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Postoperative complications of full incision blepharoplasty and ptosis surgeryUnexpected double eyelid line,Did you know?

 

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What is an unexpected double eyelid line?

OriginallyA line resembling a double eyelid that forms higher than the planned double eyelid lineThis is called an unexpected double eyelid line.

・Original line + unexpected double eyelid line → triple

・No original crease, only unexpected double eyelid line → Wide double eyelid

Some people prefer a wider crease, but in this case, an unexpected double eyelid line does not form with the same width on both sides, which can cause asymmetry.

It's not a deliberately created double line, so the indentation is also weak.

 

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What's the cause?

Double eyelid surgery essentially creates a connection between the skin and the underlying eyelid structure so that the skin folds over when the eye is opened.

 

Ideally, the sutures should be placed along the incision line. However, if the skin above that line and the deep tissue behind the eyelid become adhered, the sutures may end up being placed higher than intended.

 

 

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Who is prone to it?

・Corrected cases (especially those involving narrowing)

・When combined with ROOF resection to thin the eyelids

・People who have always had trouble opening their eyes wide

 

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How should I respond?

Unplanned double eyelid lines may appear immediately after surgery or become noticeable during suture removal one week post-op.

 

・Immediately after:

If there is a preoperative risk, or if an unexpected double eyelid line appears immediately after surgery, a lifting fixation technique is used to secure the double eyelid in place with sutures. During lifting fixation, the eyes cannot close completely even when attempting to do so, resulting in a half-closed appearance.

Protect your eyes from drying out with eye drops or ointment.

In mild cases, observation may be sufficient, or a purse-string suture may be used to assist the double fold.

In this case, you can close your eyes.

・One week after surgery

Typically, the eyelid swells most between the day after surgery and the third day, after which an unexpected double eyelid line appears. This is usually discovered when patients visit our clinic for suture removal.

Suspension fixation or pocket stitchingWe will handle it.

・One month or more after surgery:

If an unexpected double eyelid line persists, we will consider revision surgery.

Make an incision along the same line and dissect the scar tissue beneath the planned double eyelid.

Combined with ptosis surgery, we enhance the depth of the double eyelid crease, prevent re-adhesion by interposing fat, and perform suspension fixation.

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How can I prevent unexpected double eyelid lines?

We frequently receive requests to revise unexpected double eyelid lines from other clinics, so even during initial incision surgeries, we leverage that experience while simultaneously devising strategies during the procedure to prevent unexpected double eyelid lines from occurring in the first place.

・Avoid unnecessary dissection around areas where scarring may cause an unintended double eyelid line

・Harvest orbital fat or ROOF fat and use it as a cushioning agent to prevent adhesion

・Improve eye opening and enhance the crease through ptosis surgery

・In some cases, we may perform unplanned double eyelid procedures such as preventive suspension suturing or purse-string suturing.

 

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Summary

Today we discussed the unexpected double eyelid line, one of the postoperative complications of full incision blepharoplasty for ptosis.

If not addressed promptly, reoperation will be necessary.

We recommend choosing a doctor who can handle complications.

 

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Reservations can be made here.

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※There are various approaches to aesthetic medicine, and opinions and practices may differ among physicians. Please consider the information provided here as one reference only, and we hope you will choose medical care that suits you and meets your expectations.

We apologize if any unintended inaccuracies or misleading expressions were included. In such cases, we will make appropriate corrections or additions.

 

【Profile】

Plastic Surgeon Dr. Ryutaro Natsume

https://biancaclinic.jp/doctor/natsume/

Performed numerous facial surgeries, particularly focusing on the eye area and facial bones, in the field of plastic surgery.

Regarding treatments for the eye area, I believe that not only aesthetic appearance but also ophthalmic functionality is extremely important. To provide safer and more reliable treatments, I am currently deepening my expertise as an ophthalmologist.

We actively incorporate non-surgical procedures such as hyaluronic acid injections, in addition to treatments requiring surgical instruments.

From a multifaceted professional perspective encompassing cosmetic surgery, cosmetic dermatology, reconstructive surgery, and ophthalmology

BIANCA CLINIC, a leading Japanese clinic specializing in beauty and regenerative medicine, provides the latest aesthetic treatments.

【Career】

2020: Graduated from Tokyo Medical University Tokyo Metropolitan Saiseikai Central Hospital

2022 Jikei University Hospital Department of Plastic Surgery

2023 Department of Plastic Surgery Jikei University School of Medicine Kashiwa Hospital

2024 BIANCA CLINIC

【Professional Affiliations/Qualifications】

Japanese Society of Aesthetic Surgery (JSAS)

Full Member of the Japan Society of Plastic and Reconstructive Surgery

Full Member of the Japanese Society of Craniofacial Surgery

Full Member of the Japanese Ophthalmological Society

【SNS】

Instagram account　

 https://www.instagram.com/dr.natsume?igsh=OHBvd3VtajV1bmY1&utm_source=qr