KYORITSU Cosmetic Surgery
Board Member of Japan Cosmetic Surgery Association Member of the Japanese Plastic Surgery Society President of Japan Society of Aesthetic Surgery Japanese Cosmetic Surgery Society Certified Specialist Member of Japan Hair Removal Society Member of North American Liposuction Plastic Surgery Society Member of Japan Society of Aging and Aesthetic Medicine
Dr. Akihito Kujime, the director of Kyoritsu Cosmetic Surgery, has introduced a franchise system to expand Kyoritsu Cosmetic Surgery nationwide. Long-term, such as the realization of one-day liposuction surgery by establishing the "Kyoritsu-type double-embedded P-PL levator method", which is a double operation with less swelling and less pain, and by developing a patented cannula for each site. Leading the aesthetic medicine industry. He has written many books such as "Wrinkle Smoothing Clinic" and "Body Clinic".
Whether or not there is a double line on the upper eyelid, or even if it is double, the impression of the entire face, not just the eyes, will change significantly depending on the difference in double width by a few millimeters. The appeal of the double plastic surgery method is that it is not a major surgery such as bone cutting or lift-up performed by incising the skin, but it also has semi-permanent eyes that are different from temporary changes that rely on makeup and colored contacts. It can be said that the change with is obtained .
However, each person has different eyelid skin thickness and flexibility, and the required double design is also different. Therefore, it is necessary to select a double shaping method that suits the eyelids.
One of the double shaping methods is the burial method, which uses threads to make double lines without cutting the skin. In order to make the desired double line, it is necessary to know the characteristics of the double line made by the burial method and the progress after surgery.
The eyeball is a very delicate organ that is vulnerable to dryness and is damaged by dust that has invaded from the outside, even though it is a lens with excellent translucency and light collection. The eyelids protect this eyeball from foreign matter such as dust and dryness.
While sleeping, the eyelids completely protect the eyeballs like a lid, but when looking at things with the eyes during activity, the muscles pull up the upper eyelids on the black eyes. The double line is the crease when the raised upper eyelid is folded and stored like a bellows . The number of creases is not limited to one, and there are cases where multiple creases appear.
However, not all upper eyelids are double. If you have a disease such as "small eyelids" that originally have small eyes or "ptosis" that has a weak ability to lift the upper eyelids, the upper eyelids will not pull up enough to be folded and stored. It will be single. Also, those who have thick eyelids and are hard to crease will be single because double lines are hard to appear.
The ability to open and close the eyelids is due to the action of a muscle called the "levator muscle", and when the levator muscle contracts, the upper eyelid is opened and closed together with the cartilage tarsal plate at the tip of the upper eyelid. It will be pulled up.
The muscles swell when they contract, just as when you bend your arms, you get a bicep on your upper arm, but the levator muscles near your eyes can't swell because they obstruct your vision.
Therefore, the levator muscle has a thin film-like structure that expands when contracted and transmits force to the back of the eye and the tip of the upper eyelid. The force transmitted to the tip of the upper eyelid is then transmitted to the two traction fibers called the "levator aponeurosis" and "Muller muscle" that are attached to the tarsal plate.
The levator aponeurosis, which attaches to the tip of the tarsal plate from the Muller muscle, further branches and partly attaches to the skin, pulling the attachment part inward, and the double line that is the fold of the folding storage appears.
The structure of the eyes of Westerners is such that the upper eyelids are more likely to be pulled into the back and clear double lines are more likely to appear because the levator aponeurosis that adheres to the skin is stronger than that of Asians . On the other hand, it is said that there are more single Asians, including Japanese, than Westerners because of the weakness of the levator aponeurosis.
In the first place, the burial method started in Japan as a treatment method for "upside down eyelashes" where the eyelashes get inside and touch the eyeballs, and after that, it is better to have a longing for a clear double line like Westerners. It is said that the number of cases of receiving heavy eyelashes has increased.
The burial method is a double plastic surgery that leaves no scars on the eyelids, and the swelling and internal bleeding that occurs immediately afterwards are mild and less protracted . In addition, when the double line is completed, the design will be settled almost as planned before the surgery, so the finish will hardly be different from what you want. Furthermore, within about 3 months after surgery, it is possible to return to the original eyelid and change the double line by removing the buried thread. From this, it can be said that the burial method is a double plastic surgery with few failures because it can be redone (re-surgery) .
A common misconception is that the burial method will eventually come off, but the burial method is a method that gives the eyelids a chance to make double-lined "creases", so the thickness and fat of the eyelid skin. If it is kept for a long period of time in a case where the amount of shavings is relatively resistant to the burial method, the double line may be fixed without relying on threads. In other words, once the habit is established, it may become a semi-permanent double line that is no different from the natural double line .
On the other hand, once the habit has settled, it cannot be restored to the original eyelid even if the thread is removed, and there is a high probability that it will not be restored after about half a year after surgery.
There is basically no limit to the number of times you can receive the burial method .
The burial method can be re-surgery to further widen or narrow the double line . However, if you want to narrow the width, it is necessary to remove the thread from the original line, so re-operation must be performed before the habit is established.
If you want to widen the double width further, perform the burial method on the line width you want to widen. In this case, the wider line is predominant, so the original narrow line will disappear without removing the thread.
On the other hand, if you want to "narrow the double width", the original wide line must be erased or the line will not appear even if the burial method is performed at the narrowed position. I will put it back. If you want to change the double width narrower, timing is important because the original line will remain even if the thread is removed if the timing is too late .
In addition, the burial method not only makes double lines appear on the single eyelid, but also modifies the original double line to change the double width and the shape of the double line, and corrects either the left or right eyelid. It is also possible to reduce the difference between the left and right eyelids, so even those who are born double can be accepted.
Preoperative diagnosis can predict which eyelids are suitable or unsuitable for implantation.
Even for eyelids that are not suitable for the burial method, the possibility that the double line will settle is not zero, so there are cases in which the double line is settled as a result of receiving the burial method with the knowledge that it will come off. In addition, even if it comes off, the double line may become established after receiving it several times .
However, in cases where the double line is maintained for too short a period, such as when it is removed 3 times or more a year or when it is removed 5 to 6 times in total, adjust the thickness of the eyelid skin and the amount of fat. It may be advisable to consider an incision method that makes it easier for double lines to appear.
The method of sewing the levator aponeurosis or Muller muscle and the skin in a circle to make a double line appear is called the "levator method" after the levator muscle.
The method of sewing a 1 cm thick tarsal plate at the tip of the eyelid and the skin in a circle to make a double line appear is called the "tarsal plate method" after the tarsal plate.
The operation time of the burial method is about 15 minutes for both eyes, and the operation is so light that you can go home after the operation. By burying the threads and knots that make up the double line in the skin of the upper eyelid, the potential line is revealed.
① Make two small holes A and B on the surface line of the skin where a double line appears.
② Penetrate the needle with the thread from one of the holes (A) to the back of the skin (conjunctiva, A').
③ Thread the thread through the tarsal plate or levator muscle (Muller muscle) and fold it back.
④ Move the thread through the skin and thread it through the tarsal plate or levator aponeurosis (Muller muscle) at a position perpendicular to the other hole (B) (B').
⑤ Fold it back and let it penetrate to the first hole (B) and then fold it back.
⑥ Go back through the skin to the hole (A) where the needle was first inserted and let it penetrate.
⑦ Tie the ends of the threads on the loop in ② to ⑥ and make them "buried".
Since it is important to make creases for a long period of time in the burial method, threads made of "non-absorbent" material are used, and they remain embedded in the skin of the eyelids without melting for the rest of their lives.
As a result of various studies, we have come to the conclusion that nylon material is the most suitable thread material in terms of both "no burden on the body" and "keeping double lines for a long time". Nylon is a material that is also used in heart surgery and cerebrovascular surgery called "ultrafine surgery", so it can be said that its credibility is guaranteed.
In addition, anesthesia is given by injection into a part (local). The fineness of the injection needle for anesthesia is represented by "G (gauge)". The larger the number, the thinner the needle, and the thinner the number, the less pain. The size ranges from 18G to 34G, and in the burial method, 34G, which is the thinnest and about the thickness of the hair, tends to be used more often .
The double line created by the burial method is not decided arbitrarily. Double lines appear along the direction of the fibers of the skin (RSTL: relaxed skin tension line), so when the double width is determined, the shape of the skeleton and eyelids, the habit, and the eye called kenretsu. It will be a natural line that suits how to open it .
The difference in the design (shape) of the double line can be simply rephrased as the difference in width.
As you gradually widen the width from the back double (the double line is completely covered by the skin and hidden from the outside) that seems to be single at first glance, the line gradually increases. It is exposed from the skin and eventually changes from the innermost moco fold (the fold that covers the caruncle inside the inner corner of the eye) to an exposed line. At this time, the type in which the hidden line on the inner corner of the eye appears to spread toward the outer corner of the eye is called the divergent type, and the type in which the line is completely exposed from the inner corner of the eye to the buttocks is called the parallel type .
The eyelids have the following characteristics.
Therefore, the wider the double width, the more unstable the double line and the shorter the length of the double line tends to be. Therefore, it is generally said that if you move more than 1 cm away from the position where the eyelashes are growing, you will not have a double body .
The burial method does not express a double line by the method of fastening the thread. Double lines occur along the direction of the skin fibers of the eyelids, thus determining the double width and revealing potential lines. In other words, the double line is determined by the direction of the fibers of the skin of the eyelids. Therefore, even if you fasten it at one point, a double line will appear.
However, if you actually try to stop at one point in the center, the "moment" that acts will be too concentrated, and the "strength" that indicates the strength of the line will become weaker as you move away from the center, resulting in an unclear line. It will end up.
Therefore, in order to clarify the entire line, we generally keep two points that are slightly wider than the width of the black eye.
Also, depending on the desired double width, eyelid skin thickness and amount of fat, it may be better to have a little more distance. In that case, if the two points are too far apart, the line in the middle part will not be clear, so set a fastening position in the middle part as well to make it "three-point fastening".
In other words, 〇-point fastening is not the number of threads used, but the number of skin relay points for adjusting the balance and strength of the double line . Generally, the number of threads is expressed as "needle" and is expressed as "2 needles, 4 points".
Since 2-point fastening and 3-point fastening are performed with a single thread, the strength does not change even if the number of fastening points increases. On the other hand, in order to increase the fixing strength, there is a method of hanging threads that overlap the fixing loops by increasing the number of buried threads.
If you increase the number of loops, it will be more difficult to remove, but you will also know that there are side effects such as swelling and prolonged dyne time after surgery because the number of operations increases and circulatory disorders such as congestion due to tightening of the loops are likely to occur. I have to keep it. In addition, increasing the number of threads will inevitably increase the number of relay points on the skin, such as "4-point fastening" and "5-point fastening".
There are two types of double plastic surgery: the burial method, in which the skin is not cut and a double line is created with threads, the "incision method", in which the skin is incised, and an intermediate method between the burial method and the incision method. Depending on the condition of the eyelids, such as the thickness of the skin and the amount of fat, the incision method or intermediate method may be more suitable than the burial method.
The incision method removes excess skin, fat, and muscles to prepare the eyelids where double lines appear, shortens some of the stretched levator muscles, and strengthens the force to pull in the skin. To make.
There is a risk that once surgery is performed, it cannot be undone or the double line cannot be easily changed, but the double line cannot be achieved by the burial method. "Thick skin", "rich skin", "ptosis" You can also make a double line on the eyelids such as "is."
The incision method is a completely bespoke operation because the factors that prevent the appearance of double lines differ depending on whether the skin, fat, or muscle is used. Compared to the burial method, the experience, sense, and dexterity of the doctor in charge of surgery will make a difference in the finish of the double line, and the surgery cost will be higher .
In some cases, "fat removal" or "small incision", which is an intermediate method between the burial method and the incision method, is suitable.
Fat removal involves making small holes in the eyelids to remove only the fat that is blocking the appearance of double lines. Since the small incision is about 1 cm, the incision is smaller than the incision method (total incision), and it is a method to remove not only fat but also the anterior palpebral tissue (mainly the orbicularis oculi muscle).
Both may be set as separate treatment menus from the burial and incision methods.
Downtime is defined as the amount of time you have to leave your normal life due to swelling or internal bleeding associated with surgery . In other words, it is time to return to your normal daily life. If the downtime of the burial method is defined as "until the swelling and internal bleeding disappear and the surrounding people do not get swelled", it is usually about 3 days to 1 week if the double width of 5 mm to 7 mm is fixed at 2 points. Makeup is possible from the next day, so there is a possibility that it can be shortened further by makeup.
The concept of downtime is different for each person, but let's go back in time to the progress after surgery in detail.
Generally, swelling and internal bleeding last for 3 days, and it is difficult to reduce them, so please spend 3 days at rest . In addition, the burial method basically causes almost no pain after surgery and does not require an outpatient visit .
The day after surgery
It is said that the peak of swelling and internal bleeding is the timing of waking up the next morning from immediately after surgery . However, as long as the affected area is properly cooled immediately after surgery to avoid excessive fluid intake and the doctor's instructions are followed, the condition immediately after surgery will not deteriorate significantly.
In most cases, internal bleeding (mild bruising), swelling, and redness that cannot be seen at first glance unless you stare closely. The double width at this time looks about 20% wider than when it was completed .
Eye makeup will be available 24 hours after surgery, so if you do make up, it will not bother you if you meet for the first time.
3 days after surgery
During this period, you are still in an unstable state due to surgery, so follow the precautions so as not to worsen the condition such as swelling and redness, and spend your time comfortably.
2 weeks after surgery
The feeling of discomfort, such as a feeling of tightness or ruggedness, disappears naturally after about 2 weeks . However, it is a time when it cannot be said that the organization has become completely stable, and it is still forbidden to overdo it. You can drink alcohol, massage, exercise, sauna, etc., but gradually get used to it while watching the situation.
1 month after surgery
It is almost completed . However, the double line is not completely fixed, and it will be completely restored by removing the thread, and depending on the situation, "fluctuations in the condition" such as swelling may occur in rare cases.
3 months after surgery
After 3 months, almost no fluctuations can be seen, and the establishment of the line habit will be completed in earnest from this time .
The burial method can be said to be a "less failure method" in the sense that it can be completed to the double line planned almost before surgery and can be redone, but there is a possibility that the double line will disappear (take off). Even though it is a sturdy thread, it is possible that something will break it or the knot will melt. If the thread breaks or melts before the creases have settled, the double line will disappear .
In addition, the double line may not be fixed due to the fact that the skin of the eyelid is thick or the amount of fat is large, which makes the eyelid unsuitable for the burying method, or the desired double width is too wide.
Even if the thread is broken or unmelted, the double line may become thinner if the repulsive force of the eyelid, which tries to weaken the strength of the line, outweighs the force that the thread holds. .. If the thread is broken or melted, you can try it again. However, if the crease becomes weaker, the repulsive force of the eyelids does not change, so it is expected that the double line will become thinner over time even if it is reapplied. If the same result is obtained after 3 to 5 treatments, consider methods including removing fat, which is a factor that makes it difficult to crease, and cutting the skin to make a double line. May be recommended.
During the first week or so after the procedure, it will be slightly different from the double width after completion due to the effect of swelling. In this case, the difference between the left and right may disappear after completion . In addition, the apparent laterality is more affected by interference from the surroundings such as the asymmetry of the human body and the habit of raising the eyebrows, rather than the pure mistake of width. If there is a difference between the left and right due to a simple mistake in width, it will be corrected , so please consult with your doctor.
The thinnest part of the skin is the eyelid, which varies from person to person, but its thickness is less than 1 mm. Therefore, the treatment is performed so that the thread is buried deep under the skin, but when the position where the buried thread stays is a shallow layer of the skin or the skin is extremely thin, a knot ball that is popped from the skin surface. May be touched. However, in general, the knot ball tends to sneak deep under the skin over time .
Since the thread is only 0.05 mm (50 microns) thick, it is intentionally dyed blue to prevent mistakes during surgery . Of course, this pigment is harmless to the living body, and it is decomposed in the body over a period of 3 years or more and changes to colorless and transparent. Therefore, even if the color of the thread can be seen through the skin, it tends to disappear over time .
In rare cases, the knot ball may break through the thin skin of the eyelid and be exposed, or the thread may pull a point of the skin deeply, causing a dent in the skin. In that case, remove the thread and re-thread. re-over.
You may be concerned about allergic reactions caused by threads, but nylon does not cause allergic reactions.
You can wash your face from the day (6 hours or more after surgery is a guide), but refrain from bathing. You can take a bath and wash your hair from the next day, but if you warm your body too much, blood circulation will improve and swelling will tend to occur, so boiling water or long-term bathing is not recommended. It is safe to take a shower until about 2 weeks when the internal bleeding disappears.
For the same reason as bathing, please refrain from drinking alcohol or exercising for about two weeks. It is said that it is better to refrain from about 2 weeks because the influence of chlorine (hypochlorous acid) may be considered by paying attention to the water in the pool.
Makeup, including eye makeup, is possible after 24 hours, but follow the instructions of the doctor who underwent surgery.
For both hardware and software, it is recommended to refrain from 3 to 5 days just in case.
It will be possible after 2 weeks, but please follow the doctor's instructions.
For both LASIK surgery after LASIK and LASIK surgery after LASIK, obtain permission for LASIK surgery from your LASIK doctor.
The following people cannot receive the burial method.
Pregnant women can also take it when they reach the stable period of 5 months (16 weeks) of pregnancy. People who are breastfeeding are basically considered to have no problem. Also, even if you have a keloid constitution, you can receive it because there are no scars left on your eyelids.
The applicable age of the burial method is applicable to both children and the elderly, but it is intended for those who can communicate.
If you have the following eyelids that do not appear on the line even if you perform the burial method, or if you expect that the line will disappear in a short period of time, first perform a procedure to improve the condition. You need to do it.
Even if there are differences in the method and materials such as threads and needles in each cosmetic surgery clinic, the basic method of burial is the same and can be used in any cosmetic surgery. However, for small surgery such as the burial method, it seems that the doctor does not bother to consult before the surgery and only the medical staff (nurse or counselor) contracts.
At a medical institution that conducts cosmetic surgery where the doctor examines the condition of the eyelids and provides personalized medical care, please receive counseling and give a convincing explanation.
Dr. Akihito Kujime, who supervised the article, taught me how to bury Kyoritsu Cosmetic Surgery.
At Kyoritsu Cosmetic Surgery, doctors are working hard every day to refine the procedure in order to perform accurate diagnosis and lean surgery. In addition, we use anesthetic solutions, needles (for injection / surgery), and postoperative medications that have been carefully examined.
|yarn||It is harmless even if it remains in the body for a lifetime, and it is strong and uses ultra-fine threads that are about the size of downy hair. Ordered from 17 domestic and overseas manufacturers and examined.|
|Anesthetic solution||Based on xylocaine (lidocaine hydrochloride), which is highly reliable as a local anesthetic from a long history of use, it is a blend of PH regulators, vasoconstrictors, enzyme buffers, etc. Infiltration pain, which is the pain when the drug solution soaks into the tissue, is also devised to be minimized.|
|Needle (for injection)||Uses 34G (gauge) with a thickness of about 0.18mm.|
|Needle (for surgery)||Uses a needle with a rounded tip that is ideally sized, curved, and has less friction, calculated from the average Japanese eyelid thickness. Kyoritsu Cosmetic Surgery uses ultra-fine threads with a standard thickness of "7-0", that is, 50 microns (0.05 mm). It has enough tensile strength to pull a weight of 10 kg or more.|
|Medication after surgery||In addition to general anti-suppuration (antibiotic) swelling pain relievers (anti-inflammatory analgesics), we also offer supplements that are safe and suppress swelling with few side effects derived from crude drugs and supplements that accelerate the repair of damaged tissue.|
(1) Reception / Questionnaire entry
At the reception, fill out the questionnaire in the waiting room with your eyelid problems and concerns.
(2) Photographing and counseling before surgery
After taking a pre-surgery photo, a doctor will provide counseling. We will hear about the desired eyelid design and propose the optimal treatment based on the preoperative photo, considering the condition of the eyelid.
If you have any concerns or doubts about the procedure, consult your doctor at this time.
(3) Explanation and confirmation immediately before design and surgery
While considering the balance of the entire face, we will consult and decide on the desired double width and line. There is a timing to receive an explanation of the surgery again just before the procedure, so if you forget to ask or have any questions during counseling, you can check with the doctor.
(4) Eye cooling / anesthesia
Cool the eyes to reduce the pain of the procedure, and use eye drop anesthesia to wear a cover to protect the eyes. Eye drops that have the effect of suppressing suppuration are instilled, and local anesthesia is injected into the eyelids.
Pass the needle and thread through the eyelids and fix them to form a double line. The time required for the procedure is about 20 to 30 minutes, and it is said that anesthesia causes almost no pain.
Cooling and completion after surgery
After the operation, move to the recovery room, rest for about 15 minutes, and finish when the treatment area is calm. It is possible to suppress swelling by cooling after surgery. Pain relievers and antibiotics may be taken depending on the condition of the swelling.