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Upper Blepharoplasty Revision

Double eyelid correction technique Dr.Roungkaw

Blepharoplasty Revision from elsewhere by Dr. Roungkaw

Blepharoplasty Revision from elsewhere is a tough and delicate procedure in which the doctor has to evaluate eyelid disorders and plans for double eyelid treatment. The previous surgical wound must be surgically operated on in order to rectify the double eyelid. Furthermore, the doctor has to remove the fascia, including the knotted stitches embedded beneath, and reconstruct the new eyelids attractively curved in the shape of the eye. Lovely Eye & Skin Clinic is one of the extensively experienced eyelid surgery clinics that provide the art of exquisite and beautiful double eyelids, which is a specific technique by Dr. Roungkaw.

The eyelid problems were surgically operated elsewhere.

  • Small eyelid creases

Historically, some patients experienced upper blepharoplasty elsewhere. Unfortunately, it provides disappointing results, including too small eyelid creases, poorly defined eyelid creases, drooping eyelids, and no improvement following surgery. All of these factors dissatisfy patients, who must then have upper blepharoplasty revision with Dr. Roungkaw. In the case of small eyelid creases, it may be caused by excess eyelids remaining due to the design of the eyelids that do not fit the eyelid shape and the eyelid surgical decoration does not fit in. In some cases, the surgery might remove too little fat, eyelids, and excess skin, which makes the eyelid result unwell-defined and not distinct.

How to solve this problem?

The doctor will evaluate the patient's eye problems and inquire about the desired pattern and size of eyelids. After evaluating excess eyelids, the doctor will surgically remove excess eyelids and excess eyelid fat to establish a well-defined eyelid crease. In addition, there are additional desirable outcomes, such as correctly sized eyelids, larger eyelids, and fewer excess eyelids. This approach to revising double eyelids will help make the eyelids perfectly well-defined and proportionate to the face shape.

double eyelid correction because the eyelids are too small

In this case, the patient underwent an upper blepharoplasty revision due to unequal eyelid creases.

  • No-stitch upper blepharoplasty (no excess skin removal)

Upper blepharoplasty with no stitch or short lesion (short sewing) by no excess skin removal results in leftover excess eyelids, causing a variety of effects. For example, the eyelids can pile up above the crease. Furthermore, the excess eyelids make the eyes appear droopy, which is unattractive. In some cases, the eyelids fall out quickly after surgery. This technique is not appropriate for people who have excessively thick eyelids, excess fat on the eyelids, or ptosis. All of these are primarily Asian issues. For better results, remove the excess eyelid along with upper blepharoplasty; this surgical procedure results in a beautiful eyelid with no falling down of the eyelid crease.

How to solve this problem?

Double eyelids can be fixed by removing the original knotted stitches. The revised upper blepharoplasty was combined with excess eyelid removal (that caused the eyelids to appear thickly swollen) to fit the eye shape, redesigned the eyelids together with the patient's request to suit the patient’s eye shape, and then re-stitched the eyelids. This procedure makes a beautiful, well-defined crease in the eyelid, gets rid of excess eyelid skin, and improves ptosis.

  • Upper Blepharoplasty is not symmetrical on both sides.

There are numerous potential causes. First, it could be due to the surgeon's incompetence in using techniques that do not address the patient's eye problems. The removal of excess eyelids may not be performed properly, leaving behind excess eyelids. Thirdly, the patient has a ptosis problem, characterised by unilateral or bilateral ptosis at varying levels that is not fixed. The eyelid creases are clearly uneven after surgery. In cases of mild to moderate ptosis, the eyelids may be treated with regular double eyelid surgery without treating the eye muscle weakness (ptosis). However, this is only a temporary solution because it does not solve all problems that may cause the eyelids to appear sleepy, the eyelid creases to remain at different levels, or the eyelid crease to appear larger than they should be, particularly in cases of different eye structures. This can also cause various eyelid creases to appear structurally distinct.

How to solve this problem?

Upper blepharoplasty can also be performed in conjunction with adjusting the eye muscles to exert more force and elevate the eyelids more effectively if the patient has weak eye muscles. The eyelid will become more well-defined and equally symmetrical on both sides.

Performing upper blepharoplasty revision due to unequal eyelid creases

In this case, the patient underwent an upper blepharoplasty revision due to unequal eyelid creases.

 

  • The sunken eye after upper blepharoplasty

The reason for sunken eyes after upper blepharoplasty is that the knotted stitch was sewn too high, obstructing the eye muscle's exertion. In some cases, the patient naturally has deep eye sockets that already existed before surgery, but they are not rectified, resulting in the eyelid crease positioning being too high, which can also cause the sunken eye.

How to solve this problem?

The doctor will evaluate the eyelid crease and then lower it. The doctor will then redesign the eyelid crease to make it smaller. In some cases, injections of fat graft transposition will be injected into the upper eyelid area in order to lower the eyelid level. In cases of ptosis, the weakness of the eye muscles can be treated so that the eyes can be fully opened and appear more naturally beautiful.

  • Triple eyelids

The cause of triple eyelids after upper blepharoplasty may be due to the normal symptom of upper blepharoplasty with no incision. For example, the eyelid crease is not folded along the surgical trace while recovering after surgery. In order to have it folded along the surgery trace, the patient needs to try to properly align their eyelids and open their eyes according to the instructions of the doctors and staff. Then, the eyelids can be folded back along the trace. In cases requiring surgery, such as deep eye sockets with little fat, injections of fat graft transposition need to be performed. In addition, the old eyelid crease from previous surgery is obviously visible because the eyelid skin was not cut properly, causing stacking into multiple or triple eyelids.

How to solve this problem?

The doctor will conduct an assessment of the causes of triple eyelids. If it is caused by a deep eye socket, upper blepharoplasty revision will be carried out with fat graft transposition, which leads to visible double eyelid creases and improves the deep eye socket. In the case of the old eyelid crease from previous surgery, the doctor will reassess the design, taking into account the appropriate distance, and sewing the eyelids at the right depth to keep the old eyelids from appearing less visible and the new eyelids to look more naturally beautiful.

Double-layered eye remedies that have been done before, because the eyes are three layers.

In this case, the patient underwent an upper blepharoplasty revision due to unequal eyelid creases.

 

  • Irritation caused by blepharoplasty (piercing, non-incisional wound)

  After doing blepharoplasty (piercing, non-incisional wound), the eyelids may feel irritated under the skin of the eye, making the eyelids look unnatural, possibly due to the surgeon's lack of expertise and understanding of the structure of the eyelids. The knotted stitches are not at the right depth level, or sutured in an excessively shallow position on the eyelids. This causes the stitch used to hold the eyelid layer to emerge, causing irritation under the surface of the eyelids. Eye irritation can cause discomfort in the eyes.

How to solve this problem?

This can be fixed by cutting out the previous knotted stitch, and sewing to create the most natural-looking new eyelid creases. With the special technique of Dr. Roungkaw that has no knotted stitch embedded under the skin of the eyes, it can reduce irritation under the surface of the eyelids. When closing your eyes, the patients will feel more comfortable with no knotted stitches, unlike other clinics.

  • No eyelid creases.

After doing upper blepharoplasty, there are no eyelid creases or only one-side eyelid crease. This problem is caused by mispositioning the suture in the eyelid crease because some eye structures have a thin issue between the eye muscles. If the doctor has enough experience, that thin issue cannot be separated from the eye muscle. This problem leads to less adhesion of the skin to the eye muscles, leading to unwell-defined or no eyelid creases.

How to solve this problem?

This can be accomplished by removing the fascia resulting from the previous operation. The doctor will then examine the eye's structure. Then, conduct an eye design in conjunction with assessing the patient's eye shape and size requirements. After that, stitch the eyelids at the proper height and depth to create a sharp crease and a natural appearance.

Upper blepharoplasty revision (unable to see eyelid creases)

In this case, the patient underwent an upper blepharoplasty revision due to unequal eyelid creases.

 

  • The eyelash turns outwards

After doing upper blepharoplasty, the problem of eyelashes turning outwards (until the inner rim of the eye is clearly visible) may unfortunately happen to patients due to mispositioning eye design that is too low, leaving less skin below the crease of the eye layer. When the eyelids are sutured, the eyelashes are pulled outwards beyond the proper level.

How to solve this problem?

In the case of eyelashes turning outwards due to mispositioning eye design that is too low, resulting in the inner rim of the eye being clearly visible, the patients have to wait until the eyelid skin stretches out according to the period of time. However, in the case of suturing the eyelids at an inappropriate depth level, the doctor can solve this problem by blepharoplasty, removing the old eye layer and sewing a new one at the appropriate level. In some cases, the eyelashes are excessively curled and the surgical wound is still swelling after surgery. This kind of problem takes approximately 4-5 days to return to normal.

  • Unnatural scar

After doing upper blepharoplasty, it causes unnatural wounds such as unsmooth scars and, additionally, unintended creases. These problems originated in blepharoplasty (piercing, non-incisional wound). This procedure does not have excess eyelid skin removal, resulting in too many dimples and creases stacking on the eyelid crease, which is considered the patient's concern.

How to solve this problem?

This problem is corrected by the surgical removal of the old scar, the knotted stitches, and the fascia under the eye surface that causes dimples. Then, create a new eyelid with a sewing technique that makes the eyelid look natural. There are no folds on the eyelids when closing the eyes. After the surgery revision, it will help smoothen the wound on the eyelid skin so there are no convex scars, no lines, no dimples, and no folds when closing the eyes. The skin of the eyelids is smoother. and looks more natural.

  • Downturned eye (the outer corner of the eye pointing downwards)

After doing upper blepharoplasty, it possibly still causes downturned eyes, which look sad and not bright. Due to the incongruous removal of the outer corner of the eyes pointing downwards, there is excess eyelid skin on the outer corner of the eyes. This effect results in a downturned eye, which does not seem to enhance physiognomy and personal image. In some cases, the eye structure that has the brow bone pointing downwards can also affect the outer corner of the eyes to point downwards.

How to solve this problem?

This problem can be corrected by the removal of the excess eyelid skin piling up around the outer corner of the eye. To solve this problem, the doctor needs to raise the outer corner or perform upper blepharoplasty revision together with a sub-brow lift. This solution will help lift the outer corner and remove excess eyelid skin around the eyes. Furthermore, it can also help to avoid long-area eyelid lesions. In the case of having little excess eyelid skin, patients can only do a sub-brow lift, which can only hide wounds under the eyebrows so that the eyelids can look raised, in some cases where they do not require surgery. The lasers can be used to lift the skin around the eyes, such as Lovely Eye Reborn Signature, or in some cases where the eyelids fall from stretching the forehead, the injection method may be used to adjust the eyebrows and eye layers to revise the falling of the outer corner.

Double-blindfolded, because the tail of the eye fell.

In this case, the patient underwent an upper blepharoplasty revision due to unequal eyelid creases.

 

  • Fascia caused by double eyelid surgery

Fascia is the tissue created by the body to envelop foreign bodies that enter the body. As in the case of double eyelids, the foreign body is actually the surgical sutures used in wound suturing. Having fascia is a normal procedure after surgery. In some cases, double eyelids are done along with fat injections. This can lead to fatty lumps (lipomas) and fascia that stick together tightly, making the skin of the eyelids uneven and hard to fix.

How to solve this problem?

In order to handle this problem, the doctor needs to slightly remove the fatty lumps and fascia, which seem stickier and tighter than the normal blepharoplasty. Due to fat cells clumping in the fibrous tissue and also sticking to the eye muscle layer, it’s difficult to remove those parts and leave them suitably. In this case, the patients need to do blepharoplasty revision by skillful doctors, resulting in a more beautiful eyelid crease and smoother eyelid skin without any lumps.

  • Eyelids that are abnormally swollen

Because filler is injected into the brow, temples, and nose. They then descend to the eyes. This will cause the eyelids to swell abnormally. The majority of them are caused by the use of non-standard products or by an inexperienced doctor, causing filler or silicone to potentially flow to other areas. Unlike no-stitch upper blepharoplasty (no excess skin excision), in this case, more sophisticated operations are required to heal the swollen eyelids.

How can this be resolved?

In this case, the doctor will need to remove excess eyelid skin and fat. In some cases, filler clumps tightly into the large size, or fascia adheres to the surgical area. These issues can be resolved by carefully removing fascia or filler. The doctor then performs blepharoplasty as needed, resulting in smoother eyelid skin that is not swollen, a more visible eyelid crease, and brighter eyes.

Double-blindfolded, because the filler flows to the eye.

In this case, the patient underwent an upper blepharoplasty revision due to unequal eyelid creases.

 

                   Upper blepharoplasty revision is difficult in terms of surgical techniques, necessitating a surgeon with a high level of expertise. The more surgeries a patient has had, the more difficult the surgical procedure must be because the body creates a very tough and sticky fascia under the skin of the eyelids. Additionally, it is challenging to handle the expectations of patients of different levels who are dissatisfied with previous surgical procedures. Those interested in upper blepharoplasty revision can make an appointment with a doctor to discuss, evaluate, and plan the most appropriate treatment so that the results are satisfactory and do not require further revision.

The recommended timing for upper blepharoplasty revision

Typically, after upper blepharoplasty revision, the surgical area may experience swelling as a normal symptom. If you want to revise upper blepharoplasty that has already been done, it is preferable to wait 1-2 months for the swelling to subside. In the case of upper blepharoplasty with no stitch or short lesion (short sewing), the revision can be done without waiting the time because there is no, or just a little swelling during the postoperative period. Upper blepharoplasty revision requires more time for the swelling to subside than standard upper blepharoplasty. So, patients need to decide deliberately to have the surgery with a doctor who specializes in eye surgery to make the eyes more beautiful and solve eye problems comprehensively so as to have no revision again in the future.

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The result may vary depending on each person.

 

Double eye treatment by Dr. Roungkaw

The result may vary depending on each person.