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Thank You Plastic Surgery

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We incise the very spot 

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from the previous surgery area

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to remove them

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Thank You Plastic Surgery

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Hello, I'm Dr. Kim Hyung-seok from Thank You Plastic Surgery

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Today we'll talk about eye revision surgery


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while watching an example

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This is a female patient born in 1983

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who got a non-incisional procedure 10 years ago

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And again incisional procedure a year ago


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then another non-incisional 6 months ago

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So the patient had a total of three procedures


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But during all three procedures


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the patient remembers never


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removing the stitches

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The main reason the patient came to us

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was not just only because of the shape or size of her eyelid


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But a tissue called granuloma in the eyelid

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that caused this bumpy skin texture

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caused discomfort

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The clinic the patient got the procedure done


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mentioned that the incisional option was the only way to remove the granuloma

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However!

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If you can know the cause

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Even without making an incision

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it is possible to fix the problem 

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So that is what we'll look into today

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(Removing stitches on a revision eye surgery)
In my past videos, there was one video 

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where I was removing the stitches

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And because it connects with the question on


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"Why stitches are needed to be removed on a revision surgery"

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I will also answer that question as well

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(What cause granuloma?)
Here, we have lashes and brows

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Commonly, double eyelid procedure is done


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by creating holes like this for the non-incisional method

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Even though there are various ways


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but most procedures are performed where non-absorbable sutures

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is buried under the skin like this

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With one operation

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there are no problem when a thin layer of 


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non-absorbable sutures are in the eyes

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But for example, if it's double suture technique

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and double stitches are used

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or without removing the previous stitches

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adding another suture

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Or creating additional knots

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by proceeding with an incisional method

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The body could regard it as a foreign substance

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and create granuloma around the knots

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So with these bumpy spots

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they could be made of sebums

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or due to large knots

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a membrane encasing the knot could be made

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and causing something like granuloma

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So, if we look here, we can see granuloma surrounding a knot

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and just some bumpy areas

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Looking her right side of eye, you can see there are various granuloma

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at inside, middle, outside of eye

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If you don't remove these lumps inside

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it is aesthetically unpleasing and it may also

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cause some side effects later like swelling 

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due to inflammation

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So it is recommended to remove them

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For clearer understanding, here is the operating scene

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Some may find the scene disturbing

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So please watch with caution! 

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Following granulomas made by the previous suture near the double eyelid crease

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I made both incisions to remove the stitches

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and to remove the big granulomas

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The patient also wanted her double eyelid crease a litter higher 

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So I created about 6 holes

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to operate to lift her double eyelid crease

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In case of this patient's left eye

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you can even see previous stitches like this

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and it can removed by pulling it

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But the importance is not about removing that single suture

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Even if that single suture is removed

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we do not know how many sutures  

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were used previously

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So I need to explore and check inside the eyelid

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during operation

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This is the process of removing the additional sutures

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and there were more than I expected

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So it too longer to remove them all


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So, I'm not sure if you could see it

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but this footage shows an area where all the suture have been removed

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and then I removed these white granulomas inside 

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one by one

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By removing these white fibrous membranes

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we could improve the lumps underneath the skin

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So this is how we remove them


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and the advantage of this method instead of making an incision is that

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we proceed with the procedure in the previous operated area


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so there's no additional scar

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and compared to incision method

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recovery period is short

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Now the footage shows the way I removed fibrous membranes

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(Removed granuloma)
likewise I removed granulomas in opposite eye

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and removed all them on both eyes

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A thin suture expected to have been used 10 years ago

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And long sutures expected to have been used a year and 6 months ago

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All used in partial incision and non-incision double eyelid procedures

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Are shown to be completely removed

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(Before surgery/7 days after surgery)
This is a photo of her a week after

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Granuloma masses that existed before have been completely removed

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We can observe a more pleasant state

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Surgery was performed by slightly elevating the double eyelid crease

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Since it is a revision surgery, there was some swelling

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But due to the nice line flow, and the fact that she is showing fast recovery

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Good prognosis is expected

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Like such, following non-incision double eyelid surgery

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Or  incision double eyelid surgery

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it may cause problems when additional surgeries are performed 


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without removing the accumulated sutures

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So it is recommended to remove previous sutures before additional surgeries

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And if you have any more questions regarding this matter

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Leave a comment 

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And we will answer them 

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I’ll wrap up this video for today

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Thank you!

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Thank You Plastic Surgery
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