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http://www.doublefold.co.kr

What is eyelash ectropion?!

When the skin below the incision line is pulled upward tightly,

it refers to a case where the mucosa beneath the eyelashes becomes visible.

If the mucosa is excessively exposed,

it can create a poor impression, so correction is recommended.

An example of eyelash ectropion

What causes eyelash ectropion?

01. When there is not enough extra skin and the skin below the incision line is pulled upward
02. When the scar line of the double eyelid has severe adhesion
03. Excessive skin excision
04. When the wound is sutured under excessive tension because it was pulled too far upward during suturing

What is the surgical method for eyelash ectropion?

It can only be corrected through full-incision surgery.

If surgery is delayed, the ectropion shape may harden and correction may become impossible.

If surgery is delayed, the ectropion shape may harden and correction may become impossible.

It is best to have surgery as soon as possible to achieve corrective results, but if correction is done months or years later, proper correction may not be possible in some cases.

In other words, surgery should be performed before the shape becomes fixed, so that correction is possible to some extent.

The double-eyelid scar line is incised, and the skin below the incision line is lifted and dissected downward to release the tension of the skin that had been pulled tightly upward.

Usually, dissection is carried out up to near the eyelashes, and in some cases part of the orbicularis oculi muscle is also removed.

After adjusting the relaxed skin to an appropriate height, it is fixed with suture fixation so that it does not move, and then the skin is sutured.

Surgical method for eyelash ectropion - full incision

▶ Surgical process

1. The incision line is designed, including the existing scar tissue from the incision.

Preoperative design is performed to create a new double-eyelid line below the scar line and determine the width of skin excision up to the 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 skin excision width becomes 3 mm.

Determining the new double-eyelid line is based on considerations such as how much the line should be reduced and how much extra skin is available.

The average height of the line in double-eyelid revision surgery is 5 to 7 mm.

2. The skin and scar tissue are removed.

Scar tissue is excised along the design line.

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

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

3. The orbicularis oculi muscle, orbital fat, and skin adhered to the levator palpebrae superioris are dissected.

Because the skin above the double-eyelid incision line must be pulled downward, the hard scar tissue that has stuck together must be dissected.

Scar tissue dissection proceeds by dissecting between the orbital fat layer and the levator palpebrae superioris muscle, and in some cases the dissection is also performed between the muscle and fat for forward repositioning of the fat.

Through this dissection process, the tissue can be repositioned downward, and it is an important preparatory step for obtaining a natural double-eyelid line.

4. If there is contracture of the orbicularis oculi muscle, the muscle is incised or excised to remove the contracture.

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

5. To prevent readhesion, the orbital fat is repositioned to the incision line.

Forward repositioning of the orbital fat is a process to prevent the tissue from re-adhering.

If the fat is not repositioned, the tissue may stick together again, which can cause ptosis and make the eyes look sleepy and half-closed.

Sometimes a triple eyelid may form, which becomes a cause of a ruined double-eyelid line.

Another effect of repositioning the orbital fat is that if the eyelid is sunken, the hollowing can be corrected to some extent. In cases where fat grafting would otherwise be needed in the future, the surgery itself may improve the condition to some extent, making fat grafting unnecessary in some cases.

6. The levator palpebrae superioris is shortened to strengthen its function.

Levator shortening surgery is one method for correcting ptosis.

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

The method does not cut the levator palpebrae superioris; instead, it simply advances it and secures it to the tarsal plate.

During double-eyelid revision surgery, the effect of levator shortening surgery is twofold: it allows the eyes to open wider so that the eyes can be corrected to look clearer, and by opening the eyes wider, it also reduces the double-eyelid line.

▶ A quick note here - the surgical process of levator shortening surgery ◀

This method shortens the length of the eyelid-lifting muscle (levator palpebrae superioris) by folding it over 4 to 8 mm and suturing it.

① Design is made and local anesthesia is administered.

② An incision is made along the design line.

③ After the incision, the orbital septum is opened to expose the levator palpebrae superioris.

④ The levator palpebrae superioris is exposed and marked to the extent that it will be shortened, then the marked area and the upper edge of the tarsal plate are tied with sutures.

⑤ Three buried sutures are placed to create the double-eyelid line.

⑥ The outer skin is sutured.

7. After incising the orbicularis oculi muscle at the inner canthus, orbital fat is inserted between the muscles to prevent readhesion.

Along with forward repositioning of the fat, fat is inserted at the inner canthus of the eye to prevent adhesion of scar tissue.

The inner corner of the eye is the area where scar tissue adhesion occurs most easily, and adhesion in this area can make the eyes look sleepy, make it difficult to open the eyes fully, and cause discomfort when opening the eyes.

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

8. During suturing, layered suturing ensures that the repositioned structures do not move out of place.

The suturing method for double-eyelid revision surgery is not simple.

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

To achieve the originally designed double-eyelid line, the skin below the incision line must not be pulled upward.

To do this, the skin below the incision line must be firmly fixed to the tarsal plate, and sutures must also be placed so that the forward-repositioned fat is not pulled upward.

In addition, only when the orbicularis oculi muscle and the skin above the incision line are all passed through by sutures and firmly layered together can the desired double-eyelid line be achieved.

9. A small amount of anti-swelling agent (hyaluronidase) is administered to the surgical site to prevent hematoma and inflammation.

Hyaluronidase, an anti-swelling agent, is a medication that has the effect of dispersing water and rapidly reducing swelling as soon as it is administered.

However, if used in excessive amounts, it can instead cause more bruising, so it is used only in a limited way for reducing swelling.

10. The sutures are removed in two stages, on day 4 and day 7.

Sutures are usually removed around 7 days after surgery.

The reason the sutures are removed later is that in revision surgery, most cases do not have sufficient extra skin, and because the surgical process involves forward repositioning of all tissues, a lot of tension is placed on the suture line.

Therefore, if the sutures are removed on days 3 or 4, the tense suture line may open or the scar line may widen, resulting in a larger scar and causing the tissue to gradually pull upward, which also has the negative effect of making the double-eyelid line larger.

Accordingly, the sutures should remain in place until the tissue stabilizes, so it is better to leave them in longer.

To prevent the scar from becoming messy due to suture marks, most of the sutures are removed first on day 4 and only the remaining 3 to 4 sutures are left, so almost no suture marks remain.

To quickly reduce early inflammation and swelling, steroids are administered for about 1 to 2 days.

After surgery, artificial tears are used for about 1 to 3 months to prevent dry eyes.

If all of the above principles are followed with skilled technique, satisfying results can be achieved.

Examples of correction applications using the full-incision method for eyelash ectropion

The symptom in which the eyelashes lift and the mucosa becomes visible is called ectropion.

The phenomenon of eyelash ectropion occurs in cases such as:

when scar adhesion is strong or there is not enough extra skin,

or when the orbicularis oculi muscle below the incision line has been excessively removed,

or when the double-eyelid line has been fixed too deeply,

or when the eye muscles have weakened.

Surgery must remove the existing scar line and create a new line.

The ectropion is corrected by pushing the ectropion tissue downward

and ensuring that tension is not applied during suturing of the incision line.

The surgery takes about 2 to 3 hours,

the recovery period is about one week,

and sutures are usually removed about one week after surgery.

Since no bandage is applied, daily life can be resumed immediately.

Director Shin Duhan

http://www.doublefold.co.kr

Frequently asked questions and answers about double-eyelid revision surgery

Question) I want to have my first double-eyelid surgery. Can I have it performed by a doctor who specializes in revision surgery?

Answer) If the first double-eyelid surgery is done well, there will be no unfortunate need to undergo double-eyelid revision surgery.

The highest level of double-eyelid surgery is double-eyelid revision surgery, so the first surgery should be done properly so that revision surgery is not needed.

Question) Can anyone perform double-eyelid revision surgery?

Answer) Double-eyelid revision surgery requires the highest level of skill and experience among cosmetic surgeries.

If surgery is done carelessly at a clinic without experience or skill, there may be no improvement at all, and it can even ruin the impression of the eyes.

Therefore, double-eyelid revision surgery should be decided carefully, and you must have it performed by an experienced specialist.

Question) Is it not okay to do double-eyelid revision surgery and epicanthoplasty at the same time?

Answer) If a clinic recommends doing double-eyelid revision surgery and epicanthoplasty at the same time, it is very likely a clinic that does not understand double eyelids, so this should be noted very carefully.

Epicanthoplasty (Mongolian fold removal surgery) has the effect of making the inner double-eyelid line thicker.

In principle, it should not be done together with double-eyelid revision surgery intended to reduce the double-eyelid line.

If you perform epicanthoplasty, which thickens the line, together with surgery intended to reduce the line, the inner eye line may become distorted or thicker, making it impossible to achieve the desired result.

This is like two people sharing a boat, with one rowing east and the other rowing west.

Epicanthoplasty is a procedure that should be performed only when it is clearly indicated. If epicanthoplasty is truly needed for the eye shape, the decision should be made only after the revision surgery has fully settled and several months have passed.

One should not carelessly make the mistake of performing double-eyelid revision surgery and epicanthoplasty at the same time and creating a bad result.

Question) My eyelid is sunken. Can fat grafting be done together with double-eyelid revision surgery?

Answer) If the eyelid is sunken and the double-eyelid line is awkward, making revision surgery necessary, fat grafting should first be done, and double-eyelid revision surgery is possible 3 to 6 months later.

Only after the eye shape has been restored to a flatter appearance following fat grafting should double-eyelid revision surgery be performed.

During double-eyelid revision surgery, tissue must be dissected, but fat grafting cannot be performed into the dissected tissue. If fat grafting and double-eyelid revision surgery are performed at the same time, it is like scattering fat into an empty space created by dissection, so the fat will not properly take, and only the double-eyelid line will be ruined.

Therefore, doing the two surgeries at the same time is not appropriate, and if a clinic suggests doing them together, it is likely a clinic without proper understanding or experience, so this should be kept in mind.

Question) I do not like my existing double-eyelid line and want it completely loosened. Is that possible?

Answer) There are procedures sometimes called surgery to loosen double eyelids, but such surgery should not be done.

After more than one week has passed since surgery, in principle, whether the surgery was done with the buried method or the incision method, there can be no such thing as surgery to “loosen” the operated eye shape.

This is because the incision line remains visible when the eyes are open or closed, which is not only very unattractive but also often causes the eyelid to appear uneven or droopy.

Instead, the double eyelid should be made into a subtle inner double eyelid so that the line is barely visible when the eyes are open.

Some people undergo loosening surgery and then find their eye shape even more awkward, wanting to make the line again. However, once loosening surgery has been done, it is almost impossible to create a double-eyelid line again through revision surgery, so this must be kept in mind.

Question) I had double-eyelid surgery at another clinic. When can revision surgery be done?

Answer) Usually, revision surgery is possible about 6 months after the last surgery.

The reason is that the scar tissue must heal and settle completely for revision surgery to produce good results.

If the scar tissue still has redness or raised hypertrophic scarring, surgery is difficult.

The time required for scars to settle varies from person to person. Usually, after 6 months the scar has settled to some extent, but depending on the person, some settle later, so revision surgery is possible when all redness in the scar area has disappeared.

Question) I am afraid to have double-eyelid revision surgery.

Answer) Having to repeat a double-eyelid surgery that already failed once is several times more frightening than having it done for the first time.

That is because of the fear of what will happen if it fails again.

However, if you have sufficient consultation and entrust yourself to a revision surgery specialist, you can achieve the desired result.

Question) I had double-eyelid revision surgery somewhere else, but it did not improve at all. Is revision surgery still possible?

Answer) Depending on the condition, there are cases where it is truly impossible.

But if there is enough possibility for improvement through preoperative consultation, it can be returned to its original natural eye shape.

Question) What if double-eyelid revision surgery fails again?

Answer) If preoperative examination and testing show that there is no possibility, we do not attempt surgery at all as a rule.

However, if it is sufficiently possible, we can restore the eye shape beautifully along with surgical success.

Question) After double-eyelid revision surgery, when can I return to daily life?

Answer) After surgery, no bandages or tape are applied.

Therefore, you can return to daily life immediately.

There may be some swelling and bruising, but usually there is less swelling and bruising than with the first surgery.

Even after about one week, the eye shape is usually not very awkward.

Also, not applying bandages helps the swelling go down faster and allows the line to settle a bit sooner.

Question) How many times do I need to visit the clinic after double-eyelid revision surgery?

Answer) After surgery, you will usually visit about three times: the next day after surgery and on day 4 and day 7 for suture removal.

However, if the distance between the clinic and your home is very far, it is acceptable to visit only on the day of suture removal.

The final sutures are usually removed around 7 days after surgery.

Question) Compared with the first surgery, how much swelling and bruising are there after double-eyelid revision surgery?

Answer) Compared with undergoing the first double-eyelid surgery using the incision method, revision surgery usually has less swelling.

Revision surgery does not necessarily mean more swelling or bruising.

In fact, swelling and bruising are often milder than in first-time surgery, so there is no need to worry too much about them.

Question) What happens to the scar after double-eyelid revision surgery?

Answer) One of the goals of revision surgery is to improve the original messy and dark scar as much as possible.

For about 3 to 6 months after surgery, there is some redness, so the scar line may be slightly noticeable.

This is a normal process experienced by everyone who undergoes double-eyelid surgery using the incision method.

Usually, only after at least 3 to 6 months have passed does the scar line gradually fade and settle.

After 6 months, the scar line fades in most cases and becomes less noticeable than the original surgery scar.

Advantages and pride of Duhan Plastic Surgery's double-eyelid revision clinic

Experienced medical staff and safety

Director Shin Duhan, who has focused on thousands of double-eyelid revision cases, more than one case per day, works as a team with experienced nurses.

1:1 customized surgical plan

Based on each individual's double-eyelid condition, the plan takes into account gender, overall facial harmony, and the patient's own wishes.

The rate of correcting from an outer line to an inner line, and performing epicanthoplasty or canthoplasty at the same time as double-eyelid surgery, is steadily increasing.

If revision surgery is combined with epicanthoplasty or canthoplasty in eyes for which those procedures are appropriate, the effect is doubled.

The height of the double-eyelid line and the line shape (inner line, in-out line, outer line, etc.) reflect the patient’s preference, and the trend in double-eyelid lines these days is “naturalness.”

Double-eyelid revision surgery without side effects

People undergoing double-eyelid surgery worry whether the line will loosen or whether scars will remain.

Side effects are reduced through Director Shin Duhan’s analysis and the ability to precisely perform the line exactly as analyzed.

In addition, delicate incision and suturing reduce concerns about asymmetry.

Results that are difficult to imitate

There are many clinics that perform double-eyelid revision surgery, but the fact that the surgery name and method are the same does not mean the results will be the same.

With over 20 years of extensive experience, we provide the optimal beautiful line for each individual patient.

Double-eyelid surgery is often thought of as a simple procedure, but revision surgery is quite difficult.

Double-eyelid revision surgery includes a delicate process of newly designing the line and completely separating and dissecting the previously adhered double-eyelid tissue.

Through careful dissection, there are no later side effects such as a bumpy line or adhesion that causes the line to roll upward.

With skill that neatly organizes not only the skin layer but also all tissues in the fat and muscle layers one by one, even extreme revision cases can achieve results that are difficult to imitate.

Double-eyelid revision surgery and ptosis correction at the same time

At our clinic, ptosis correction is included in double-eyelid surgery, so we correct sleepy eyes or dull eyes where the pupils are covered.

By shortening the levator muscle that opens the eyes, we adjust how much of the pupils are visible and make the eyes look clearer.

Research, lectures, and educational activities on double-eyelid revision surgery

The most trustworthy answers come from extensive clinical experience.

Double-eyelid revision surgery is like a premium product perfected over time.

Through this accumulated experience, we also carry out research and educational activities.

Increased consultations about double-eyelid revision surgery

As new clinics spring up and perform double-eyelid surgery indiscriminately, requests for double-eyelid revision surgery are also increasing, which is truly unfortunate.

If revision surgery is repeated several times and still fails, the amount of extra skin decreases, making subsequent double-eyelid revision surgery an even more difficult extreme procedure.

Double-eyelid surgery is not only about making the first choice carefully; when considering revision surgery, it should also be considered carefully with the thought that it may be the last chance.

Craftsmanship for a highly refined and beautiful face

A doctor who performs double-eyelid surgery among cosmetic procedures must have the sensibility of a designer as well as a doctor.

If one insists only on a uniform double-eyelid line without understanding what makes a beautiful line, it is impossible to create the perfect line that suits each patient.

If you do not have an eye for it, or even if you do but lack the skill to reproduce it, a masterpiece will not be created.

We do our best down to the very last stitch to provide beauty and satisfaction to each and every patient.

Honest surgery with sincerity

We recommend surgery when it is likely to result in more than 80% satisfaction, but we do not proceed with unnecessary surgery even if requested.

We aim to be a clinic that treats patients honestly through skill and results.

A trustworthy premium clinic

There is a reason works by master artisans are expensive.

It is because they create works that are beautiful and valuable.

Our clinic has pride and confidence in our surgery.

Proper surgery will become an opportunity to build confidence throughout your life.

We will be a clinic that delivers satisfying results, rather than a clinic that recommends surgery at a low price and has multiple doctors take turns performing the procedure.

http://www.duhans.com