홍진주성형외과

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[ Cause of depressed scar and eyelash eversion ]

Excessive removal of muscle and soft tissue just below the double eyelid line
There is abundant soft tissue in the outer layer of tarsus in Oriental eyelids, which separates the levator muscle and tarsus from the covering skin. Although an adequate amount of tissue should be removed, excessive, irregular removal can make a deep depressed scar on the double eyelid line.

If the muscles and tissues are excessively removed, the multi-layered structure is distorted resulting disruption of the normal structure underneath the skin. The irregularity of the surface with interrupted shadow makes the scar depressed.

The skin surface smoothness could be restored by scar excision and realignment of the layered structure along the normal skin crease.
Excessive removal of muscle and soft tissue just below the double eyelid line
After soft tissue reduction, the marginal skin should be fixed firmly to the deeper structure (tarsus, levator muscle or aponeurosis) to form an adhesion. At that time, the dissected skin can be fixed in various manner.
If it is fixed in method 1(fixed to the higher position), the skin would be stretched and thinner than upper skin. The step deformity occurs on the line due to the skin thickness difference between upper and lower side. It creates a depressed scar and deep fold. The eyelashes are lifted than the normal position and then hidden white mucosa might be exposed unnaturally.

If it is fixed to a lower point like method 3, the skin under the double eyelid line is loosely sagging over the eyelashes, and the fold becomes shallow or easy to relapse
If the depressed scar is combined with the eyelashes eversion, the skin below the line should be fully dissected and fixed in a neural relaxed line (Method 3)
Not parallel to the natural skin crease
If the line is not parallel to the natural skin crease. The skin folds unnaturally with irregular unwanted wrinkles. Irregular multi-folds make discontinuous shadows which are more prominent than a wide scar tissue. This irregular discontinuous silhouette makes unnatural “Plastic Surgery” look

=> It is necessary to align the irregular shadow of the unnatural skin folds by correcting the line parallel to the natural skin crease.

The skin edge alignment of the suture should be even to each side
Wrong edge alignment Correct edge alignment
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    Selected Plastic clinic for the
    “Let Me IN” for the medical support.
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