To clear puffy eyelids
An explanation of ROOF resection
ROOF (retro-orbicularis oculi fat) is fatty tissue that extends in an areal pattern under the orbicularis oculi muscle of the upper eyelid and over the orbital septum. Thick ROOF results in a puffy, heavy eyelid.
ROOF Resuction is a procedure in which the ROOF is removed to reduce the thickness of the eyelid and create a clean, thin eyelid.
It is indicated for those who have a puffy upper eyelid or want to remove the thickness of the upper eyelid.
Features of our ROOF resection
- The ROOF is removed through an incision made under the eyebrow or from the line of the double eyelid. ROOF resection can be performed alone, but is often performed in conjunction with an upper eyelid lift or full incision.
- For local anesthesia, we use 34G ultra-fine needles (needle thickness 0.2mm) to minimize pain.
- Surface anesthesia and intravenous anesthesia are used for those who are afraid of even the slightest pain.
- The day after surgery, you can shower, wash your face, and apply make-up except for on your eyelids.
- 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 make-up to your eyelids the day after stitches are removed.
Surgery method
When performed at the same time as full incision method
A skin incision is made along the double eyelid line and the ROOF is removed in the area where the eyelid is to be thinned.
If necessary, orbital fat is also removed (lipectomy of the upper eyelid).
The surgery is completed with internal processing of the skin and deep tissue to create a double eyelid. At this time, plastic surgical sutures are used to minimize scarring.
When performed at the same time as upper eyelid lift
A skin incision is made along the lower edge of the eyebrow and the ROOF is removed in the area where the eyelid is to be thinned.
If necessary, the orbicularis oculi muscle is also removed.
Close the wound by suturing it in a plastic surgical fashion. A firm internal treatment will minimize scratches.
We use the best plastic surgical sutures for wound healing, which are internally sutured with high-performance absorbable ultra-fine thread and externally sutured with non-absorbable ultra-fine thread.
We also offer skin suturing with ultra-fine transparent thread.
Aftercare for ROOF resection
《After surgery》
Condition of the affected area
The lower brow or double eyelid line is sutured with a very fine black thread. The stitches are usually removed in 4-7 days.
Bruising may occur around the eye, but it will usually disappear in 1-2 weeks.
The swelling may make it somewhat difficult to open the eyes. It will ease over time.
Immediately after the surgery, there is some discomfort in the eyelid. This also eases over time.
Post-operative checkup and aftercare
You will be examined by the doctor just before you go home after 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 make-up 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 the surgery except around the wound.
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 from the day after surgery if there is no discomfort. They certainly can’t be worn 2-3 hours after surgery due to the effects of anesthesia.
《Days 4-7 after surgery》【Please book an appointment for stitches removal】
Condition of the affected area
Major swelling will go down in about a week after surgery.
Mild swelling may be noticed for a week or two, but will disappear over time.
Initially, the scar will be red. The redness varies from person to person, but it will subside in 1-2 months.
In rare cases, there may be a slight bump.
In rare cases, the suture thread may come out.
Bruising may occur around the eye, but it will usually 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, and your stitches will be removed.
Lifestyle advice
Eye make-up, skin lotions and creams can be applied after stitches removal.
Please avoid rubbing the eye area too much.
From the 7th day after the day of surgery, you will be able to bathe 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 of the scars will vary from person to person, but this will settle down in 1-2 months.
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-protect 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.
Redness of the scar will also be improved.
Post-operative checkup and aftercare
You will be examined by a doctor.
There is no post-operative procedure.
Lifestyle advice
You can resume all of your daily activities.
FAQ
The swelling around the eyelids will go down in roughly 4-5 days.
The stitches are usually removed 4-5 days after surgery.
The day after the stitches are removed, you can apply make-up 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).
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, and by administering the local anesthetic very slowly.
For those who are still afraid of pain, we offer intravenous anesthesia, where you will be unconscious and breathing as usual.
Post-operative pain is usually very mild.
We will prescribe a mild analgesic and anti-inflammatory drugs just in case.
About 60 minutes.
Fees
| ROOF Resection | ROOF Resection only | ￥330,000 |
|---|---|---|
| In combination with full incision method or upper eyelid lift | ￥110,000 |
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.
If you experience any symptoms, we have a solution for you.
We will always improve your symptoms.
Normal post-operative symptoms
Swelling
Major swelling will improve quickly in 1-2 week after surgery, then any mild swelling will be noticeable for another week or two.
Things will completely settle down in 3-6 months.
Bruising around the eye
There may be bruising around the eye, but it will disappear in a week or two.
Eyelid discomfort
Immediately after ROOF resection, the eyelids will feel strange, but this will disappear over time.
Scars
You will see some redness for 1-2 months after surgery, but it will become 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 and complications
Exposure of buried absorbable sutures
If this happens, we will 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 / too narrow double eyelids
After the swelling has subsided, we will evaluate the shape and perform revision double eyelid surgery to adjust the width.
Eyelids are hollowed
In the unlikely event that the desired effect is exceeded, adjustments can be made with fat grafting or hyaluronic acid injections.
Eye surgery list
Detailed information on each eye surgery procedure, including case photos, case progress photos, procedure duration, post-operative course, downtime, aftercare, risks, side effects, and complications.
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, 2003-2005
Daito Central Hospital Plastic and Reconstructive Surgery, 2003-2005
Ritz Cosmetic Surgery Tokyo Clinic, 2005-2008
Primo Azabujuban Clinic, 2009~
Head Director, Primo Medical Corporation, 2011~
Head Director/Director, Primo Azabujuban Clinic, 2020~
