Eyes - SM Plastic Surgery

Broadly, they divide into double-eyelid surgery (buried suture, natural adhesion, incision), ptosis correction, canthoplasty (medial, lateral, lower), under-eye surgery (lower blepharoplasty, fat repositioning) and revision. Which suits varies with the lid, the strength of eye opening and what you want to improve, so the decision follows a detailed assessment.

Where the lid is thin with little fat, the buried-suture method — fixing with thread, no incision — suits; where the lid is thick or fat and skin sag, the incisional method, which refines before fixing the line, suits better. The natural adhesion method (partial incision) sits between the two, and the method is chosen after examining the eye.

Double-eyelid surgery makes the crease; ptosis correction adjusts the strength of the levator so the eye opens more clearly. Where ptosis with weak eye opening is present, a crease alone rarely brings a clear eye area, so ptosis correction is considered alongside.

The inner line is designed low and narrow for a restrained, natural eye area; the outer line high and wide for a clear, open one seen from the front. Which line suits varies with lid thickness, the distance between brow and eye and the strength of eye opening, so it is designed around facial proportion.

Double-eyelid surgery, ptosis correction and canthoplasty are sometimes performed together, depending on the eye. Whether to combine varies with the lid and the goal, so the necessary extent is decided through careful consultation.

Director Lee Muyoung, a plastic surgery specialist, handles everything from consultation through to the operation himself. Because the person who examined your eyes also performs the surgery, the design agreed in consultation carries straight through to the procedure. You can ask about anything directly at your consultation.

We check eyelid thickness and fat volume, skin elasticity and eye-opening strength, and also look at the gap between the eyes, the horizontal length of the eye, the distance between brow and eye, the balance with the nose, and harmony with the face shape. Even for the same operation, these findings change the method and the line design. The findings are reviewed with you in consultation.

The approach differs depending on whether the cause lies in the crease, in eye-opening strength, or in drooping skin. If the eyes look unclear because there is no crease we look at crease design; if eye-opening is weak, at ptosis correction; if skin is covering the eye, at upper eyelid surgery. We separate the cause first, then decide what needs to be done.

For younger patients the focus is often crease design and clarity of the eyes, while from mid-life onward drooping eyelid skin and reduced eye-opening strength are often addressed together. Even for the same double eyelid procedure, the method changes with skin laxity and elasticity. We judge by the condition of the eyes rather than by age.

We review the method and course of your previous surgery together with the current state of the eyelid, then explain what can realistically be improved. Revision involves more to consider than a first operation, so timing and method are decided carefully. Surgical records or photographs of your progress are helpful at consultation.

Photographs showing the eye shape you have in mind, or a note of what currently bothers you, make the consultation easier. If you have had eye surgery before, knowing when and how it was done, along with photographs of your progress, helps our assessment. Which method suits you is decided as we look at the examination findings together.

How much it changes depends on the height of the crease, the extent of any epicanthoplasty, and whether ptosis correction is combined. The range runs from designs that stay natural to those that make the eyes distinctly clearer, so we first confirm the impression you want and design within facial proportion without overdoing it. Results vary from person to person.

During recovery, swelling and irritation can leave the eyes feeling dry or gritty. This usually eases as healing progresses, but if it lasts a long time or worsens it needs to be checked at follow-up. Recovery differs from person to person, so please tell us about any discomfort as it arises.

Before the surgical site has settled, inserting and removing lenses can irritate the eyelid, so we do not recommend it. The timing depends on when the sutures come out and how recovery is going, so we advise as we follow your progress. Until then, glasses are the better option.

Photographs alone make it hard to gauge eyelid thickness, eye-opening strength and skin elasticity accurately, so we can only indicate a rough direction. The actual method is decided after examining the eyes in person. Photo consultations are best treated as a reference.