to predict the success of revision surgery.
In patients with ptosis, if levator function is significantly reduced, surgery may not be possible.
As a rule, surgery should not be performed when levator function has fallen below a certain threshold.�a0
Other examination methods for double eyelid revision surgery
○ Measurement of eyelid skin thickness
○ Examination for the presence of eyelash ectropion
○ Examination of the scar and scar adhesion in the existing double eyelid line
○ Selection of the method that can produce excellent procedure effects and maximize satisfaction
○ Measurement of the height and symmetry of the existing double eyelid line (scar line)
○ Measurement of the amount and presence of orbital fat, and the thickness and presence of the orbicularis oculi muscle
○ Measurement of the degree of ptosis by measuring palpebral fissure height (the vertical size when looking straight ahead naturally at eye level)
○ Measurement of the horizontal eye length and the distance between the eyes (to determine the presence of epicanthal folds)
○ Measurement for strabismus
Surgical planning based on the above test results
① Setting the height and design shape of the new double eyelid line
② Setting the width of skin (scar) excision
③ Setting the width of levator muscle shortening
④ Determining whether orbicularis oculi muscle excision is needed
�a0
Based on the above test results, we predict the postoperative outcome and estimate the likelihood of surgical success.
We recommend surgery only when it is judged to be possible.
If surgery is not possible, we explain why it is not possible or explain how far surgery can realistically be performed.
In revision surgery,
sufficient clinical experience and
the surgeon's technical skill must be supported.
Revision surgery is performed at many clinics,
but in most cases the results are not very good.
�a0
Revision surgery requires a great deal of experience and accumulated know-how,
so it is not a surgery just anyone can perform.
�a0
In our country, the number of surgeons who can perform revision surgery
and consistently produce results that satisfy patients
is not very large, so please keep this in mind.
�a0
To understand exactly where and how the first surgery went wrong,
and how it should be improved,
is necessary to achieve good results.
�a0
If there is sufficient excess skin, revision surgery is fully possible.
The purpose of revision surgery is broadly divided into two goals.
Restoring a large, clear eye shape
and
restoring a natural double eyelid line.
Director Shin Duhan
�a0http://www.doublefold.co.kr�a0
Candidates for double eyelid revision surgery
Please check whether you may fall into any of the double eyelid revision candidates below.
Candidates for double eyelid revision surgery
When the line is too large
From a general standpoint, a double eyelid line that is only slightly visible is natural and attractive.
If the line is too thick, the eyes can look half-closed, and the other person may perceive the impression as strong and rough.
Causes include a line designed too high, scar adhesion, ptosis, or insufficient excess skin.
Correction involves relaxing or removing the existing high line and designing a new line at an appropriate height.
However, the height of the new line varies from person to person, and it is important to design it by considering factors such as excess skin and eye size, choosing the most natural height for that individual.
Candidates for double eyelid revision surgery
When the eyes look half-closed
If the eyes do not open naturally after double eyelid surgery and look half-closed, they should be corrected so that they open naturally and clearly again.
A half-closed-looking expression can easily leave a bad impression on anyone.
Causes include congenital ptosis, pseudoptosis, and scar adhesion.
For correction, in cases of ptosis, the most common surgical method is to correct it by performing levator shortening or resection.
Candidates for double eyelid revision surgery
When the lines are uneven
Everyone has a little asymmetry, but noticeable asymmetry should be corrected.
Causes include incorrect design, loosening of the line, scar adhesion, or ptosis on one side.
For correction, if the double eyelid lines are uneven on both sides, the double eyelid surgery must be redone to match the desired side.
However, if revision surgery is performed on only one side, the eyes will not be perfectly symmetrical immediately after surgery. Even with a properly performed operation, it takes at least 1 to 2 months to observe the correction of the asymmetry, so careful decision-making is necessary when operating on only one side.
Candidates for double eyelid revision surgery
When the incision scar is too severe
If the scar is very visible when the eyes are closed after incision-based double eyelid surgery, it should also be corrected with the incision method so that almost no scar remains.
Causes include improper suturing of the incision line, removal of stitches too early, which widens the scar gap, removal of stitches too late, which leaves stitch marks, and individual constitutional differences.
For correction, the existing scar should be excised and the muscle and skin should each be sutured in a single layer, with very precise suturing so they do not become misaligned.
The timing of stitch removal is also important, and it should be removed at an appropriate time so that it does not affect the scar.
Candidates for double eyelid revision surgery
When the double eyelid line has loosened
After surgery, the appearance may be good at first, but over time the width of the line may narrow or loosen again. This often happens after buried-suture methods, with the line gradually loosening and descending.
Causes include performing a buried-suture method on thick skin, an incorrect double eyelid surgical technique, a large amount of fat, naturally thick skin or orbicularis oculi muscle, or factors that make line adhesion less likely in that person.
For correction, depending on the patient's eye condition, the line is corrected through incision or partial incision methods so that it does not loosen again and becomes a clear line.
Candidates for double eyelid revision surgery
When the line is deformed due to scar adhesion
After a previous double eyelid surgery, the scar above the incision line may adhere and create another line above the original line, resulting in a double line.
The appearance of another line above the incision line means the previous surgical method was incorrect, so it is a candidate for correction.
Causes include not performing orbital fat repositioning, atrophy of orbital fat, or excessive fat removal.
For correction, in such cases the adhered incision line must be released and made into a single line.
In all double eyelid surgeries, the position of the incision line should become the double eyelid line.
Candidates for double eyelid revision surgery
When there are triple double eyelids
This refers to a case where another line appears in addition to the existing incision line.
It may appear below the incision line or above it.
Causes include scar adhesion, sagging skin, sunken eyelids, and loosening of the line.
The correction method varies depending on the cause, but other lines except for the reference incision line should be excised and corrected.
Candidates for double eyelid revision surgery
When the outer line is thicker than the inner line
Ideally, the double eyelid line should naturally become wider from the inner eye toward the outer eye.
However, if the inner line is wider than the outer line, this is an abnormal shape and should be corrected.
Causes include unnecessary epicanthoplasty, incorrect design, and excessive skin excision.
For correction, a new design should be made to relax the existing scar line, make the inner line as close as possible to an in-fold line, and correct the line so that it widens naturally from the inner side to the outer side.
Unattractive double eyelids
These are the general types of unattractive double eyelids.
Do you perhaps have any of the unattractive double eyelids below?
Please check whether any of the following applies to you.
Unattractive double eyelid No. 1
When the double eyelid line is too thick
In almost no case does a large double eyelid line suit the face.
A natural line is appropriate when it is only slightly visible while the eyes are open.
A large line is a representative example of an unattractive double eyelid and is one of the most common indications for revision surgery.
Unattractive double eyelid No. 2
When the area below the line looks swollen, as if puffed up (sausage phenomenon)
This is the swelling that appears beneath the double eyelid line, commonly called the sausage phenomenon.
It gives the impression that the surgery was done only a few days ago and can make the viewer feel uncomfortable.
Causes of the sausage phenomenon include thick skin and orbicularis oculi muscle, a line designed too high, or partial loosening of the line.
Correction is done by partially excising the orbicularis oculi muscle and then pulling the skin to correct it.
Unattractive double eyelid No. 3
When the double eyelid scar line is clearly visible
This is when, after double eyelid surgery, if you slightly lower your gaze, the incision mark is so visible that it looks as if the eyelid has been cut with a knife.
Causes include constitutional factors, but also improper suturing and poor timing in choosing when to remove the stitches.
It should be corrected by excising the scar and suturing it precisely, in line with scar correction procedures.
Unattractive double eyelid No. 4
When there are epicanthal folds
There are cases where the double eyelid line does not continue all the way and disappears in the middle.
If the inner double eyelid line disappears, it can give a slightly cramped impression.
Epicanthoplasty is also called inner corner surgery. When double eyelid surgery and epicanthoplasty are performed together to create the double eyelid, the line can continue all the way through and create a natural line.
Unattractive double eyelid No. 5
When there are wrinkles below the line
If there are multiple lines below the double eyelid line, the double eyelid line looks messy.
A beautiful line should be small and made clearly into a single line, but if there are many fine wrinkles in addition to the double eyelid line, the eye shape can look older and the overall impression can look worse.
In such cases, correction can be done with a partial incision method, or if that is not feasible, with a full incision method that removes a certain amount of skin.
Unattractive double eyelid No. 6
When the double eyelid line is not clear and looks blurry
A double eyelid line should be fairly clear to be attractive.
When the line loosens and becomes blurry, it looks like a wrinkle rather than a refined line, which gives a bad impression.
In such cases, it needs to be changed back to a clear line.
Unattractive double eyelid No. 7
When the line is too deep and too dark
It also looks awkward if the double eyelid line appears too deep or too dark.
Causes include sagging skin and sunken areas around the incision line.
The line should be clear, but a double eyelid line that looks too deep also falls under unattractive double eyelids.
Unattractive double eyelid No. 8
When there is an excessive outfold line that extends beyond the inner corner of the eye
An excessive outfold double eyelid line often feels artificial and awkward.
An in-fold line that disappears in the middle because of epicanthal folds is also awkward, but an outfold line that extends past the inner corner of the eye is also awkward and creates a strong impression, so it falls under unattractive double eyelids.
Unattractive double eyelid No. 9
When the double eyelid line is not smooth and has irregular curves
A beautiful double eyelid is one in which the line curves smoothly.
The ideal line is one where the inner part is small and becomes wider toward the outer side without irregularities.
However, a wavy line in which the inner line is wide, becomes smaller in the middle, and then widens again at the outer side is one of the awkward line types.
Unattractive double eyelid No. 10
When the eyelid is sunken beneath the double eyelid line
If there is a sunken area above the double eyelid line, the face can look older, or the line may become larger or deformed and look awkward.
Sunken eyelids are a major cause of double eyelid deformation, so the sunken area should be corrected with microfat grafting.
Unattractive double eyelid No. 11
When the double eyelid line has unnecessary epicanthoplasty
Unnecessary epicanthoplasty can cause various problems.
Epicanthoplasty should only be performed when truly needed for eyes with epicanthal folds, and unnecessary or excessive epicanthoplasty can cause side effects such as excessive exposure of the inner mucosa, a severe outfold line, eyes that appear too close together, or a harsh-looking gaze.
Unnecessary epicanthoplasty often makes the impression look worse, so caution is needed.
Unattractive double eyelid No. 13
When the double eyelid line has canthoplasty
This falls under surgeries that should never be performed in cosmetic surgery.
It is even stated in plastic surgery textbooks that it is better not to do this procedure.
Canthoplasty is a procedure that can cause various side effects such as mucosal exposure, eyelid ectropion, a harsh eye shape, and severe scarring.
The rate of side effects from canthoplasty is over 90%, and since it can create irreversible and severe side effects, caution is necessary.
Canthoplasty surgery
Recently, complaints about side effects from canthoplasty performed at other clinics have become frequent.
Canthoplasty refers to a procedure that opens the outer corner of the eye, unlike epicanthoplasty.
Types of canthoplasty side effects
○ Eyelid ectropion and lifting of the eyelid
○ Distorted scars at the outer corner of the eye
○ Mucosal exposure and eyelid sagging
○ Excessive exposure of the lower white of the eye
○ Deformation of the eye shape and twisting of the outer canthus
○ Dry eye syndrome and tearing
Examples of canthoplasty side-effect correction surgery performed at other clinics
Canthoplasty should be performed only on eyes that can benefit from the procedure, and it must be done safely by an experienced, skilled specialist to avoid problems.
How Duhan Plastic Surgery performs canthoplasty restoration surgery
�a0
Based on more than 20 years of extensive clinical experience and know-how,
when the outer corner of the eye is lifted,
and the horizontal length of the eye is short,
performing both canthoplasty and lower canthoplasty together can
change the eyes to look larger and gentler.
However, in the case of outer-lower canthoplasty, depending on the shape and structure of the eye shape and eyeball,
there are eyes that show a great effect and eyes that do not.
�a0
In the case of outer-lower canthoplasty, the adhesions are sufficiently removed through skin dissection,
so they do not reattach, and the surgery delicately sutures from the inner conjunctiva of the eye to the ligament-fascia layer,
the muscle layer, and the skin layer according to the anatomical structure.
This surgical method compensates for the drawback of the previous canthoplasty,
which was that it reattached.
Because the skin and mucosa are sutured separately, it does not form a D-shape,
and there is no concern that it will reattach.
�a0
Also, unlike other clinics,
it is not performed with skin incision alone,
and by firmly fixing it to the periosteum, it does not loosen and is a safe surgery that can also be restored later.
�a0
The sutured area is naturally concealed along the eye-corner line,
minimizing visible scarring, and due to years of know-how in double eyelid revision surgery,
the delicate and precise suturing leaves almost no scar.
�a0
Through many surgeries, we have increased patient safety and satisfaction.
Our clinic does not perform surgery that makes every eye look the same.
With one-on-one customized design, we tailor the design to the patient's eyes,
creating a natural eye shape that harmonizes with the existing double eyelid line.
Director Shin Duhan
Beautiful double eyelids
The content below is the general standard for beautiful double eyelids.
Beautiful double eyelid No. 1.
The double eyelid line should be almost invisible.
A natural and beautiful double eyelid is one that is barely visible or only slightly visible when the eyes are open and looking naturally forward.
Many people mistakenly believe that if double eyelid surgery is done, the eyelids should be large and clearly visible when the eyes are open for it to be considered successful.
If a large and distinct line appears when the eyes are open, it is often a sign of an incorrect double eyelid.
A beautiful eye shape is better than simply a pretty eye shape.
That means a mood-filled eye shape is more beautiful than just an attractive eye shape.
If, when you look in the mirror, the double eyelid line is slightly visible or almost invisible, you can consider it a very successful double eyelid.
In such cases, the line becomes visible when you lower your gaze slightly, creating a more atmospheric eye.
Beautiful double eyelid No. 2
The eyes should open widely.
There are cases where the double eyelid line is large but the eyes do not open well.
In such cases, the result should be considered unsatisfactory.
The eyes should open large, bright, and clearly to create a more atmospheric and beautiful eye shape.
If you look at your eyes in the mirror, you can tell by checking whether almost all of the dark iris is visible or only part of it is visible because it is covered by the eyelids.
The most natural eye shape is when the eyelids cover only a small portion of the dark iris, and when looking straight ahead, there should be no impression of sleepiness or fatigue.
Beautiful double eyelid No. 3
There should be no epicanthal folds.
There are also double eyelids in which, because of epicanthal folds (inner canthal skin folds), even after double eyelid surgery only the outer part of the line is visible and the line disappears from the inner corner of the eye.
In such cases, if necessary, it is better to perform epicanthoplasty so that the line appears all the way to the inner side.
However, epicanthoplasty should be performed only when truly necessary.
If the distance between the eyes exceeds 40 mm, it is judged that epicanthal folds are present, and if the patient wants it, epicanthoplasty (inner corner surgery) is performed.
However, if possible, it is better not to perform epicanthoplasty when the distance between the eyes is under 40 mm.
If surgery is performed below 40 mm, the distance between the eyes may become narrower, causing the eyes to appear too close together, and in some cases a side effect may occur in which the inner line becomes wider than the outer line.
Beautiful double eyelid No. 4
If the eyebrows are slightly lifted upward, the eyes become much more attractive.
After double eyelid surgery, if the lashes are slightly lifted upward, the result looks more beautiful.
Sometimes the eyebrows remain sagging after double eyelid surgery, but compared with that, if the eyebrows are also slightly lifted, the result looks more beautiful. So while performing double eyelid surgery, it is better to slightly adjust the direction of the eyebrows as well.
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