[Rari Plastic Surgery] Is skin excision really the cause of incomplete eye closure (lagophthalmos) after double eyelid removal surgery? - Double eyelid removal without excision

Among the stories circulating about double eyelid removal surgery,

the two most common topics are recurrence and incomplete eye closure.

Of these two,

the issue people generally consider more serious is

incomplete eye closure.

People without specialized knowledge usually think that the reason incomplete eye closure occurs after double eyelid removal surgery

is skin excision.

However, I prepared today’s post to explain the other, more important anatomical cause in an easy way^_^

First, let’s solve a quiz~

Please look at the question below!

Now, did you check the question carefully?!

I’m really curious whether you found the answer easily haha

The patients above are photos of the eyes of patients who underwent double eyelid removal surgery at Rari Plastic Surgery with their eyes closed.

All of them were photographed on the day of stitch removal, 5 to 7 days after surgery.

Using random sampling, the surgery timing and order were arranged randomly.

To give you the answer first

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The answer is!!

With skin excision: 2, 3, 4

Without skin excision: 1, 5, 6

How well did that match your expectations?!!

I think many people were surprised.

Because it was quite different from what they had in mind haha

To understand why the result differs from expectations,

we need to understand the principles behind double eyelid removal surgery.

The photo above shows part of a longitudinal section of the eye.

On the skin side, from top to bottom, there are the eyebrow and the double eyelid fold line, and below that the eyelashes, and you can also see that there are various tissues inside the eyelid.

The principle by which a double eyelid is formed is

the white line area marked with a red circle behind the double eyelid

is adhered and stuck together, and when the eye opens, the muscle is pulled inward and lifted along the blue arrow,

which creates the fold.

So when performing double eyelid removal surgery,

first, all of that double eyelid adhesion is released,

then the septum is opened and the inner fat is pulled downward,

and it is brought to the incision line near the eyelashes and secured so that the white lines cannot adhere to each other again.

This is exactly the key point related to incomplete eye closure.

If the fat that was positioned inside the septum to prevent adhesion is pulled downward and secured near the incision line,

the upper eyelid portion is naturally pulled upward due to the momentum of trying to return to its original position and the elasticity of the fat.

In the end, regardless of skin excision,

the very principle of double eyelid removal surgery itself becomes the cause of the eyes closing slightly less.

Of course, if a constant force is applied over time,

the incomplete eye closure gradually decreases and eventually the eyes close fully,

but that requires a certain amount of time!

Let’s look at actual photos.

This patient had a large natural double eyelid with an out-line.

A natural double eyelid removal surgery was performed without excision.

Before surgery, when the eyes were closed, they closed well,

but on the 7th day after surgery, when the stitches were removed,

you can see that the eyes were not closing fully.

As mentioned earlier, the surgery was performed without excision.

In contrast,

this person had undergone incision double eyelid surgery and ptosis correction surgery more than 10 years ago.

This person had double eyelid removal surgery with some skin excision.

Before surgery, when the eyes were closed, they closed well,

but on the 7th day after surgery, when the stitches were removed,

you can see that the eyes were not closing fully.

As mentioned earlier, the surgery was performed with skin excision.

From here, we can see that whether or not skin excision is performed,

after double eyelid removal surgery, the eyes may not close fully,

which means the cause of incomplete eye closure is not skin excision.

Also, when it comes to excision versus non-excision, people with natural double eyelids can choose either option,

but for people who previously had double eyelid surgery and have an incision scar,

if skin is not excised, the existing incision scar cannot be removed,

so it is better to excise the skin for scar improvement.

Even if surgery is performed with skin excision, as time passes like this,

the eyes that were not closing fully will naturally begin to close completely.

With skin excision ▼

Without skin excision ▼

Looking at the photos with the eyes open,

what actually distinguishes whether skin excision was done or not is not incomplete eye closure,

but rather

[whether you want to remove the double eyelids without making the eyes smaller, while making them clearer]

or

[whether you want to remove the double eyelids while making the eyes feel a bit smaller, horizontally longer, and less burdened because large eyes feel too heavy]

.

If skin is not excised,

the extra skin can cover the eyelids and make the eyes look smaller,

and if the extra skin is excised,

the eyes can look clearer without being covered by the eyelids.

Today, we looked through the story about double eyelid removal surgery,

from the anatomical principle, to examples, to the recommended surgical direction.

Many people who are worried because of double eyelids they do not like may be exposed these days to the provocative term “side effects of double eyelid removal surgery” and to misunderstandings,

and may not be able to achieve what they want.

There are many options, and through sufficient consultation,

you can change your appearance in the direction you want,

so I hope you come to the clinic and receive a consultation without worry.