[Rari Plastic Surgery] Why Double Eyelids Can Come Undone After Double Eyelid Surgery

As more and more patients undergo double eyelid surgery, it has become common,

the case of double eyelids coming undone after surgery also happens more often than expected.

Cases where the surgical double eyelid comes undone can largely be divided into two types.

The first is when the eyelid comes undone because the skin, tarsal plate, and muscle were not properly fixed.

The second is when the skin, tarsal plate, and muscle were properly fixed,

but over time the double eyelid came undone due to physical force.

Double eyelid surgery creates adhesions between the outer skin and the tarsal plate-muscle tissue,

and when opening the eyes, the crease formed as the muscle pulls the outer skin inward because of this adhesion is the double eyelid line.

If the adhesion connecting the eye-opening muscle and the outer skin comes undone, or if scar tissue in between swells and increases the distance between the skin and muscle tissue,

the skin does not fold inward when the eyes open, so the double eyelid may appear to have come undone.

There are many reasons why a double eyelid can come undone. A patient’s constitution is also very important. Some people keep having their double eyelids come undone even after surgery because their bodies do not form adhesions well. So for these people, rather than insisting on double eyelid surgery, it may be better to remove the double eyelid line altogether if it has come undone and become wrinkled and messy.

Cause 1. Weak eye-opening muscle strength

For a double eyelid to form, the skin tissue adhered to the muscle must fold inward for the eyelid crease to form. If the eye-opening muscle is weak, the adhered skin tissue does not pull inward strongly, so in this case the double eyelid may “look undone.”

Cause 2. Severe adhesions around the double eyelid line

During double eyelid surgery, only the area where the crease is created should form a linear adhesion scar so that the eyelid crease is formed by that adhesion. But if thick, large scar tissue develops around the eyelid line, the inner adhesion becomes undone because of the scar tissue.

For a similar reason, the eyelid line at the outer corner may split into two lines, or a second eyelid line may form in a place other than the designed crease line.

Cause 3. Lack of skill on the part of the surgeon

To create a double eyelid, the skin tissue must be connected to the correct tarsal plate or muscle tissue. If the anatomical structure is not accurately identified and the fixation is not made to the correct target structure, even if a double eyelid forms at first, it will soon come undone.

In fact, if a doctor has undergone specialist training, even after performing only a certain number of cases, the anatomical structure can usually be understood sufficiently. So cases where the eyelid comes undone due to a lack of surgical skill are actually quite rare.

Then, to prevent double eyelids from coming undone, which is better: the non-incisional method or the incisional method?!

Here is why the non-incisional surgery tends to come undone more easily.

Because the non-incisional double eyelid surgery is performed through tiny holes in the skin,

the knots that bind the skin and tarsal plate may not be tightened firmly due to muscle or fat tissue trapped in between, loosening the connection between the skin and the tarsal plate and making it more likely to come undone. The same applies when the upper eyelid skin is thick or there is a lot of fat.

The outer skin must be pulled to the targeted tarsal plate tissue and firmly fixed there, but with eyes like this, it is not easy to secure the tissues firmly through small holes.

On the other hand, if surgery is performed with the incisional method,

it is easier to pull the skin to the inner tarsal muscle tissue that we are targeting, allowing for firmer fixation, so it may come undone less often than with the non-incisional method.

Of course, this does not mean that every non-incisional surgery will definitely come undone, or that incisional surgery will absolutely never come undone. As mentioned earlier, depending on constitution and adhesion formation, a non-incisional surgery can still remain stable, and an incisional surgery can still come undone.

There are many other reasons why a double eyelid can come undone besides the causes mentioned above.

If a patient leaves major swelling untreated early after surgery because ice packs are inconvenient, if they do not rest enough and strain their eyes, or if they apply physical force such as rubbing their eyes frequently, of course the holding strength of the stitches tied for adhesion can weaken and the double eyelid may come undone. Also, as skin sags due to aging, it may look as if the double eyelid has come undone.

Therefore, to prevent the double eyelid from coming undone,

many kinds of effort are needed!

Remember one, two, three, four, and if you are worried because your double eyelid keeps coming undone even after multiple surgeries, don’t forget to also consider double eyelid removal surgery ~