I’m in my mid-40s and have protruding eyes + thin skin + double folds + hollowness in the eyelids. I already had double eyelids, and although the shape on both sides was different, I had lived without any major dissatisfaction, but over the past few years the eyelid hollowing has gradually gotten worse, double folds have appeared, and the shape seems to be getting more and more strange. On the more severe side, by evening it feels harder to keep my eyes open, so I decided to get double eyelid surgery. I originally planned to just go to 1 or 2 famous places, but the more consultations I had, the harder it became to choose a clinic. 1. ㅇㅇ1 The first place I visited. They said I wasn’t bothered by the asymmetry between both eyes and seemed to worry about making my impression look too strong, so they recommended brow lift + fat grafting / for double eyelid surgery, either skin excision and fat grafting (which may cause wrinkles) depending on what I choose; the doctor recommended a brow lift. 2. ㅂㅇㅇㅇ (Dr. Jo ㅇㅊ) Did not recommend brow lift (because the amount of skin excision would be large, the eyes would become more uneven, and the double eyelid line sags more toward the outer side, so improvement was needed) Recommended excision plus double eyelid surgery, and fat grafting. 3. ㅇㅇq Skin excision double eyelid surgery, ptosis correction, fat lowering, fat grafting Although it is my first double eyelid surgery, it is a difficult case; they said a small amount of skin excision and ptosis correction are needed. Because they would also do fat grafting, if tissue folds down over it, the back part of the double eyelid line would be hidden, so they explained that some excision was necessary. 4. ㄱㄴㅅㅇ Incisional double eyelid surgery without excision, fat grafting Did not recommend a brow lift. 5. ㅁㅅㄹㅇ Highest difficulty level (protruding eyes, thin skin) Incisional double eyelid surgery without excision, ptosis correction with about 5% expected effect (good eye-opening strength, but to prevent the risk of loosening and to improve double folds and hollowness) Because the eyes protrude and the skin is thin, they said it should not be touched carelessly. If you excise, there is a risk of lagophthalmos; the double folds and hollowness should be addressed by properly releasing the skin adhesions and through ptosis correction, but a perfect solution is difficult and recurrence may happen later. They said fat grafting has more downsides than upsides, and that fat lowering and upper-eyelid fat repositioning are methods they personally do not trust. 6. ㅌㅇㅅ (Dr. ㅇㅅㄱ) Incisional double eyelid surgery without excision, eye-opening strength is 8 out of 10 so it is decent, but a slight ptosis correction is needed. Upper-eyelid fat repositioning could solve the double folds and hollowness (because it seems like there is fat there since this is the first surgery, and if needed a little fat grafting during surgery). 7. ㅇㅅㅇㅇㅈ Excision double eyelid surgery, upper-eyelid fat repositioning Because there is sagging flesh on the eyes, it should be removed, and ptosis correction is unnecessary because the eye-opening strength is good. They said the double folds and hollowness can be solved with fat repositioning without fat grafting.
Even though this is my first surgery, it seems like a difficult case because of the protruding eyes and the already formed double folds and hollowness. I thought it would just be a simple double eyelid surgery, but the opinions differ on ptosis correction, skin excision, and fat repositioning, so it’s hard to decide. After looking into it, I feel like I probably need fat repositioning or fat grafting because of the hollowing and double folds... But since my eyes protrude, I’m worried about lagophthalmos, and I’m also afraid that if I do it without excision, I’ll end up worrying about the same thing again 2-3 years later. If anyone has had surgery in a similar case or is deliberating about it, please let me know?