Post-operative corrections
Who is revision double eyelid surgery suitable for?
- For those who want to adjust the width of their double eyelids.
- For those who want to correct the difference in width between the right and left sides of their double eyelids.
- For those who want to reduce the prominence of their double eyelids.
An explanation of revision double eyelid surgery.
Revision double eyelid surgery is a procedure to correct double eyelids when they are not the desired width, or the difference between the left and right sides needs adjusting, or the line needs cleaning, etc.
We receive a lot of requests to narrow the width of the double eyelid because the initial incision method is too wide. The narrowing is done by revision double eyelid surgery.
If the skin under the double eyelid is excessive and sausage-like, it will ride on the eyelashes, making it difficult to raise the lashes, and it will hide eyeliner.This condition also makes the double eyelids wider, but the excess skin hangs down over the eyes, making them look smaller.These symptoms can be improved by revision double eyelid surgery.
Features of our revision double eyelid surgery
- 34G ultra-fine needles are used for local anesthesia (with a needle thickness of 0.2mm), resulting in minimal pain.
- Surface anesthesia and intravenous anesthesia are used for those who are afraid of even the slightest pain.
- The line is firmly fixed on the aponeurosis of the levator palpebrae superioris muscle to form clear double eyelids.
- Orbital fat removal is also available upon request.
- The day after surgery, you can shower, wash your face, and apply makeup except for the eyelid area.
- Skin sutures can be removed early on the fourth or fifth day. Because we use the buried suture method with 7-0 ultra-fine absorbable thread (plastic surgical sutures).Scarring will be minimal.
- Skin suturing with transparent thread is also available.
- You can apply makeup to your eyelids the day after stitches are removed.
Reasons to perform revision double eyelid surgery
If you have had double eyelid surgery and are not satisfied, we can perform revision double eyelid surgery to improve the result.
If your double eyelids are too weak, too narrow, or too wide; or if you are concerned about the difference between the left and right eyelids; or the scars are too prominent; we will suggest appropriate correction methods.
Press + to see the answer
I want to make my double eyelids wider because they are too narrow.
One option is the buried suture method which is suitable for some patients.
If the buried suture method isn’t possible, the incision method is used.
For those with a lot of sagging skin, the upper eyelid lift is recommended.
For the incision method, an incision is made along the desired line.
Depending on the patient’s wishes, a CO2 laser can be used to make an incision to reduce bleeding.
If there is a lot of sagging, the excess skin is removed.
The orbicularis oculi muscle, anterior eyelid tissue, and submuscular connective tissue are also removed as needed.
If there is excessive orbital fat, it is removed.
Revision double eyelid surgery can be combined with ROOF resection depending on the case.
Suturing with 7-0 ultra-fine absorbable thread minimizes any scarring.
I wish to make my double eyelids narrower because they are too wide.
If the buried suture method is used, the double eyelids will disappear and become narrower when the buried threads are removed.
If the incision method is used, the skin under the line can be removed; or revision double eyelid surgery can be used to separate the skin from deep tissue adhesions and intervene with orbital fat in between.
With revision double eyelid surgery, the incision is made along the desired line.
In this case, depending on the patient’s condition and wishes, a skin incision can be made using a CO2 laser to reduce bleeding.
If there is a lot of sagging, the excess skin is removed.
The orbicularis oculi muscle, anterior eyelid tissue, and submuscular connective tissue are also removed as needed.
Any adhesions from the double eyelid line of the previous incision are carefully removed.
The orbital septum is opened to locate the orbital fat.
If there is sufficient orbital fat, it is used to form narrow double eyelids.
If there isn’t enough orbital fat, revision is performed using ROOF.
In some cases, fat grafting of orbital fat from the lower eyelid may be performed.
Sutures are made with 7-0 ultra-fine absorbable thread which minimizes scarring.
Ptosis surgery is another method to narrow the double eyelid width by improving the opening of the eye.
In this case, the levator palpebrae superioris muscle is shortened and reattached to the tarsal plate. Fine adjustments are made while the patient is sitting and holding a mirror to check the extent of the eye opening.
The degree of the eye opening and the difference between the left and right eye are both carefully adjusted.
After that, intravenous anesthesia is administered, and then the skin and deep tissues are carefully sutured with 7-0 ultra-fine absorbable thread over the entire incision area.
With conjunctival side ptosis surgery, no skin incision is made and the eyelid opening is adjusted by fixing the levator palpebrae superioris muscle.
If you have double eyelids of differing widths and want to align them.
The surgical technique used will depend on whether it is being done to fit either the wider or narrower side.
If there is a difference in the degree of each eye opening, this may require adjustment through ptosis surgery.
If there is a difference in the amount of skin between the left and right sides, an appropriate excision is made.
If the position of the eyebrows is the cause of this difference, Botox on the forehead is an effective treatment.
When there is excess skin under the double eyelid line that looks like a sausage.
We can remove this excess skin.
This will make the double eyelid width slightly narrower.
If the patient does not wish to touch the double eyelid line, there is another procedure where the skin is removed at the eyelash line of the upper eyelid.
The double eyelid line is shallow
Skin excision is performed if necessary.
Any excess tissue inside is removed.
The double eyelid line is formed with sutures in the levator palpebrae superioris muscle and skin using 7-0 ultra-fine absorbable thread.
The double eyelid line is too tight
Tissue adhesions are peeled away to loosen the double eyelid fixation, and the new double eyelid line is firmly fixed with 7-0 ultrafine absorbable thread.
Scar from the double eyelid surgery is misshapen or rough
The scar is trimmed and the skin is re-stitched to make it clean and tidy.
The buried suture is performed with 7-0 ultrafine absorbable thread.
The double eyelid line is too tight
Tissue adhesions are peeled away to loosen the double eyelid fixation, and the new double eyelid line is firmly fixed with 7-0 ultrafine absorbable thread.
Scar from the double eyelid surgery is misshapen or rough
The scar is trimmed and the skin is re-stitched to make it clean and tidy.
The buried suture is performed with 7-0 ultrafine absorbable thread.
If the eyelashes are raised and too much mucous membrane is visible
Tissue adhesions are peeled off to loosen the double eyelid fixation that has been pulled up too far.
The new double eyelid line is fixed with 7-0 ultrafine absorbable thread.
If the eye opening becomes narrower after double eyelid surgery
We will make every correction necessary, such as releasing tissue adhesions or narrowing the double eyelid line.
If necessary, we will perform ptosis surgery.
If you want to remove any previous buried thread.
We thoroughly look for threads before creating a double eyelid through the incision method.
Our incisional double eyelid surgery uses 7-0 ultrafine absorbable thread, so no foreign objects remain in the eyelids afterwards.
We use the best sutures: internally, with high-performance absorbable ultra-fine thread; and externally, with non-absorbable ultra-fine thread.
We also offer external suturing with ultra-fine transparent thread.
Aftercare for revision double eyelid surgery
《After surgery》
Condition of the affected area
The newly formed double eyelid line is sutured with very fine black thread.
The stitches are usually removed in 4-7 days.
The double eyelid is a little wider and tighter than expected. This is due to temporary edema.
Bruising may occur around the eye.Any bruising will usually disappear in 1-2 weeks.
Depending on how the double eyelid is corrected, the eyelash angle may be too steep and the mucous membrane will be visible.
Occasionally, the previous double eyelid lines may remain.
An extra scar often appears on the eyelid.
Post-operative checkup and aftercare
You will be examined by the doctor just before you go home on the day of surgery.
Antibiotics, painkillers (the pain is usually mild, but we prescribe them just in case), and gastric medicine will be prescribed for 3 days after surgery.
Lifestyle advice
You can wash your hair and take a shower on the same day after surgery.
Please only wash your face with water, not soap.You can use soap or facial cleansing foam from the next day onwards.However, please do not rub the wound.If the thread gets stuck or it tears, it may bleed.Please do not pick the scab or any other part of the wound, and try to rest.
Please do not apply any cosmetics to the affected area until the stitches are removed.
Please refrain from taking a bath or doing any strenuous exercise for about a week.
Make-up can be applied from the day of surgery except around the eyes.When sleeping, please use cushions to elevate your upper body and head.
Please refrain from drinking alcohol and smoking for about a week.
Contact lenses can be worn 4 hours after surgery if there is no discomfort.They certainly can’t be worn 2-4 hours after surgery due to the effects of anesthesia.
《Days 4-7 after surgery》【Book an appointment for stitches removal】
Condition of the affected area
The swelling will go down in a week or two.The double eyelid is a little wider and tighter than expected. This is due to temporary edema.Things will completely settle down in about 6 months.
Initially, the scar will be red.The redness varies from person to person, but it will subside in about 1-2 months.In rare cases, there may be a slight bump, due to edema.
There may be bruising around the eye.Any bruising will disappear in 1-2 weeks.
Decreased sensation may occur on the eyelash side of the incision.This usually takes a few months to recover.
Post-operative checkup and aftercare
You will be examined by a doctor 4-7 days after surgery.
Your stitches will be removed.
Lifestyle advice
Skin lotion and creams can be applied after stitches removal
Eye makeup is also OK, once the stitches are removed.Please avoid rubbing the eye area too much.
From the 7th day after the day of surgery, you can take a bath and exercise as usual.
After removal of stitches, please keep the scar moisturized and UV protected.
Our wound cream (1,100 yen inc. tax) can be applied to make the wound less prominent.
《1-3 months after surgery》【 It is recommended that you visit for a checkup at this time.】
Condition of the affected area
The wound will gradually heal completely, but there will be some swelling for a while.
The redness and elevation of the scars will vary from person to person, but this will settle down in 1-2 months.
In rare cases, the suture thread may come out.Since it is a fine absorbable thread, it can usually be left untreated, but if you are concerned about it, we will remove the stitches.
Post-operative checkup and aftercare
You will be examined by a doctor.
There is no post-operative procedure.
Lifestyle advice
Please continue to moisturize and UV-care your scars.
《6 months after surgery》【It is recommended that you visit for a checkup at this time.】
Condition of the affected area
The wound has almost fully healed.
Numbness of the eyelash side and scar redness will both have improved.
Post-operative checkup and aftercare
You will be examined by a doctor at each checkup.
There is no post-operative procedure.
Lifestyle advice
You can resume all of your daily activities.
FAQ
Questions answered about revision double eyelid surgery.
Click on each question to see the answer.
Pain will be minimal, because our local anesthetic contains extra agents to reduce any discomfort.To minimize injection pain, the amount of anesthetic used is kept to a minimum of 1-1.5 cc for both eyelids.
Pain is also minimized by using an ultra-fine 34G needle, as well as a new needle for each eyelid.The local anesthetic is administered very slowly which minimizes pain.
For those who are still afraid of pain, we offer general anesthesia.Under general anesthesia, you will be comfortably unconscious and breathing as usual.
The swelling around the eyelids will go down in roughly 4-5 days.
The swelling duration will vary depending on the width of the desired line.If the double eyelid is wider than 10mm, the swelling may last for 1-2 months.
Makeup can be applied immediately after surgery except for the eyelids.
The stitches are usually removed 4-5 days after surgery.The day after the stitches are removed, you can apply makeup to your eyelids.
For 1-3 months after surgery, there will be some redness and stiffness. Redness can be concealed with make up.
We use sutures with absorbable thread (6-0 PDS), which results in a clean scar.
If you have persistent redness, we will provide appropriate treatment at the post-operative checkup (free of charge).
Post-operative pain is usually very mild.We will prescribe a mild analgesic and anti-inflammatory drugs just in case.
It will last about 1 hour and 30 minutes.
The excess fat can be removed during the revision double eyelid surgery.
The advantage of incision double eyelid surgery is that it can remove the sagging of the eyelids.
For those who do not want to have two or three double eyelid lines, revision surgery can improve this.
Fees
| Revision Double Eyelid Surgery | ￥440,000 |
|---|---|
| Revision Double Eyelid Surgery (more complex version involving tissue transfer or grafting) |
￥550,000 |
All fees displayed include tax.
Risks and side effects
Underneath is a list of things that may occur.
In order to prevent any of these symptoms from occurring, we take safety measures and perform treatment with the utmost care.
We also have a solution for any symptoms should they occur.We will always improve your symptoms.
Post-operative course
Swelling
Major swelling will go down in 3-7 days after surgery.Mild swelling may be noticeable for a week or two.Things will completely settle down in about 6 months.
Bruising around the eye.
There may be bruising around the eye.
It sometimes occurs, but it will disappear in a week or two.
Eyelid discomfort
Immediately after the incision method, the eyelids will feel strange.
This will disappear over time.
Scars
You will see some redness for 1-2 months after surgery.
It will become less noticeable over time.
Sensory abnormalities
The skin on the eyelash side of the incision line will become less sensitive.
This will improve over time.
Risks, side effects, and complications
Exposure of buried absorbable sutures
Remove the stitches.
Infection
Although rare, there is risk of infection with any surgery.
If infection occurs, it may be necessary to treat it with antibiotics or remove any pus by small incisional drainage.
Too wide / narrow double eyelids
After waiting for the swelling to subside, we will evaluate the shape and if correction is necessary, we will perform another revision double eyelid surgery to adjust the width.
Disappearance of double eyelid line
In the case of the incision method, it is extremely rare for the lines to disappear, but if they do, we will re-open the incision, remove the orbital fat, and apply internal treatments.
Changes in eyelid morphology
The angle of the eyelashes may change, and the mucous membrane at the eyelid margin may become more prominent.
The incision method can reliably create a firm and deep double eyelid.
Limitations of revision double eyelid surgery
The previous lines may be difficult to erase and may remain.
You may have two double eyelid lines.
When narrowing a wide double eyelid, correction may be difficult depending on the previous surgery.
If there is still orbital fat, there is a good chance that double eyelid can be revised.
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Supervising Doctor
Under the supervision of our plastic surgeons, we operate our website in accordance with medical advertising guidelines.
NORIHIRO OHBA M.D. Ph.D.
HEAD DIRECTOR/DIRECTOR
Qualifications and Academic Affiliations
Doctor of Medicine
Board Certified Plastic Surgeon, Japan Society of Plastic and Reconstructive Surgery
Board Certified Aesthetic Plastic Surgeon, Japanese Society of Aesthetic Plastic Surgery
Board Certified Aesthetic Plastic Surgeon, Japanese Society of Aesthetic Surgery
Anesthesiologist certified by the Ministry of Health, Labor and Welfare
Member of International Society of Aesthetic Plastic Surgery (ISAPS)
International Member of American Society of Plastic Surgeons (ASPS)
Member of Japan Society of Cranio-Maxillo Facial Surgery
Member of Japan Society of Laser Surgery and Medicine
Career
Graduated from Osaka City University Faculty of Medicine, 1996
Osaka City University Hospital Plastic and Reconstructive Surgery, 1996-1999
Osaka City University Graduate School of Medicine, 1999-2003
Osaka City University Hospital Plastic and Reconstructive Surgery, 2003-2005
Sano Memorial Hospital Plastic and Reconstructive Surgery(part-time)
Daito Central Hospital Plastic and Reconstructive Surgery(part-time)
Ritz Cosmetic Surgery Tokyo Clinic, 2005-2008
Primo Azabujuban Clinic, 2009~
Head Director, Primo Medical Corporation, 2011~
Head Director/Director, Primo Azabujuban Clinic, 2020~
