|Correction of eye shape, do I need it
Ptosis correction shorten eye opening muscle so that the patients can open their
So, the eyes will look brighter and bigger and the pupil is more exposed when
they gaze straight.
It's original name is ptosis correction but nowadays correction of eye shape operation(NoonMae
KyoJeong in Korean)becomes more popular, which was named to eliminate the sense
Ptosis correction sounds serious, but correction of eye shape sounds sweet and
Many Korean plastic surgeons nowadays recommend correction of eye shape instead
of simple double fold operation or blepharoplasty indiscrimately and it is abused
as a way of increasing cost of eye surgery.
Even if ptosis correction is a very good procedure when it is recommended
to whom need more eye opening, it can causes many
serious complications and unwanted results sometimes.
1. Pseudoptosis(Fake ptosis)
Ptosis is an abnormal condition of one or both upper eyelids in which the eyelid droops because of a congenital or acquired weakness of the levator muscle or paralysis of the third cranial nerve.
Pseudoptosis is a condition resembling ptosis, due to abnormalities other than those found in the eyelid elevator muscles.
Many Asians who have redundant eyelid skin looks like they have ptosis, but they have pseudoptosis in fact.
That means it should be corrected with blepharoplasty, not with ptosis correction.
Let's compare next 2 pictures.
Both patients seem to have drooping eyelids before surgery which were corrected with eye surgery.
Their eyes look brighter and bigger after surgery.
▲ Who have ptosis and pseudoptosis ?
Even plastic surgeons can't discriminate pseudoptosis and ptosis by just watching this kind of photos.
To diagnose pseudoptosis and ptosis, we should see the movement of their eyelids.
(The first one had pseudoptosis and was corrected with blepharoplasty and the second one had ptosis and was corrected with ptosis correction.)
Can people who have normal eyes or pseudoptosis look better when they undergo ptosis correction ?
The answer is No.
Ptosis correction to normal patients can make more scar tissue in deep layer of eyelids and cause discomfort in eye opening, headach, and dry eyes easily.
In addition, the revision of ptosis correction is harder and more complicated than the revision of double eyelid surgery or blepharoplasty.
In a nutshell, they became to have worse results after wasting their unnecessary money.
(The cost of ptosis correction is double the cost of double eyelid surgery.
The cost of revision of ptosis correction is double the cost of revision of double eyelid surgery)
There are several reasons why ptosis correction is recommended indiscrimately.
The first reason is consultation is done with consultants, not with doctors.
Many clinics(most of big clinics) in Seoul hire consultants who have no medical knowlege and give incentives according to their raising incomes.
So, consultants in Korea can't discriminate ptosis and pseudoptosis.
Have you seen any flight attendants who can diagnose ptosis and pseudoptosis ?
And they usually have an interest in raising income only and try to recommend more expensive procedures.
The second reason is many doctors can't discriminate ptosis and pseudoptosis.
In Korea, any doctors can do plastic surgery.
Plastic surgery clinics by general physician are three times more than clinics by board certified plastic surgeons
The third reason is too cheap double eyelid surgery.
The cost of double eyelid surgery is the same (about 1,000 USD which is about 1/3 of the cost in US and Japan) for over 20 years because of too much competition in plastic surgeons in Seoul.
So, some surgeons cheat to recommend more expensive ptosis correction instead of cheaper double eyelid surgery.
These pathetic doctors abandoned their ethics and chose money.
The fourth reason is incorrect self diagnosis of patients.
Many patients nowadays do self diagnosis before coming to consultation and they are convinced that they need ptosis correction.
They believe more the opinions of unspecialized people in internet than the diagnosis of doctors.
What a distrust !
Some patients get angry or treat me as a quack when I recommend double eyelid surgery instead of ptosis correction because they were recommended ptosis correction by other doctors.
What a nonsense it is !
Each has an appropriate remedy and doctors will help you to decide what is the best for you.
The fifth reason is unreasonable expectation of patients.
Many patients misunderstand they will become more beautiful when they undergo more expensive and more complicated procedures.
The truth is more expensive and more complicated procedures are good for whom have more complicated condition.
The best results are usually come from simpler and cheaper procedures to whom have better condition.
More complicated procedures usually raise the risk and make more scar which interfere with revision later.
The number 1 principle in plastic surgery is less risky and more effective procedures are the best.
2. Heavy eyelids
There are many causes of heavy eyelids.
The most common cause of heavy eyelids in Asians is excess eyelid skin.
(If the skin is excess, it looks bulky and if the skin is stretched, it looks light.)
The other causes are thick eyelid skin, thick orbicularis oculi muscle, excess fat in eyelids, and excess subbrow fat.
▼ If the patient with heavy eyelids undergo ptosis correction, the excess eyelid skin is crowded more and the eyelids look fuller.
In addition, they may look angry and unnatural.
In heavy eyelids, eyelidlift with subbrow excision is more appropriate.
By removing excess thick eyelid skin, thick orbicularis oculi muscle and subbrow fat, thin eyelid skin is lifted up and stretched, which makes their eyelids look much lighter.
In addition, patients feel easier in opening their eyes and their eyes look bigger and smarter.
Eyelidlift with subbrow excision is strongly recommended to whom have thick eyelids even if they are very young.
▼ She had thick eyelids with excess skin, thick orbicularis muscle and excess fat.
She had a difficulty in opening her eyes and raised her eyebrows always when she opened her eyes.
Of course, her eyes looked too small and ptotic before surgery.
Right side eyelidlift with subbrow excision was done and compared both sides.
You can find how effective this eyelidlift is in this photo easily.
Her right eye looks much bigger and lighter and shows small double fold crease which was hided before surgery.
Many doctors recommended her ptosis correction which would have made her look angry but she chose eyelidlift and get to have light eyelids and big eyes.
Two birds in one stone !
3. Complications of ptosis correction
Every surgery has a risk of complication.
The more complicated procedures have more risk than simpler procedure.
The most common complication is discomfort in eye opening and closing and resultant angry apperance.
No matter how big the eyes are, discomfort and unnatural appearance can't be endured.
Then, the shortening of levator muscle should be released.
The next common complications are undercorrection and overcorrection.
Unlike simple double fold surgery, ptosis correction is more difficult and complicated and needs many experiences.
▼ Undercorrection makes their eyes look still sleepy.
Sometimes, the eyes can become smaller after ptosis correction.
▼ Overcorrection makes startled and unnatural appearance.
Notice irregular eye shape (pinched appearance) on her right.
▼ Irregular correction is quite common.
Especially medial uncercorrection is common because the anatomy of medial eyelid is more complicated.
When you plan plastic surgery, finding appropriate procedures is the most important and difficult job.
The next important thing is good surgery
Of course, postoperative care is also important.
Finding appropriate procedures to each patient needs highly specialized knowledge, experience, and imaginative power of the doctors.
You should not lean on unprecise advice or suggestion from your family, friends, and internet.
You should open your mind and seek advice from the doctors who can help you decide what is the best for you.
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Hyuncheol Park MD