Eyelid Line Revision - SM Plastic Surgery

The aim is to lower the line by releasing the upper adhesion of the high-set line so the new line settles below. How far it can be lowered varies with the earlier method and the scar, and results vary from person to person.

Line height and the degree of opening are compared for each side to diagnose the cause, aiming to adjust toward symmetry. Complete symmetry can be difficult for any individual, so the approach works to reduce noticeable difference.

So the tissue and adhesion can settle, waiting 6 months to 1 year after the earlier surgery is usually recommended. Where the line went badly wrong early on, however, early correction before the scar hardens may be considered, so a consultation is needed.

Lid thickness, the strength of eye opening and the distance to the brow are reassessed, aiming to redesign a curve that suits facial proportion. What can be changed varies with the existing line and the scar.

In revision, adhesion is refined and the new line fixed; but with lid thickness and habit, change can come with time. Fixation methods and aftercare aim to reduce the risk, and results vary from person to person.

When the crease was set low and barely shows, we re-examine the thickness of the eyelid and the lid-opening strength and reset both the position and the fixation of the line. If the eyelid is thick or the lifting strength is weak the crease may still show less, so we explain what is achievable at the examination.

When an older line and a newly formed fold are both visible, we release the adhesion and re-fix the eyelid so that a single crease settles in. How much the overlapping marks fade varies from person to person depending on the state of the tissue.

For a line made by the buried-suture method, we remove the fixing sutures, clear the adhesion and then design a new crease. There is usually less scar tissue to deal with than after an incisional line, but the method depends on where the sutures remain and how much adhesion has formed, so it is decided after examination.

A crease set too high can leave the eyelid draping heavily over the eye, so lowering it often makes the impression lighter rather than smaller. If the lid-opening strength is weak, however, lowering alone may not be enough, and we judge at the examination whether to adjust that as well.

Part of the judgement can only be made once the adhesion of the previous line has actually been released, so we give an expected range at consultation and finalize it during surgery while looking at the tissue. How far it can come down depends on the earlier method and the extent of the scarring.

Because the adhesion of the existing line usually has to be cleared, an incision is often needed. It depends on the earlier method and on how much has to be adjusted, so the suitable approach is decided after a detailed examination.

Photos are welcome, since they help us understand the impression you are after. Eyelid thickness, lid-opening strength and the distance to the brow differ from person to person, however, so the same line does not suit everyone, and we adapt the height and curve to your facial proportions.

We generally guide a return to daily activities from about seven days, but the crease itself takes longer to settle naturally. The time varies widely with how much adhesion was released and how thick the eyelid is, so we confirm it through follow-up visits.

Adjusting the lid-opening strength changes how far the eyelid rises, so a crease at the same position can look different afterwards. When ptosis correction is performed together, we design the crease height taking that change into account.

The line can loosen at the outer corner or become hidden under overhanging skin, so we re-tidy the adhesion and the curve at the end of the crease. If drooping of the eyelid is also present the approach may differ, and we confirm this at the examination.