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Extreme revision surgery to correct a damaged line

When the double eyelid condition is very poor,

this refers to surgery that restores eyes whose appearance is difficult or nearly impossible to return to a normal eye shape

to something close to normal.

In cases where revision surgery has been performed multiple times, or where there is severe scar adhesion along the incision line,

if foreign substances such as filler have been injected into the eyelid,

or if lump-like fat has been grafted so that the contour and adhesions are severe,

and for eye shapes with severe ptosis,

the goal of extreme revision surgery is to restore the eyes to a form close to normal.

Extremely damaged double eyelids

What is the difference between extreme double eyelid revision surgery and general double eyelid revision surgery?

General revision surgery may have some steps that are simple or omitted depending on the condition, but in extreme revision surgery, when there is not enough extra skin or the existing scar line is too high and dark, making surgery nearly impossible, instead of excising the scar, subcutaneous dissection is performed and a new line is created underneath it.

To release scar adhesion, it refers to the full use of all available techniques for revision surgery to restore a natural double eyelid, including multi-layer tissue dissection and rearrangement, insertion of microfat tissue, levator palpebrae superioris shortening, and dissection and excision of the orbicularis oculi muscle below the incision line.

What is the process for extreme double eyelid revision surgery?

01. If tissue or skin is lacking, measure the limit of how much it can be extended and then extend it.
02. If the levator palpebrae superioris function is almost absent, calculate the limit to which it can be lifted.
03. If the skin is very thick, make a plan to excise the orbicularis oculi muscle to create thinner tissue.
04. If scar adhesion is very severe and cannot be released, plan for microfat insertion after scar dissection.
05. If the sausage-like appearance is severe, plan to eliminate it through incision-line dissection and partial excision of the orbicularis oculi muscle.
06. If the scar line is very high, make a plan to smooth it rather than excise it.
07. If the scar line is extremely dark and sunken and cannot be excised, plan to fill in the sunken area.
08. If eyelash eversion is severe, plan to correct the ectropion by dissecting beneath the eyelash root.​

​http://www.doublefold.co.kr​

Examples of applying extreme double eyelid revision surgery

Double eyelid revision surgery can still produce good results even in very difficult and challenging cases if performed according to principles with sufficient planning.

However, surgery is not possible in every case.

If there is too little extra skin or scar adhesion is very severe, there are limits to surgery, and sometimes surgery is not possible at all.

If, based on the preoperative examination, it is judged that revision surgery will be difficult, the rule is not to make a surgical plan at all.

Choosing when consultation for double eyelid revision surgery is very difficult or complex

During consultation, after coming in for an examination, there are cases where, from the surgeon's perspective, the eye shape is very challenging or there is no confidence in creating a satisfying result.

In such cases, one cannot simply say during the consultation that the outcome is guaranteed, but on the other hand, saying that it is just a little difficult can reduce trust in the hospital or lead to being mistaken for an inexperienced doctor.

From the surgeon's perspective, if one judges the patient's condition accurately and explains what is difficult and why the result may not be good, trying to provide an honest and principled consultation, some patients accept this, but many others take it negatively.

They come to believe that the doctor lacks skill and is of a lower standard.

In the end, the surgeon is pushed into a situation where, even for a very difficult operation, they must give an exaggerated consultation such as "it will definitely turn out well" in order to avoid being seen as an unskilled doctor, and if the patient is swayed by such exaggeration and undergoes surgery, the situation may become even more bleak.

From the patient's perspective, it is very important to distinguish between what is said without exaggeration and a surgeon who stands by their judgment.

There are various possible prognoses for double eyelid revision surgery.

Some people think that meeting a skilled doctor for revision surgery will always lead to a good result, but this is a very dangerous assumption.

Even the most skilled doctor may have cases that improve after surgery, but there are also cases that cannot improve even with surgery, and sometimes the result may be unsatisfactory.

Before surgery, you should keep these three possibilities in mind and assess realistically whether surgery is possible, how much improvement is possible if it is, or whether it is impossible.

Cases where double eyelid revision surgery is difficult or impossible

There are many cases in which double eyelid revision surgery is impossible or difficult, such as when there is no or insufficient extra skin, when the scar line is too dark and adhesions are difficult to release, when the skin and muscles are excessively thick, when the tissue has become hard and thick due to multiple revision surgeries, when there is severe sausage-like swelling but there is a high chance it will push down again and recur even after surgery, or when there is severe ptosis.

Just as there are patients that can be saved and patients that cannot, no matter how skilled and capable the doctor is, the same applies to double eyelid revision surgery.

When surgery is very delicate and difficult, patients themselves need to understand the limits, but many people do not want to accept those limits.

If you proceed with surgery while simply hoping that somewhere there must be a hospital that can perform it perfectly, you are setting yourself up to fall deeper into a bigger pit.

Therefore, you must carefully judge the limits and prognosis of your current condition before deciding on surgery.

http://www.duhans.com

​http://www.duhans.com​