Double Eyelid Surgery FAQ

WHY DO I HAVE SLEEPY OR DROOPY EYES AFTER DOUBLE EYELID SURGERY?

In some cases, a patient can develop sleepy or droopy eyes after Asian blepharoplasty or double fold eyelid surgery. The cause of this drooping is a condition called ptosis. Eyelid ptosis means that the patient’s eyelid elevating muscle (known as the levator muscle) was naturally weak. Unfortunately, many plastic surgeons don’t catch this muscle weakness and misdiagnose the patient’s drooping eyelids. This may be due to patients raising their eyelids due to the nervousness of being at a doctor’s office. None-the-less, the patient finds they have asymmetrical or balanced drooping of the eyelids after surgery, causing them to need revision.

Many patients are totally unaware that they have eyelid ptosis because when they look at themselves in the mirror, they tend to unconsciously raise their eyelids. For Asian eyelid surgery and Korean eyelid surgery to be successful, the patient’s eyes need to be diagnosed correctly.

Another reason why patients look sleepy or have droopy eyelids after double eyelid surgery is that during their surgery, scar tissue accumulates where the monolid is created. Double fold eyelid surgery typically involves making an incision and fixating the deeper layer of eyelid tissue such as the levator aponeurosis or the tarsus.

However, during this process, there can be scar formation caused by coagulating and bleeding. The heat that is delivered to the eyelid tissue can create a significant scar that will add extra weight to the eyelid. Therefore, after the double fold eyelid surgery, the patient will notice the increased weight. It is extremely important to operate and limit bleeding so that there would be minimal internal tissue damage while the double lid is created. This principle applies to all Asian eyelid and Korean eyelid surgery.

Dr. Kenneth Kim puts extra attention towards examining the patient’s preoperative eyelid muscle function during the consultation. If the patient has eyelid ptosis, he will recommend performing eyelid ptosis repair at the time of the double fold eyelid surgery. Dr. Kenenth Kim has a unique method that minimizes bleeding and tissue injury meaning the patient will avoid unnecessary internal scar formation.

Dr. Kim’s patients will experience a rapid recovery and notice improved eyelid muscle function. What this means is that rather than looking sleepy or droopy, the patients will look more awake and the eyes will feel lighter after the double eyelid surgery.

HOW OFTEN DO I HAVE TO DO DOUBLE EYELID SURGERY?

Patients who have had previous double eyelid surgery often ask if they will need to have another Asian blepharoplasty done in the future. For elderly patients, the answer is usually no, but if a patient has had double-fold eyelid surgery early in life such as during their late teens or early twenties, the patient may likely require another procedure by their forties or fifties. This is because the eyelid skin hoods over time. As the upper eyelids hood, the skin will make the double lid appear smaller and smaller. The double eyelid fold may also loosen naturally over time. Double eyelid folds become loose because the connective tissue that forms the double lid stretches and weakens with age.

As patients age, there are a few options for revision double eyelid surgery. One option is simply to remove excess upper eyelid skin in order to address hooding of the upper eyelid. This can be done by removing the skin just below the eyebrow or above the double-fold eyelid. Another option is to recreate the double lid by re-performing the same double-fold eyelid surgery.  This option is recommended for those whose double eyelid fold has loosened.

Determining when or how the procedure should be performed is always based on the specifics of the individual patient’s case. Factors such as how quickly the patient’s skin is aging, their skin’s natural collagen structure and density, and whether or not the patient has eyelid ptosis. In patients with eyelid ptosis, the surgical technique used will move the eyebrow to help open the eyes, making the brow and upper eyelid drop. This results in making the double eyelid fold appear smaller.

When choosing your options for double eyelid surgery, there are many factors to consider. Dr. Kenneth Kim will walk you through the details of your personalized procedure, explain different double eyelid fold options, and recommend the appropriate technique that matches your needs.

HOW MUCH SWELLING SHOULD I EXPECT AFTER EYELID SURGERY AND DOUBLE EYELID SURGERY?

Swelling after eyelid surgery or double eyelid surgery has a lot to do with how the surgery was performed. When the monolid is surgically changed to a double eyelid during surgery, there can be much bleeding and tissue trauma. The reason for bleeding is that there are many small vessels in the eyelid. And Asians, in particular, have more blood vessels. During blepharoplasty, much bleeding along the eyelid can occur. And in order to stop the bleeding, the vessels get coagulated in the double lid. However, the coagulation involves delivering heat to the double-lidded eyes.

Another factor that will lead to prolonged swelling after eyelid surgery and double eyelid surgery is tissue trauma. The plastic surgeon must meticulously dissect the eyelid tissue during the blepharoplasty. The eyelid, like other parts of the body, is made up of layers. Excellent plastic surgeons dissect tissue layers in an ultra-precise fashion. And when Asian eyelids are dissected in this perfect way, then the swelling of the Asian eyelid will be minimal. The patient should expect swelling in their double-lidded eyes to decrease within two weeks. At the two weeks period, the eyelid is still swollen but significantly less than after surgery. After 1 month, the swelling should be seventy percent resolved. At the three months period after surgical conversion of monolid to double eyelid, the swelling should be ninety percent resolved.