VPI Double Eyelid Technique emphasizes aesthetic standards, prioritizing the proportion between the eyeball and palpebral fissure, the shape of the inner and outer canthi, the length and height of the palpebral fissure, the distance between the upper eyelid margin and eyebrow, the shape and position of the eyebrows, the arrangement and density of eyelashes, as well as the harmonious proportion between the eyes and other facial features.Experts note that while current clinical cases demonstrate the effectiveness of double eyelid techniques, unsuccessful outcomes can occur due to various factors. Below, we explore the manifestations of unsuccessful double eyelid surgery!
Inconspicuous double eyelid crease
Manifested as partial or complete disappearance of the crease, commonly seen in suture-based techniques and suture-pad methods. So-called "high-molecular double eyelid" and "mold-pressing" methods currently marketed are essentially variations of suture techniques.The failure stems from incorrect technique selection. For individuals with thick, puffy eyelids, the buried suture method fails to achieve permanent adhesion between the tarsal plate and skin at the double eyelid crease. Inadequate removal of pre-tarsal orbital fat and orbicularis oculi muscle before incision prevents proper adhesion between skin and tarsal plate.
Failed Double Eyelid Revision Methods: For complete disappearance of the double eyelid crease, redo the procedure using the appropriate method. Thin eyelids with no or minimal epicanthal folds may opt for the suture method. Thick eyelids (puffy eyes) and significant epicanthal folds should switch to the incision method.For partial disappearance of the crease, revision surgery may be performed only on the affected area, ensuring consistent curvature and natural appearance with the remaining crease. Excessively Narrow Double Eyelid Refers to an absolute width of the double eyelid being too narrow (less than 5mm), resulting in a hidden double eyelid.Compared to the patient's facial structure and palpebral fissure width, excessively narrow double eyelids appear disproportionate. This is related to design and suturing techniques—either the designer (including the patient's initial request) planned an overly narrow crease, or suturing occurred too low during the procedure.
Failed Double Eyelid Revision Method:Reopen along the original incision. Thoroughly dissect the skin below the existing crease, extending dissection as far as possible toward the gray line at the lower margin of the upper eyelid. Remove as much orbicularis oculi muscle and pre-tarsal tissue as feasible. During suturing, fully utilize the elasticity of the upper eyelid skin by elevating and suturing the incision to increase crease width (by 1 to 3 mm).For younger patients, this technique can subtly lift the lashes for enhanced aesthetics. Additionally, thinning the subcutaneous tissue beneath the double eyelid line creates a more natural and realistic post-operative appearance.