The eyes are the most visible part of the face, making them a frequent site for inquiries and actual surgeries. Perhaps due to the popularization of eye surgery, there seems to be a perception that it is a "simple procedure." However, it is problematic to view it as such. This is because there are quite a few cases where patients decide on revision surgery due to unsatisfactory results. A typical example is when patients are dissatisfied because the surgery was performed to create thick, prominent lines without sufficient consideration of their facial characteristics and eye condition. In such cases, surgery to undo the double eyelid crease can be performed.

What is double eyelid removal surgery?
Double eyelid retraction surgery is performed when the double eyelid itself does not suit the patient. Unlike revision surgery, this procedure involves either completely removing the double eyelid or re-creating a lower line depending on the condition of the eyes. Retraction surgery may be performed when the patient is dissatisfied with the results of a double eyelid line created previously, when the line has loosened or become thick like a sausage line after surgery, or when the line height differs between the two eyes. It can also be considered when the double eyelid is deep enough to lift the eyelashes after surgery or when there is insufficient skin. Furthermore, men generally prefer a natural-looking double eyelid line that is barely visible; therefore, for male patients, retraction surgery may be recommended if there is no significant possibility of improvement through revision surgery.

What precautions should be taken when removing double eyelids?
The focus of double eyelid retraction surgery is to re-incise the original incision line to reconstruct and restore the eyelid to its pre-operative state. The key is to release the formed double eyelid, and the procedure is often performed by either completely unraveling it or by creating a shallow, low line after releasing the crease. This is why it is considered a more complex and difficult surgery than the initial surgery to create the double eyelid. After retraction surgery, the previous double eyelid gradually fades away. Subsequently, the following may occur: 1. The double eyelid completely unravels, making the line itself invisible; 2. The crease loosens, creating a natural crease of about 2–3 mm around it (if you desire a more natural-looking double eyelid than before, it is advisable to undergo revision surgery 6 months after the retraction); or 3. As the double eyelid completely unravels, a thin, natural crease may be created at a height less than half the width of the previous crease.

When is the release surgery, and when is the timing for revision surgery?
If you remain dissatisfied with your double eyelids despite having fully recovered, you should decide on a revision surgery after monitoring your condition for approximately 3 to 6 months. It is recommended to wait at least 6 months after the initial surgery before proceeding with revision surgery. However, since the time required for the scar tissue from the previous surgery to soften and for swelling and redness to subside varies from person to person, the timing of the revision surgery should be determined while observing your progress. If the double eyelid line needs to be removed, it is necessary to thoroughly assess the current shape of the eyes and the condition of the tissue. This means that checking for issues with the existing double eyelid line is fundamental, but you must also verify the stability of the tissue. Since the skin tissue of the eyes is the thinnest in the body, a surgical plan must be established through thorough consultation with your attending physician before the operation.

Written by = Hidoc Medical Reporter Dr. Do Eon-rok (Plastic Surgeon)