Do I need revision double eyelid surgery?

Double eyelid surgery is widely considered as an easy and less invasive procedure. This misjudgment may lead to the regrettable decision. Selecting just any random clinic, chasing the cheapest price or the soonest available surgery slot resulted in many failed operations. In this article, we want to tell you about revision double eyelid surgery and explain who, when and why might need it.

According to the International Society of Aesthetic and Plastic Surgeons, double-eyelid surgery remains one of the most popular plastic surgeries in the world, with more than 1 million surgeries performed in 2018. Blepharoplasty is also known to be the most popular cosmetic procedure in Korea. It is also controversial. Critics say that the operation makes patients look “less Asian,” while proponents say that it is simply a matter of beauty — bigger eyes equals more attractiveness. Most Koreans do not have double eyelids, which makes them look sleepy and tired. That is why the popularity of this procedure in Korea is so huge.

ISAPS official statistics on plastic surgery popularity for 2018

Is Double Eyelid Surgery easy?

Many patients think it is a simple procedure that slightly incises the skin and suture but the fact is that it really depends on the surgeon’s technique and your condition. The doctor will have to check the thickness of your skin, the volume of fat, remaining skin, etc. After checking all these factors, the surgeon’s skill will play its role. A surgeon must take all patient’s individual features into consideration to design double eyelids suited to their face. This procedure requires an exceptional carefulness and attention to detail, as the slightest difference of 1 mm may ruin the result. Therefore, blepharoplasty so often requires correction. We will show you a case study of three patients who underwent their revision blepharoplasty at our clinic.

Before and After pictures of patients who underwent Revision Double Eyelid Surgery.

Revision double eyelid surgery – case 1
Revision double eyelid surgery – case 2
Revision double eyelid surgery – case 3

All 3 patients needed to undergo revision ptosis correction after having it performed at another facility. Their creases were too high due to wrong adhesion, giving an unnatural, obvious look. Well performed double eyelid surgery gives natural result matching patient’s face. However, it is not easy. As we mentioned before, it requires much experience and exquisite carefulness when designing and performing the procedure. Moreover, the revision surgery is much more demanding than the first one. So, how doctors design this perfect eye and how do they judge if re-operation is necessary?

Five features for beautiful eyes – designing the perfect double eyelid.

To create beautiful and natural-looking double eyelids, eye surgery should be conducted in consideration of the height and depth of the fold, the volume of eyelids, adhesion, and the strength of ocular muscles (levator muscles). If such components are not harmonized, the results of the operation may be unsatisfactory, or the eye shape may look awkward on the patient’s face. In this case, re-operation may be required.

1. Height

Everyone had different eye shape and skin condition. The most important is to find the optimal height of the fold. Thick double eyelids make you look edgy from a long distance, but make you appear vacant from a close distance. On the contrary, thin double eyelids look natural from a long distance but make you look overdone from a closer approach. Therefore, it is important to find the most optimal height of double eyelids to prevent such a situation.

2. Depth

Determined by the direction of the front and rear parts of the eyelids and their length, plays the crucial role in double eyelids visibility. In some cases, the height might be the same but thin double eyelids disappear in the depth of one’s fold. 

3. Strength

Misjudgment of levator muscle strength when performing the double eyelid surgery via ptosis correction is a reason for 80% of revision cases. Most people’s faces are asymmetric and have different strength of ocular muscles. An operation should be conducted considering the strength balance of both eyes. If this condition is not met, the operation will result in more visible asymmetry and misshapen eyes. [ Ref.: Revision double eyelid surgery – case 1 ]

4. Adhesion

To ensure proper adhesion the amount of skin to remove during the surgery must be accurately evaluated. If too much skin tissue was removed, it may cause excessive adhesion and hollows under the double eyelids. In this case, the eye shape is unnatural. In the opposite case, it may cause triple folds.

5. Volume

If the upper eyelid is too thick, it may cover the double eyelids making them almost not visible at all. On the contrary, when they lack volume, it may result in unnatural overexposed double eyelids. Making them look fake and swollen – so-called sausage eyelids.

Recovery process

The recovery process after revision double eyelid surgery is not much physically demanding and it is relatively quick. The patient can come back to their usual activities as soon as 1 week after the operation. We are showing you our patient’s pictures for the reference. Can you say what was wrong with her double eyelids after reading our blog?


Do I need revision double eyelid surgery?

We have explained five main factors of beautiful eyes above. For well-performed blepharoplasty, the surgeon must consider all of them. Only then the new eye shape will meet an absolute balance. If you suspect depth, height, strength, adhesion, or volume does not work together – your eyes are still droopy; asymmetrical; eyelids are over or underexposed; look swollen after the whole recovery process is over; are too thin etc., you should certainly contact your surgeon. However you must consider that every person is different, thus the recovery process might differ a lot. Swelling, asymmetry or any of above-mentioned condition might still be present during recovery but the final effect might be satisfactory. If after the whole recovery process, you can see any of those symptoms, the revision surgery should be taken into consideration.

How to choose the surgeon for revision surgery?

Double eyelid revision, just like any other revision procedure requires much more experience and know-how than the first surgery. It is also much more expensive, so you would want to make it your last. Therefore, you must choose wisely. Not to mention that the surgeon must be board certifiedhere is the article of how to check it. When you choose the clinic, you should ask for the most experienced doctor – we do not doubt that the new surgeon can give beautiful effect, but if it comes to revision? Experience is what matters. You must also be careful of so-called shadow doctor practice – the patient has the consultation with famous, experienced, and titled doctor, the face of the clinic, but the surgery is performed by a sub-hired, less experienced surgeon. That is why you should ask if the clinic has CCTV in the surgery room. What should trigger your caution is too flexible surgeon’s availability. The famous surgeon should be booked-up for upcoming weeks or, even months in the peak season.