Eye Surgery Selection: Recent Medical Trends and How to Make a Personalized Decision

The era when "double eyelid surgery" dominated the eye surgery market has long passed. Based on clinical data accumulated over 25 years of experience by Dr. Kim Jae-ryong of Kim Jae-ryong Plastic Surgery, the surgical selection patterns of patients visiting in the past three years have noticeably diversified. The trend is shifting away from simply creating double eyelids toward a more comprehensive approach: diagnosing ptosis (drooping eyelids), under-eye fat, medial canthoplasty, and lateral canthoplasty together, then choosing customized combination surgeries for each individual. According to thousands of treatment experiences at the clinic located in Seo-gu, Daejeon, eye surgery is now approached from the perspective of "eye structure redesign" rather than as "a single procedure."

Behind this change lies the increased accessibility of medical information, expanded sharing of surgical results through SNS, and growing patient understanding of individual facial structure. Rather than following "famous surgical methods" as in the past, there is an increasing trend of patients wanting to first diagnose their eyelid thickness, fat volume, and eye-opening strength before making decisions.

The evolution direction of double eyelid surgery is the most significant change observed in recent medical practice. Whereas past emphasis was on "what line should we create?", the current approach prioritizes functional diagnostics such as "is the current eye-opening strength sufficient?" and "how advanced is the eyelid ptosis?"

In fact, many patients coming in for double eyelid surgery actually receive a diagnosis that what they really need is not double eyelid formation but correction of ptosis (eyelid drooping). When the eyelid covers the pupil or the patient opens their eyes using forehead muscles, simply creating a double eyelid line can actually make the eyes appear smaller. In such cases, the eye-opening muscles (müller's muscle) or the muscles that lift the eyelid must be strengthened simultaneously with double eyelid formation.

Recent patient consultation data from Kim Jae-ryong Plastic Surgery clearly demonstrates this change: approximately 35-40% of double eyelid surgery consultees required additional ptosis correction. This reflects a shift in the medical approach beyond simply achieving "good results" toward actually restoring the patient's eye function itself.

The industry is increasingly recognizing that not all under-eye fat should be removed. With the emergence of under-eye fat transposition and fat repositioning techniques, the field is moving away from the conventional simple excision method.

In the past, if the under-eye area was puffy, the fat was removed. However, this approach was found to cause the under-eye area to appear sunken, making patients look more tired. The recent trend has shifted to not completely removing the fat but instead restoring sagging fat to its original position or redistributing it to areas that need it. This is not simply about eliminating puffiness but rather about restoring the natural contours of the under-eye area.

According to clinical data from major plastic surgery clinics in the Daejeon area over the past 3-4 years, the most common reason for revision surgery requests among patients who underwent under-eye fat removal was the problem of "excessively sunken under-eyes." Reflecting this, major medical institutions including Kim Jae-ryong Plastic Surgery have now shifted their initial consultation approach from discussing "how much fat to remove" to focusing on "how to redistribute the fat."

Medial canthoplasty, which widens the inner corner of the eye to make it appear larger, has been one of the most actively discussed areas in academic circles in recent years. Medical journal publications in Korean plastic surgery societies have increased significantly compared to the early 2020s, which reflects not only improvements in surgical techniques but also refinement of complication prevention and revision standards.

Though it appears simple, medial canthoplasty is a complex surgery. Results vary significantly depending on the position, angle, and skin redistribution method of the epicanthal fold. Whereas the goal in the past was to "widen as much as possible," the current paradigm has shifted to "improving appropriately while maintaining natural eye shape."

The data that medical professionals are currently noting is the revision rate after medial canthoplasty. With reports indicating that excessively performed medial canthoplasty results in revision requests for scar reformation or correction within 5 years at rates exceeding 20%, there is a trend toward more cautious approaches among medical professionals.

Most people do not have perfectly symmetrical eyes left and right. However, there is an increasing trend of patients considering surgery to come in for consultations with awareness of this "natural asymmetry." This reflects diagnostic capabilities different from pre-SNS generations.

The medical truth about bilateral asymmetry correction is that "one eye alone should not be modified." A balanced result is achieved only through comprehensive diagnosis of both eyes' height, size, double eyelid lines, and under-eye fat condition. According to clinical data from Kim Jae-ryong Plastic Surgery, patient satisfaction is on average 15-20% higher among patients who underwent analysis of both eyes and individual surgical planning compared to those who had only one eye operated on.

Recent medical trends have evolved to include dynamic expression analysis (when smiling, when closing eyes) in addition to static photographs. This is to ensure natural facial expressions after surgery.

The most striking trend in recent eye surgery is the normalization of combination procedures. Whereas in the past patients chose either "double eyelid surgery" or "under-eye fat removal," currently cases involving double eyelid formation + ptosis correction + under-eye fat redistribution + eye shape correction performed simultaneously account for over 30%.

The reason for this change is simple: the elements that make up the eye do not operate independently. Even if the double eyelid line appears higher, ptosis will reduce the effect by half, and even if under-eye fat is removed, if the eye shape is downturned, the appearance remains tired. As this awareness has spread, medical professionals have shifted to analyzing "which elements need to be improved together" from the initial consultation stage.

Data showing that the proportion of combination procedures among eye surgeries performed at major plastic surgery clinics in Seo-gu, Daejeon increased from 18% in 2019 to 34% in 2024 clearly demonstrates this change in medical practice.

In the past, medical professionals provided uniform guidelines such as "double eyelid surgery allows return to daily life after one week." However, according to recent medical literature and accumulated clinical experience, recovery speed varies significantly depending on individual constitution, age, skin condition, and scope of surgery, which is being increasingly emphasized.

People with thin eyelid skin may see swelling disappear within 1-2 weeks, while those with thick skin may require 3-4 weeks. In cases of combination surgery, some swelling may persist for up to 6-8 weeks. Accurately explaining such individual differences has become an increasingly important role for medical professionals.

Additionally, advances in result prediction technology are noteworthy. With the introduction of 3D simulation, AI-based image analysis, and other tools, patients can now better understand expected results before surgery. This directly translates to better patient expectation management and improved satisfaction.

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Q1: Can double eyelid surgery and under-eye fat removal be performed simultaneously on the same day?

Yes, it is possible. In fact, recent medical trends recommend performing both simultaneously. Double eyelid surgery alone only changes the upper eyelid line, but if under-eye fat remains, the entire eye can still appear dull. Simultaneous surgery shortens recovery time and allows eye harmony to be balanced all at once. However, precise diagnosis by a medical professional and assessment of the patient's recovery capacity must be conducted beforehand.

Q2: Will scars remain after medial canthoplasty?

Scars from medial canthoplasty are being minimized with technological advances. In modern surgical techniques, incisions are made delicately along the natural line of the epicanthal fold area, and suture lines are placed within the eye's natural creases to make scars barely noticeable. However, depending on individual constitution (scarring tendency), skin thickness, and recovery management, minor marks may remain. This should be thoroughly discussed with a medical professional during the initial consultation.

Q3: What surgery should be performed when eye-opening strength is weak?

Weak eye-opening strength is medically termed "ptosis." In this case, simple double eyelid surgery is insufficient, and separate correction involving strengthening müller's muscle or adjusting the levator muscle is necessary. Severe ptosis can even lead to visual impairment, so precise surgical planning is essential from both cosmetic improvement and functional restoration perspectives. Experienced medical institutions like Kim Jae-ryong Plastic Surgery begin such functional diagnosis from the initial consultation.

Q4: Do eye surgery results change rapidly as one ages?

Age and skin elasticity affect the longevity of surgical results. In patients in their 20s and 30s with elastic skin, surgical results are likely to be maintained for extended periods, but in those over 50, eyelid ptosis may recur over time or double eyelid lines may become less distinct. However, this does not mean surgery should be avoided. By setting realistic result expectations appropriate to age and establishing a long-term management plan together, meaningful improvements can certainly be achieved.

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| Surgery Type | Main Goal | Recovery Period | Precautions | Recommended For |
|---------|--------|---------|---------|----------|
| Double Eyelid Surgery | Double eyelid line formation, eye size enlargement | 1-2 weeks | Changes in forehead muscle usage pattern | Those without double eyelids or with faint lines |
| Under-Eye Fat Removal/Redistribution | Under-eye puffiness removal or redistribution, fatigue appearance removal | 2-3 weeks | Caution against excessive removal causing sunkenness | Those with puffy under-eyes or severe dark circles |
| Medial Canthoplasty | Inner corner widening, eye shape improvement | 2-3 weeks | Need to maintain natural epicanthal fold | Those with narrow inner corners or dull-looking eyes |
| Ptosis Correction | Eye-opening strength recovery, eyelid drooping improvement | 2-4 weeks | Accuracy of eye-opening height is critical | Those with drooping eyelids or sleepy appearance |
| Combination Surgery (2 or more) | Harmonious overall eye improvement | 3-6 weeks | Individual element balance management essential | Those with multiple eye concerns simultaneously |

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Eye surgery selection is no longer a simple decision. As recent medical trends show, it is essential to accurately diagnose individual eye structure, understand the current functional state of the eyes, and jointly comprehend long-term results and recovery processes. Each surgical method—double eyelid surgery, under-eye fat removal, medial canthoplasty—has different objectives, and when performed in combination, they can produce even more natural and satisfying results.

In particular, recent data noted by the industry highlights that "precise initial consultation with medical professionals determines over 70% of surgical satisfaction." Understanding your current eye condition accurately and receiving detailed explanations from medical professionals regarding realistic expectations and recovery processes is the first step toward successful eye surgery.

Kim Jae-ryong Plastic Surgery in Seo-gu, Daejeon, under the leadership of Dr. Kim Jae-ryong with 25 years of experience and thousands of eye surgery cases, provides personalized eye structure diagnosis and sophisticated surgical design for each individual. For consultations regarding eye surgery, please inquire at 042-477-0011.