Double eyelid surgery creates a brighter expression.

A human pupil of the eye is approximately 10mm in length. However, a single eye lidded person shows approximately only 7mm of this. A double eyelid surgery can increase this up to 8mm. This difference of 1mm brings a significant change to a person's expression. A rough analogy would be the difference in perceived height of two people who are 160 cm and 176 cm in height, respectively. Just a 10% change in the eye brings an enormous amount of difference.

As such, it's not just the line of the eye, but the naturalness of the expressions that is the real essence of a beautiful eye. Double eyelids play a very important role in expressions and a double eyelid surgery can be called 'the surgery that creates expressions'.

I normally ask patients to bring a photo of a desired outcome, because a picture is worth a thousand words and it helps me to get a better sense of the goals of the patient. The outcome can never match the photo 100%, but it will be as close to it as possible.

The importance of communication between the physician and the patient can't be stressed enough. It is important to fully discuss what the patient wants and to find a common denominator that can be agreed upon. It is also important from the patient's perspective to fully discuss and think through the procedure in order to obtain a desirable outcome.

Types of double eyelid surgeries

Which is prettier, a single eyelid or a double eyelid? The answer is both, whatever looks better on you.

Most westerners have big eyes and double eyelids, which make them look more attractive. However, Asians have relatively fewer percentages of double eyelids and 70% of Koreans lack double eyelids. It's not necessarily true that double eyelids are more beautiful, but if made, brings about a better expression through livelier eyes.

The effect of a double eyelid surgery is better with thinner eyelids and longer eye length. Shorter length eyes can also be improved by cutting the end of the eyes and lengthening it. Thicker eyelids improve less with surgery, but if the reason for the thickness is not in the inherent thickness of the eyelid but with the fat or muscle underneath, then the effect of the surgery can be improved by removing the fat and/or incising the muscles.

Double eyelid surgery can be classified into the incision method and the non-incision method. The non-incision method is better for patients with thinner and younger skin since it leaves no scars. The incision method is more suited for patients with sagging skin.

In the past, the incision method usually didn't come undone but took about 2 months to gain naturalness, whereas the non-incision method tended to become undone. Nowadays, the non-incision method rarely becomes undone and the incision method takes about 1 week to become natural.

In cases that require precise shaping of the line, the incision method is preferred.

Re-surgery(multiple surgery) of the double eyelid

The surgical revision can be largely grouped into the following three categories: thickening of the eyelid, thinning of the eyelid, and reshaping of the eye line. These can generally be accomplished through resurgery. It's relatively easy to thicken an eyelid, but the reverse requires a high degree of skill and experience and is considered one of the most difficult parts of eye cosmetic surgery.

One of my patients received surgery from a Chinese doctor and the eye line was too large and unnatural. The Chinese doctor told her to wait for the naturalness to return, but 5 years have passed already and she became upset every time she looked at the mirror because the upper eye looked too hollow.

There's little chance for the eye to become more natural in the future if it's already been 5 years and naturalness hasn't returned. This is especially true if the line of the surgery was too high.

She received a resurgery that removed the scars set in the skin and repositioned the line to a more desirable lower position. Although it's not frequent that fat is reinserted into the eyelid, it was performed because too much fat was removed from her first surgery and her eyes looked sunken.

The resurgery was focused on improvement rather than achieving perfection.

Clinical examples of double eyelid surgery