As public perceptions of plastic surgery have changed, there is less resistance to improving insecurities or transforming into a desired image through surgery. Among these, the eye shape and double eyelids are areas considered by people of various ages, including high school students, university students, and office workers. This is because advances in medical technology have reduced the burden in terms of cost and time compared to the past. However, even though double eyelid surgery has become a common procedure, revision surgery is not uncommon, so caution is needed.
 

There are various cases that require revision after eye surgery. Revision is chosen when the results are unsatisfactory, such as 'sausage eyes' where the double eyelid line looks puffy and swollen, mucosal show (eversion), asymmetrical eyes after the double eyelid has loosened, or the formation of multiple folds.
 

'Sausage eyes' refers to cases where the double eyelid still looks thick, as if post-surgical swelling remained, even long after surgery. Sausage eyes are highly likely when the line was set unreasonably high during surgery, or when unnecessary subcutaneous fat and muscle beneath the line were not sufficiently removed.
 

When performing revision eye surgery, the first step must be a thorough analysis of why the previous double eyelid surgery failed, so that it can be corrected. Since the reasons for revision differ from person to person, the cause of failure must be examined and analyzed from multiple angles before deciding on the surgical direction.
 

For example, methods for correcting sausage eyes are broadly divided into the 'skin excision' method and the 'double-line' method. Before deciding on skin excision, it is important to check carefully whether there is enough excess skin, and to approach the procedure cautiously to avoid side effects such as lagophthalmos (incomplete eyelid closure) or dry keratitis.
 

The double-line method creates a new line by making an incision lower than the existing line. The existing thick, high double eyelid line is dissected to release the adhesion, and depending on the case, upper eyelid fat repositioning or eyelid fat grafting may need to be performed at the same time.
 

Revision eye surgery is a far more demanding, highly complex procedure because it operates again on tissue already damaged by a previous surgery. It should therefore never be decided on hastily and must be approached with even greater care and thoroughness. In revision surgery, the focus should be on accurately identifying the cause of the first surgery's failure and correcting what went wrong.
 

The current eye shape, skin thickness, position of the eyes, eye-opening strength, excess skin, and the skeletal characteristics around the eyes must all be considered comprehensively. To improve not only the aesthetic aspects but also the functional aspects at the same time, one should choose a board-certified plastic surgeon with extensive surgical experience and know-how.

Written by: Dr. Yeon-ji Lee, NANA Plastic Surgery

 

Source: Sae Jeonbuk Shinmun (http://sjbnews.com/)