2026-05-29
Dr. Shim Jeong-hwan Explains Sausage Eye Revision Surgery!
Hello~ Your beauty universe! This is Uber Plastic Surgery :) ❤ Today, we have prepared a time for Dr. Shim Jeong-hwan to explain sausage eye revision surgery. What is a sausage double eyelid? If the line looks too thick and unnatural compared to the eyes, or if it looks swollen like someone who just had surgery, it is commonly called a sausage double eyelid. Broadly speaking, it can be divided into cases where (1) the line itself is high, (2) the fixation...
Hello~
Your beauty universe!
This is Uber Plastic Surgery :) ❤
Today, we have prepared a time for Dr. Shim Jeong-hwan
to explain sausage eye revision surgery.
What is a sausage double eyelid?
If the line looks too thick and unnatural compared to the eyes, or if it looks swollen
like someone who just had surgery, it is commonly called a sausage double eyelid.
Broadly speaking,
it can be divided into cases where (1) the line itself is high, (2) the fixation is deep, and (3) the eye-opening muscle is weak
as the main causes.
First, for a clearer understanding, we need to know the anatomical structure of the eye.
< Anatomical Structure of the Eye >
It would be great to understand the anatomical structure perfectly,
but that might just make things more complicated, so I will explain just 3 key parts first.
These are the eye-opening muscle (levator muscle), the tarsal plate, and the skin.
The eye-opening muscle is the muscle responsible for opening the eyes.
At the end of this muscle, it is attached to a tissue called the tarsal plate.
This tarsal plate is a relatively firm cartilage-like tissue, so when you open and close your eyes,
you can think of it as holding the shape so that the eyelid moves consistently.
When the eye-opening muscle contracts and pulls, it lifts the tarsal plate upward, allowing the eye to open.
The outermost structure is the skin.
Between the skin and the tarsal plate, there is the orbicularis oculi muscle and the pre-tarsal tissue. It will be easier to understand if you consider the skin, orbicularis oculi muscle, and pre-tarsal tissue
as one unit, so please keep in mind that when I mention the skin from now on, it includes these tissues.
< Principle of the Double Eyelid >
Double eyelid surgery creates a connection (adhesion) between the eye-opening muscle (levator muscle) and the skin.
Once this connection is made, the eye-opening muscle pulls the eyelid to open the eye, and at the same time, it pulls the connected skin inward,
creating a double eyelid line at that location.
< Causes of Sausage Double Eyelids >
(1) A line that is too high
If the double eyelid line is set too high without considering the skin thickness (+ pre-tarsal soft tissue),
a sausage double eyelid can occur.
It is said that for every 1mm increase in the line's height, the volume of the tissue below the line almost doubles.
For example, for a person with a skin thickness of 10, if the line is raised by 1mm, 2mm, and 3mm,
the volume increases exponentially to 10, 20, 40, and so on.
However, for a person with a skin thickness of 1, it increases to about 1, 2, 4, and so on.
Assuming that a volume over 10 gives a sausage-like appearance, someone with thick skin should not have a line set higher than 7mm.
For those with relatively thin skin, even if the line is set at 7, 8, 9, or 10mm, the volume is only 8, so it does not look like a sausage.
Of course, even with thin skin, if it is raised to 11mm, it might start to look a bit like a sausage, right?
Therefore, the line height must be carefully checked and determined before surgery,
and setting a line too high without considering one's own skin thickness should be avoided.
(2) Deep (high) fixation
It might be a bit confusing, but the height I mentioned earlier refers to the height measured from the outside, from the eyelashes to the line on the skin.
Even if the line height is set appropriately, if the point where the skin is connected to the eye-opening muscle,
that is, the internal fixation, is set too high or too deep, the eyelashes will flip up (=ectropion), creating a deeply fixed double eyelid,
which also becomes what is commonly known as a sausage double eyelid.
If it is set at 7mm on the outside, it should be fixed at 7mm on the inside as well. But if it is set at 7mm on the outside
and fixed at a 10mm position on the inside, the skin is pulled, lifting the eyelashes along with it, resulting in a sausage double eyelid.
(3) Weak eye-opening muscle
Lastly, if the eye-opening muscle is weak, the line does not fold sufficiently, making the line look thick,
and creating a synergistic effect with sleepy-looking eyes, which can make it look like a sausage double eyelid.
🍀 Solutions and Surgical Methods 🍀
The various reasons above can act in combination, or a sausage double eyelid can be caused by a single factor.
The solution is simply to address the underlying cause, right?
(1) In the case of a high double eyelid, it can be resolved by lowering the position of the double eyelid line.
However, the previous high double eyelid must be eliminated.
At this time, the surgical method differs slightly depending on the amount of excess skin available down to the desired line height.
Eliminating the previous double eyelid is the same, but if there is enough excess skin, the surgery is performed by excising the skin.
Conversely, if there is a lack of excess skin, an incision is made on the new line,
and the previous double eyelid is released only from the inside, proceeding with what is commonly called the 'double-line incision' method.
Even if the previous double eyelid is eliminated this way, a double eyelid may try to form in that spot again,
or a triple fold may occur due to a lack of volume above the eye,
so the surgery should not end just by releasing the double eyelid.
There are various methods to prevent this, but typically, a process of inserting fat is required.
(2) The same applies to a deeply fixed double eyelid.
The deeply fixed previous double eyelid is released, and a new double eyelid with appropriate strength is fixed.
In cases where the sausage appearance is severe due to weak eye-opening strength, a ptosis correction surgery that pulls the eye-opening muscle to improve the eye-opening strength
must be added. We will look into the details of ptosis correction next time.
To put it simply today, ptosis correction involves dissecting the eye-opening muscle and reattaching it shorter.
Then the eye-opening strength becomes stronger. You can understand it this way.
If you have double eyelids, look in the mirror and open your eyes wide. The width of the double eyelid decreased, right?
In cases where the eye-opening strength is weak like this, strongly correcting the eye-opening strength to reduce the width of the double eyelid can be done in parallel.
As such, sausage double eyelids can be fully corrected through various methods, so please visit the clinic
to have a thorough consultation with the doctor about the causes, and we hope you achieve great results through surgery.
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