[Under-Eye Surgery Duhan Plastic Surgery] - [Dark Circle Combo Program]

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What is the Dark Circle Combo Program?!

At the same time as dark circle surgery,

aegyosal, fat grafting, Indian band,

outer-corner Botox, lifting, age spot laser, and more

can be performed together

through simultaneous procedures

to create a fresher eye area.

Director Shin Duhan

Dark Circle + Aegyosal Combo Program

This is a recommended program at Duhan Dark Circle Clinic that combines dark circle removal with an aegyosal procedure that adds volume under the eyes to create a brighter eye area.

1. What is the aegyosal procedure?

Aegyosal is a colloquial term, and it refers to a procedure that creates a slightly fuller image just below the lower eyelashes in order to emphasize an eye area that looks flat and less attractive, making it appear more refined.

Even when dark circles are located just below the eyelashes, aegyosal can help make them look less noticeable.

An eye area that is flat and lacks charm can be made more attractive by creating aegyosal.

2. What is the relationship between aegyosal and dark circles?

When dark circles are distributed under the eyelashes, fat can be placed to create aegyosal in that area. During this process, the dark skin expands and yellow fat fills in, which helps soften the appearance of dark circles.

Aegyosal is also created, changing the eye area to a more appealing look.

However, if aegyosal is created in an eye area where the under-eye area is already sunken, shadowing can become more noticeable below the aegyosal and make the under-eye area look darker, so only suitable patients are carefully selected after an accurate examination.

If the aegyosal procedure makes dark circles worse, it can lead to a result that is worse than doing nothing at all, so the decision should be made carefully under a specialist’s judgment.

3. Creating aegyosal with fat grafting

One of the best methods for creating aegyosal is fat grafting.

The reason is that the natural skin tone is reflected, so the color itself looks natural and not awkward.

Therefore, it helps improve dark circles while also producing a natural shape.

① Based on a precisely diagnosed surgical plan, the design is made while considering the degree of the Indian band hollowing and the bone structure.

Before the procedure, the area where fat will be grafted is marked.

It is usually grafted just below the eyelashes.

② Under sleep anesthesia, local anesthesia is administered to the donor site.

• Under sleep anesthesia, local anesthesia is given to both the treatment site and the donor site.

③ Fat is collected from areas where a lot of fat has accumulated.

• Because local anesthesia (sleep pain-free anesthesia) is used, there is almost no pain.

• A fine liposuction cannula is used to collect the fat into a syringe.

④ The harvested fat is centrifuged to remove impurities (anesthetic, oil, blood, etc.), then transferred into a 1cc syringe.

The impurities include blood, serum, anesthetic, oil, and water, while the components purified by centrifugation are mainly blood, anesthetic, and water.

Oil and other components are removed through a two-step natural absorption method before being transferred into a 1cc syringe.

A quick note

The needles used for 1cc syringes are fitted with the clinic’s in-house developed microneedles (micro grafting cannulas).

Microneedles are special grafting cannulas used only by this clinic, enabling ultra-precise grafting.

⑤ Under local anesthesia, fat is grafted under the eyes.

• The needle enters from the outer side of the eye as the fat is grafted.

• The amount of fat grafted is adjusted according to the individual’s characteristics.

⑥ Procedure completed, return to daily life

Bruising and swelling may occur, but daily life is possible after makeup, and concentrated autologous fat increases skin elasticity and improves durability.

4. How is care handled after the aegyosal procedure?

Aegyosal is one of the under-eye fat grafting areas where bruising occurs most easily, so bruise management is necessary.

① Starting the day after the procedure, the bruised area should be well covered with skin-tone cosmetics.

② Daily life is possible from the day after the procedure, and if swelling does not go down well after about a week, it is helpful to receive an injection to reduce swelling.

③ Four days after the procedure, it is fine to go to a sauna or jjimjilbang and sweat.

5. Other ways to create aegyosal

① Filler products (Restylane, Juvederm, Aquamid, Artecoll)

There are many different types of commercially available filler products.

Most were developed to improve fine wrinkles, so if used for that purpose, they are generally not a problem.

However, they are not suitable for large-volume use.

Also, some products can cause inflammation and may even lead to serious side effects.

Because almost all filler products are colorless and transparent, using them to create aegyosal can cause the under-eye area to look swollen and transparent, almost like a blister, which often contrasts awkwardly with the surrounding skin tone.

They are not a recommended method because of the risk of side effects and the unnatural color appearance when trying to create under-eye contours.

② A method using fat repositioning

Some clinics recommend creating aegyosal through fat repositioning.

It is not possible to create a satisfying aegyosal with fat repositioning.

Aegyosal should protrude smoothly just below the eyelashes, but orbital fat cannot be forcibly pushed toward the lashes to create a natural aegyosal contour.

In most cases, the aegyosal shape is barely formed, or the protrusion appears not directly under the lashes but below that, making the shape look awkward.

Caution is needed when attempting to create aegyosal with fat repositioning.

③ A method using Alloderm (acellular dermal matrix)

There are cases where solid artificial dermis such as Alloderm or SureDerm is used to create aegyosal, but this requires cutting the skin, leaves scars, and may fail to produce a natural shape, instead creating an artificial appearance, so it is not a recommended method.

In the case of liquid Alloderm, the cost is high and the absorption rate is high, so results are often insufficient when a pronounced projection is desired.

Examples of under-eye aegyosal micro fat grafting

Dark Circle + Upper-Eye Fat Grafting Combo Program

This is a program that gives volume to sunken or wrinkled upper-eye areas with Colpet fat grafting at the same time as dark circle removal, creating a more three-dimensional eye area.

1. What is upper eyelid hollowing (sunken eyelids)?

Upper-eyelid micro fat grafting is a procedure applied when the eyelids are sunken and make you look tired or older. In addition to aesthetically restoring sunken eyelids, it also helps functionally by making it easier to open the eyes.

2. What are the indications for upper eyelid hollowing (sunken eyelids) micro fat grafting?

① When the upper eyelids are sunken, fat grafting lifts the eye area and creates a natural look.
② It has the effect of making eyes that appear bulging like a goldfish look relatively more recessed.
③ If the double eyelids are too large, it can make the double-eyelid line descend naturally and reduce the width of the crease.
④ Sunken eyes caused by lack of fat can make opening the eyes uncomfortable and tiring. This tired feeling can be improved with fat grafting.

3. What is the role of orbital fat?

① It gives the eyelid contour volume and softness.

② It protects the eyeball from external impact.

③ It acts as a lubricant so that the levator palpebrae superioris muscle (the eyelid-lifting muscle) can move smoothly.

4. What effects are obtained with upper-eyelid micro fat grafting?

■ Aesthetic aspect - restoring sunken areas for a softer and younger-looking eye area

■ Functional aspect - easing the movement of the levator palpebrae superioris muscle that opens the eyes, thereby reducing eyelid fatigue

5. Where is upper-eyelid micro fat grafting performed?

The goal of upper-eyelid fat grafting must satisfy both aesthetic and functional purposes.

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

The most accurate location for fat grafting is where orbital fat is located, and the newly grafted fat should blend with the existing fat in this area for a good result.

However, if grafting is done incorrectly into the orbicularis muscle layer, the eyelids can become uneven and heavier, causing greater discomfort when opening the eyes.

Therefore, upper-eyelid fat grafting must be performed precisely with accurate anatomical knowledge in order to achieve the desired result.

6. What is the procedure for upper-eyelid micro fat grafting?

① Based on a precisely diagnosed surgical plan, the design is made while considering the degree of under-eye hollowing and even the bone structure surrounding the eyeball.

Upper-eye micro fat grafting is not simply fat grafting; the surgery is performed while considering the degree of upper-eye hollowing and the bone structure surrounding the eyeball.

The preoperative design determines the amount of fat to be grafted and the width of the grafting area based on comprehensively analyzed data.

② Fat is collected from areas where a lot of fat has accumulated, such as the lower abdomen, waist, or thighs.

• Because local anesthesia (sleep pain-free anesthesia) is used, there is almost no pain.

• A fine liposuction cannula is used to collect the fat into a syringe.

In the upper-eye area, large amounts of fat are not needed, so the lower abdomen is usually the donor site.

Fat is harvested gently with a syringe and a fine suction cannula to collect living fat cells.

When a larger cannula is used, the fat is suctioned more roughly, which makes precise grafting difficult, so it is better to use a fine cannula.

During suction, the fat is collected broadly across a wide area to avoid contour irregularities in the abdomen.

③ The harvested fat is centrifuged to remove impurities (anesthetic, oil, blood, etc.), then transferred into a 1cc syringe.

The impurities include blood, serum, anesthetic, oil, and water, while the components purified by centrifugation are mainly blood, anesthetic, and water.

Oil and other components are removed through a two-step natural absorption method before being transferred into a 1cc syringe.

A quick note

The needles used for 1cc syringes are fitted with the clinic’s in-house developed microneedles (micro grafting cannulas).

Microneedles are special grafting cannulas used only by this clinic, enabling ultra-precise grafting.

④ The micro fat grafting cannula is inserted along the predesigned line on the upper eye area and the fat is grafted.

The amount grafted into the upper eye area varies by individual, and an appropriate amount is grafted.

It is accurately placed into the orbital fat layer, creating a soft contour and a high survival rate.

Fat that has had almost all of the oil removed is called concentrated fat. The concentrated fat is transferred into a 1cc syringe and fitted with the clinic’s in-house developed microneedles (micro grafting cannulas).

Microneedles are special grafting cannulas used only by this clinic, enabling ultra-precise grafting.

The procedure is injected into the locally anesthetized treatment area, and the injection is performed evenly and precisely into the designed area using the clinic’s in-house developed ultra-precise microneedles.

Distributed grafting of an appropriate amount of fat without clumping is important for fat survival and the expression of a smooth contour.

⑤ After grafting, normal daily life is possible immediately, and washing the face is possible from the next day.

Duhan Plastic Surgery’s Colpet fat grafting causes almost no swelling, so return to daily life is possible. Concentrated autologous fat increases skin elasticity and improves durability.

7. How many sessions are needed for upper-eyelid micro fat grafting?

Eyelid fat grafting has a relatively high survival rate compared with other areas.

A satisfactory effect can usually be achieved with one session, or at most two sessions.

The interval between sessions is 3 to 10 months, and for repeat treatment, the fat that was harvested at the time of the first grafting is thawed and used.

However, if a patient is satisfied after one session, a second procedure is not always necessary.

Because the survival rate of fat varies by individual, the decision on a second procedure should be made after at least 3 months.

8. How long does upper-eyelid micro fat grafting last?

After fat grafting, the volume decreases as some of the fat is absorbed over a period of 3 to as long as 6 months.

If the fat then fully survives and no further absorption occurs, the remaining fat stays permanently.

The surviving fat does not melt away on its own.

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

Therefore, the surviving fat remains as your own tissue for life.

9. What are fat survival and the survival rate in 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, while 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% may remain after several months.

Fat survival is higher in areas with better blood circulation, and the area around the eyes has the best blood circulation on the face, so fat grafting in this area has a higher survival rate than in other areas.

Therefore, around the eyes, a permanent effect can be obtained with just one procedure.

However, because repeat procedures are sometimes needed, it is better to think of fat grafting as something done about twice.

10. What are the side effects of fat grafting?

The side effects are only mild swelling and bruising.

Aside from that, there are essentially no other side effects.

Because the procedure uses autologous fat rather than a foreign substance, there is no immune rejection or inflammation.

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

Some people experience side effects after procedures done at clinics with insufficient fat-grafting experience, but that is an issue related to the operator’s skill.

If grafting is done into the orbicularis muscle layer rather than the orbital fat layer, the eyelids can become heavy and uneven; if too much is injected, the eyelids can become excessively swollen and daily life may become difficult; if overinjection causes ptosis where the eyes do not open well; or if the fat is absorbed and the effect is minimal, various problems can arise.

Results differ from clinic to clinic, so it is better not to receive the procedure from someone without fat-grafting experience or from a non-specialist in plastic surgery.

Examples of upper eyelid hollowing (sunken eyelid) fat grafting

Dark Circle + Indian Band Combo Program

This is a program that removes dark circles at the same time as removing the sunken wrinkle line that crosses the front cheek, called the Indian band.

1. What is the Indian band - front cheek wrinkle?

An Indian band refers to a sunken wrinkle line that runs across the front cheek.

It is also called a front-cheek wrinkle, and the cause is mostly congenital, with the wrinkle line sometimes being noticeable at a young age.

If the wrinkle line is present, it makes you look older and gives a less favorable impression, so the wrinkle line should be corrected.

2. What is the relationship between the Indian band and dark circles?

The Indian band creates another wrinkle line below the under-eye sunken wrinkle line, making the face look older and worsening the darkness under the eyes.

When dark circles and the Indian band are present together, both should be treated at the same time for effective correction of dark circles.

3. What causes the Indian band?

① It occurs at the boundary with fuller cheek flesh because the skin under the eyes is very thin

② Relative indentation of the fat contour line caused by protruding orbital fat

③ A constitutional occurrence without sagging skin

④ Sagging skin due to aging

4. What are the surgical methods for correcting the Indian band?

① Under-eye micro fat grafting

② Removal of orbital fat under the eyes

③ After removing orbital fat, serial fat grafting into the wrinkle line

④ Lower blepharoplasty to cut and tighten the skin

5. What is the micro fat grafting procedure for the Indian band?

① Based on a precisely diagnosed surgical plan, the design is made while considering the degree of Indian band hollowing and the bone structure.

The surgery for the Indian band is performed while considering the degree of hollowing and the bone structure.

The preoperative design determines the amount of fat to be grafted and the width of the grafting area based on comprehensively analyzed data.

② Fat is collected from areas where a lot of fat has accumulated, such as the lower abdomen, waist, or thighs.

• Because local anesthesia (sleep pain-free anesthesia) is used, there is almost no pain.

• A fine liposuction cannula is used to collect the fat into a syringe.

In the case of the Indian band, large amounts of fat are not needed, so the lower abdomen is usually the donor site.

Fat is harvested gently with a syringe and a fine suction cannula to collect living fat cells.

When a larger cannula is used, the fat is suctioned more roughly, which makes precise grafting difficult, so it is better to use a fine cannula.

During suction, the fat is collected broadly across a wide area.

③ The harvested fat is centrifuged to remove impurities (anesthetic, oil, blood, etc.), then transferred into a 1cc syringe.

The impurities include blood, serum, anesthetic, oil, and water, while the components purified by centrifugation are mainly blood, anesthetic, and water.

Oil and other components are removed through a two-step natural absorption method before being transferred into a 1cc syringe.

A quick note

The needles used for 1cc syringes are fitted with the clinic’s in-house developed microneedles (micro grafting cannulas).

Microneedles are special grafting cannulas used only by this clinic, enabling ultra-precise grafting.

④ The micro fat grafting cannula is inserted along the predesigned line of the Indian band and the fat is grafted.

The amount grafted into the Indian band varies by individual, and an appropriate amount is grafted.

It is accurately placed into the correct location, creating a smooth contour and a high survival rate.

Fat that has had almost all of the oil removed is called concentrated fat.

The concentrated fat is transferred into a 1cc syringe and fitted with the clinic’s in-house developed microneedles (micro grafting cannulas).

Microneedles are special grafting cannulas used only by this clinic, enabling ultra-precise grafting.

The procedure is injected into the under-eye treatment area under local anesthesia, and the injection is performed evenly and precisely into the designed area using the clinic’s in-house developed ultra-precise microneedles.

Distributed grafting of an appropriate amount of fat without clumping is important for fat survival and the expression of a smooth contour.

⑤ After grafting, normal daily life is possible immediately, and washing the face is possible from the next day.

Duhan Plastic Surgery’s Colpet fat grafting causes almost no swelling, so return to daily life is possible. Concentrated autologous fat increases skin elasticity and improves durability.

Examples of Indian band + dark circle micro fat grafting

Examples of Indian band micro fat grafting

6. What other treatment methods are there for correcting the Indian band?

① A method using orbital fat removal

This is applied when there is relative indentation of the fat contour line caused by protruding orbital fat.

Considering the degree of protrusion, it is important to determine whether fat removal is effective or whether fat should be grafted into the wrinkle line beneath the fat.

This judgment should be made while considering the operator’s experience and the eye shape desired by the patient. If fat is removed when the protrusion is not severe, the wrinkle may become less noticeable, but the entire under-eye area may appear sunken, so the decision must be made carefully.

② Lower blepharoplasty

Lower blepharoplasty is a surgical method that improves sunken wrinkles by pulling the under-eye skin upward, removing the excess skin, and suturing it when wrinkles occur due to sagging under-eye skin.

If the sagging of the under-eye skin is so severe that the nasolabial area below the eyes cannot be corrected even with fat grafting or fat removal, lower blepharoplasty can be used for correction.

If fat is removed while the skin is sagging, the correction is often poor and the wrinkles often increase.

Also, because fat grafting may make only the under-eye area look more bulging, lower blepharoplasty is necessary in most older patients with sagging skin.

③ A procedure using fillers

Fillers (Restylane, Aquamid, Artecoll, etc.) were mainly developed to correct fine wrinkles around the eyes and are not suitable for contour correction of the face.

There are cases where fillers such as Restylane or Aquamid are used to fill in hollow areas, but this can create an uneven under-eye appearance and may cause the skin to look pale rather than returning to its natural skin tone, so it is not a recommended treatment.

There is also a relatively high chance of causing inflammation, so the procedure requires careful attention.

Because the under-eye area requires precision and must not develop side effects, injecting foreign substances is not desirable.

④ A method of performing orbital fat removal and fat grafting in sequence

Even after orbital fat removal, wrinkles may become less noticeable or remain.

In such cases, additional fat grafting must be performed along the wrinkle line.

This means finishing the wrinkle line that was not completely removed by fat removal with fat grafting.

It is usually performed about one month after fat removal.

Before treatment, it is common to plan in advance for the possibility that fat grafting may also be needed if fat removal alone is expected to be insufficient.

Whether fat grafting will be needed is determined by the operator’s experience. Before the procedure, both fat removal and fat grafting may be planned, but if, by good luck, fat removal alone eliminates the wrinkles, then fat grafting is not performed.

Sometimes other clinics recommend performing fat removal and fat grafting at the same time, but these should absolutely not be done simultaneously.

The reason is to first see the result of fat removal, then design precisely according to that result and adjust the amount of grafting based on the degree of hollowing.

However, if fat grafting is done immediately without knowing how much and where the area will settle after fat removal, the grafting cannot be done properly.

It is the same as roughly coloring in a sketch before you know what the outline will look like.

In under-eye procedures that require such precision, this is against the principles of the procedure and should be kept in mind.

In some cases, fat removal alone can provide a satisfactory result, which is another reason why fat grafting should not be done at the same time.

Dark Circle + Outer-Corner Botox Combo Program

This is a program that solves wrinkles around the outer corners of the eyes with a simple Botox procedure at the same time as dark circle removal.

1. What is outer-corner Botox?

Injecting a small amount of Botox into the outer corner area blocks the nerve signals that control muscle movement, allowing wrinkles to be removed safely without affecting other muscles.

Botox is a brand name, and the ingredient is a type of neurotoxin produced by the anaerobic bacterium Clostridium botulinum, which also causes spoilage in canned food.

When this neurotoxin acts on the human body, it blocks acetylcholine, a secreted substance at the nerve endings, and has the effect of paralyzing muscles.

2. What is the history of Botox use?

Botox was first used in ophthalmology in the 1970s to treat strabismus, and from the late 1980s it began to be used for wrinkle correction, including blepharospasm. More recently, it has also been used for localized hyperhidrosis (a condition of excessive sweating) in parts of the body.

It has been used for nearly 30 years, so side effects from the drug itself can be considered minimal.

By applying this muscle-paralyzing effect, it has recently drawn attention for wrinkle removal.

Botulinum toxin type A (brand names: Botox, Dysport) is used.

3. How is the outer-corner Botox procedure performed?

The commercialized botulinum toxin is diluted and injected into the area where wrinkles are to be removed.

There is almost no pain during the procedure, the effect appears in 2 to 3 days, and there is no problem with daily life immediately afterward.

However, the drawback is that after 3 to 4 months, muscle strength gradually begins to return, and after about 6 months the effect of the medication disappears completely.

If desired, the procedure can be repeated at that time.

The design marks the areas where Botox is needed for the procedure.

① The outer-corner area is disinfected, and the areas to be corrected are marked with a design pen.

② The Botox is placed into a syringe.

③ Botulinum toxin is injected along the marked areas. Usually, 0.5cc is injected at each marked site.

④ You can immediately put on makeup, go home, and continue daily life.

Outer-corner wrinkles are removed with the Botox procedure.

4. What anesthesia method and procedure time are used?

Botox is performed without separate anesthesia.

A topical anesthetic cream (EMLA) may be applied, but it is generally considered to have little effect.

Because topical anesthetic cream only numbs the surface layer of the skin, it has almost no anesthetic effect for Botox procedures, which require deeper injections.

Local injection anesthesia is painful when the needle pierces the skin, so pain is also caused during the anesthesia process.

It is less painful to receive the Botox injection directly without anesthesia.

Because Botox procedures use the thinnest 30-gauge needle, there is not much pain other than a slight sting, so there is no need to worry too much about pain.

The procedure time is very short, about 1 to 2 minutes per area.

5. What are the side effects of Botox procedures?

① If injected into too many areas, especially under the eyes and around the mouth, facial expressions can become stiff.

② If Botox is injected under the eyes in cases of senile lower eyelid ptosis, ectropion can occur.

③ When injected into the forehead or between the eyebrows, ptosis may occur, causing the eyelids to droop.

④ Around the eyes, there are many blood vessels, so bruising can occur after injection.

⑤ If Botox is administered repeatedly on a regular basis, antibodies against Botox may form in the body, and the lasting effect of wrinkle correction may gradually decrease.

6. How can the side effects of Botox procedures be prevented?

It is best to receive treatment from a specialist with abundant procedural experience.

Even if an unwanted result occurs from Botox, once the effect wears off the condition returns to what it was before the injection, so permanent side effects are rare.

7. Is Botox effective for all wrinkles?

Botox works by paralyzing the facial expression muscles so they cannot form wrinkles, so it is effective for wrinkles that appear when making facial expressions.

However, it is not very effective for deep wrinkles that remain even when the face is at rest.

For wrinkle correction in this resting state, hyaluronic acid preparations such as DermaLive or Restylane are used.

Dark Circle + Lifting Combo Program

This is a program that removes dark circles and simultaneously lifts aged, sagging skin to remove wrinkles and restore volume.

1. What is Endotine lifting?

It is a procedure that is mainly effective for sagging facial skin and deep expression wrinkles.

As people age into their 30s and 40s, skin aging accelerates, the eyelids sag, and wrinkles form on the forehead.

Wrinkles make a person look tired and lacking energy, and the glabellar wrinkles make the person look angry, giving an unattractive impression.

Deep forehead wrinkles make the face look stuffy and older.

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

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

The Endotine fixation plate is made of absorbable material and has 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 safe procedure compared with others.

Endotine received FDA approval in 2003, so its safety has already been verified, and it is currently gaining great popularity, especially in the United States.

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

2. What are the indications for Endotine lifting?

3. What are the advantages of Endotine lifting?

① It is safe.

It is performed under sleep anesthesia, so there is less concern about pain.

A small incision in the scalp and the use of an endoscope leave almost no visible scar.

② It is simple.

It is a relatively simple surgery, with minimal scarring.

It has the advantage of a fast recovery period.

Because recovery is fast, the return to daily life is also fast.

③ The effect is lasting and good.

Because the procedure is distributed across multiple areas, the effect is better than existing surgical methods.

The fixation plate is absorbed into the skin, and its effect lasts.

4. What types of Endotine are used for lifting?

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

5. Endotine lifting for improving sagging cheeks

6. What is the endoscopic Endotine lifting surgery method for improving sagging cheeks?

① The design is made according to a precisely diagnosed surgical plan.

The incision area is designed, and the insertion position and length of the Endotine are measured.

Sleep anesthesia and local anesthesia are used.

Because sleep anesthesia is combined, there is no pain at all.

② After the temporal incision, dissection is performed above the muscle.

Because the incision is small and located in the scalp, there is no scarring or hair loss.

After the incision, blunt scissors are used to dissect above the fascia without bleeding.

③ After confirmation with the endoscope, the Endotine is inserted.

After dissection, the endoscope is used to confirm accurate dissection and bleeding.

After dissection, the Endotine is inserted to pull up the sagging cheeks.

④ After fixing the Endotine to the fascia, the incision is sutured.

The Endotine is firmly fixed to the fascia and the scalp is sutured.

Elastic tape is applied to prevent swelling and sagging.

The tape is removed after 2 to 3 days, and shampooing is possible from 4 days after surgery.

The stitches are removed after 7 days.

7. Examples of Endotine lifting surgery for cheek fat

8. Endotine lifting for improving forehead wrinkles

9. What is the Endotine surgery method for improving forehead wrinkles?

① The design is made according to a precisely diagnosed surgical plan.

The incision area is designed, and sleep anesthesia and local anesthesia are used.

Because sleep anesthesia is combined, there is no pain at all.

Because the incision is small and located in the scalp, there is no scar or hair loss on the forehead.

After the incision, dissection is performed above the periosteum to lift the frontalis muscle.

② The corrugator muscle is removed using an endoscope.

Using an endoscope, the corrugator muscle that creates the glabellar wrinkle is found and removed.

The corrugator muscle is the muscle that causes wrinkles between the eyebrows.

Removing the corrugator muscle helps eliminate glabellar wrinkles.

When removing the corrugator muscle, it is important to carefully dissect around the supratrochlear and supraorbital nerves to avoid nerve damage.

③ After confirmation with the endoscope, the Endotine is inserted.

Grooves are made with an instrument at the place where the Endotine will be fixed, and it is secured.

After fixation, the frontalis muscle flap is pulled up as much as possible to secure the Endotine.

The scalp is sutured and the forehead is bandaged.

The bandage is removed after 2 to 3 days, and shampooing is possible from 4 days after surgery.

The stitches are removed after 7 days.

10. Examples of Endotine lifting surgery for forehead wrinkles

11. What is the Endotine surgery method for eyebrow lifting?

12. What is the Endotine surgery method for improving sagging front cheeks?

13. What are the advantages of Endotine surgery?

Minimal incision and no scarring.
The lifting effect is stronger and lasts longer than thread lifting.
Unlike non-dissolving thread lifting, Endotine dissolves and disappears, so there is no foreign-body reaction.
Even after Endotine dissolves, the lifting effect remains after the tissue has been repositioned.
Recovery after the procedure is quick.

14. How long does the effect of Endotine lifting last?

The biggest advantage of Endotine is that, because it is a soft material, there is no foreign-body sensation, and since it dissolves after about a year, there are no side effects from foreign-body reactions.

Also, the lifting effect is strong, and even after Endotine dissolves, the lifting effect remains.

The duration varies by individual, but it lasts about 5 to 10 years.

15. What are the side effects of Endotine lifting?

The effect of Endotine is determined by the degree of accurate dissection and the degree of pull within the effective radius.

Dissection should be performed correctly above the fascia and the device should be firmly fixed to the fascia, but if the fascia is dissected incorrectly, facial nerve damage can occur, so it is better not to receive the procedure from someone with insufficient experience or from a non-specialist in plastic surgery (a specialist in another field or a general practitioner).

Question) What are the risks of surgery?

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

Although extremely rare, even if a problem occurs, it is relatively minor, and for individually occurring side effects, it is best to consult the attending physician.

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

16. What are the characteristics and advantages of Endotine lifting?

Existing surgical method	Comparison	Endotine lifting
Less than 1 year	Duration	Over 5 years
10~25cm	Incision size	2cm
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, awkward	Facial change	Voluminous and natural

Dark Circle + Age Spot Laser Combo Program

This is a program that removes dark circles at the same time as removing facial blemishes and age spots with a laser to create bright and clear skin.

1. What is age spot laser (carbon dioxide laser)?

A mole is also called a nevus, and it occurs due to excessive localized deposition of melanin pigment.

There are two main methods for removing moles: dermabrasion and excision.

For small moles, an electrocautery device or laser resurfacing is used to shave off and remove the mole, while larger moles with deep roots may be removed surgically.

Various lasers have been introduced into dermatology and plastic surgery over time.

Among them, the carbon dioxide laser is the most widely used laser in plastic surgery and dermatology.

The main function of the carbon dioxide laser is to safely shave the skin without bleeding.

The CO2 laser is designed to remove moles without bleeding while causing minimal thermal damage to the tissue.

2. What is the usual course after laser removal of age spots?

You can wash your face and apply makeup immediately after removing moles, blemishes, and age spots.

After carbon dioxide laser resurfacing, you can wash your face, apply makeup, and continue daily life right away.

If you were afraid of mole removal because you could not wash your face or wear makeup, laser treatment allows you to continue social and daily activities without major problems.

3. What is the age spot laser removal procedure?

① First, local anesthesia is administered to the area with age spots or blemishes.

② For age spots or freckles and blemishes, a topical anesthetic (EMLA) may also be used.

③ The laser beam is aimed at the area with the age spots, and the laser beam is fired to resurface the area with blemishes or moles.

④ The laser must resurface down to the root of the age spot for it not to recur.

However, if the resurfacing goes too deep, a sunken scar may occur, so the depth is carefully adjusted.

⑤ After the laser procedure, ointment is applied, makeup is put on, and the patient goes home.

⑥ After returning home, wash the area twice a day and gently apply the prescribed ointment.

The ointment only needs to be applied for about 7 days, and makeup can be applied immediately after using the ointment.

4. Examples of age spot laser treatment

5. What is the course after laser treatment?

① After laser treatment, the area where the age spot was removed may temporarily look sunken, but it gradually fills in and heals.

Healing usually takes about 7 to 10 days.

② After the wound has healed, erythema, a normal process, occurs. Erythema means that the area where the age spot was removed changes color to pink.

This erythema disappears within 1 to 2 months in the case of small spots, and may take more than 3 months for large age spots.

It is a temporary phenomenon, so there is no need to worry even if erythema occurs.

③ As the erythema gradually disappears, the skin returns to its original color and leaves a faint scar.

However, the scars at the sites where age spots or blemishes were removed are so small that they are barely noticeable.

6. What precautions should be taken after laser treatment?

① It is best to avoid places with strong ultraviolet exposure, such as beaches or ski resorts, for about 1 to 2 months.

Strong ultraviolet rays can cause melanin pigment to deposit in the skin and may cause blemishes and age spots to recur.

If you must go to a place with strong ultraviolet exposure, it is best to wear a hat or apply sunscreen.

② You can wash your face immediately after the procedure, but it is best not to use soap on the area for about 3 to 4 days.

Soap can cause pain and irritation in the area where the mole was removed.

③ Apply ointment immediately after washing your face.

Use the ointment prescribed by the clinic, and apply only a very thin layer, being careful not to apply it too thickly.

If applied too thickly, the wound may become soggy and heal poorly.

④ It is fine to wear makeup when going out after applying ointment.

Makeup does not cause any particular problems in the area that received the laser procedure.

7. What is the recurrence rate of age spots, moles, freckles, etc.?

It is common to see recurrence after mole removal.

In the case of age spots, the deeper the roots and the wider the lesion, the higher the chance of recurrence.

For freckles, the recurrence rate is about 30%, and for age spots there is also a recurrence rate of 30 to 40%.

Question) If a mole with deep roots is completely resurfaced to prevent recurrence?

Answer) If a mole with deep roots is completely removed out of concern for recurrence, the skin may be excavated too deeply and later leave an unsightly sunken scar.

Even if recurrence occurs, when the root is deep, it is usually a reasonable approach to remove it again later if it recurs.

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