Eye Plastic Surgery in Korea and the Years After It

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Surgery changes tissue at one moment, and the face around it keeps aging. A crease can stay in place while the skin above it loosens again. Removed under-eye fat does not return, but the cheek below can descend. Durability depends on which layer was treated and which were left alone.

The table gives a qualitative view. It is a planning aid, not a promise, and individual healing varies.

Whether a crease lasts depends on how firmly the skin is linked to the deeper structures that lift the lid. With stitch-only methods, a known problem is that the fold can loosen and fade. With incision methods, scar tissue helps hold the line, at the cost of longer swelling.

Fan and Low, writing in Aesthetic Plastic Surgery in 2009, described a continuous buried stitch passed in two directions through the skin and the top of the lid plate. In their 51 patients followed from 2003 to 2008, no crease disappeared and no corneal injury occurred. It was a single-team case series without a comparison group, so it shows that fixation design matters rather than settling which method lasts longest. The separate double eyelid pages on this site cover the methods themselves.

Lower lid surgery treats bags, hollows and loose skin, and its short-term record is reassuring. In a 2018 review in Aesthetic Surgery Journal, Wilson and colleagues pooled 49 studies with 10,698 patients. The review reported reoperation in 0.77%, scleral show in 0.37%, lid malposition in 0.25% and ectropion in 0.24%.

The weaker point was follow-up. Only 29 of the studies stated how long patients were followed, with a mean of 14.8 months, and photographs beyond 24 months existed for just 10 patients. The authors concluded that longevity is poorly documented. For a visitor, this means a surgeon's description of long-term results rests largely on clinical experience, so it is fair to ask how many years of follow-up that experience covers.

The structures around the eye keep moving after any operation. The brow often lowers with age and pushes skin onto the upper lid, skin elasticity drops, and changes in the cheek and eye socket alter the lower lid contour even when the first operation healed well.

None of this means surgery failed; a result from age 30 simply sits on a different face at 50. Some people later choose a brow procedure, a skin trim or filler rather than repeating the first operation, so ask which future steps are likely.

Because published long-term data are limited, a personal record has real value. Simple, consistent photos make it easier to tell normal aging from an early problem.

• Take front and side photos in the same light at one week, one month, six months and one year.
• Photograph with eyes open, gently closed and looking up, so crease height and lid closure are both visible.
• Note dryness, watering or difficulty closing the eye, with dates.
• Keep the operative summary that lists what was done to each lid.
• Send the photos to the operating clinic before deciding on any revision.