By Choi Min-seok
Published February 25, 2026

Double eyelid surgery is a widely performed eye plastic surgery procedure. However, some patients remain dissatisfied with their results and continue to seek consultations for revision double eyelid surgery or other forms of revision eye surgery. In particular, when the double eyelid crease is excessively thick, as in “sausage eyes,” or when the crease is uneven between the two eyes, the issue can affect not only appearance but also the overall impression of the face. As a result, more people are consultation seeking for revision surgery.

Common concerns following double eyelid surgery include an overly thick double eyelid crease that creates an unnatural “sausage eye” appearance, uneven eyes caused by differences in the height or shape of the crease on each side, and a crease that has loosened or become less defined. In such cases, rather than simply recreating the double eyelid crease, it is necessary to comprehensively assess the tissue changes caused by the previous surgery and the individual's eye structure before determining the appropriate approach to revision surgery.

Dr. Lee Jun-hee of Realee Plastic Surgery

Revision double eyelid surgery is often more complex than the initial procedure. Before surgery, factors such as existing scar tissue and adhesions from the previous surgery, skin thickness, the amount of eyelid fat, and eyelid-opening strength need to be comprehensively evaluated. In particular, revision surgery for “sausage eyes” may require releasing excessive tissue or adhesions and creating a new double eyelid crease at an appropriate height. A detailed approach tailored to the individual's eye structure is essential. Above all, carefully comparing the eyes before and after the original double eyelid surgery is important for accurately identifying the cause of the current concerns.

As more people have come to prefer a natural-looking appearance, there has also been an increase in inquiries about revision procedures that lower or soften an existing double eyelid crease. However, revision double eyelid surgery varies depending on the individual's eye condition, the extent of revision required, and the correction technique. Therefore, it is advisable to make a decision after receiving a thorough consultation and detailed assessment from a plastic surgery specialist. When choosing a clinic for revision eye surgery, patients should look beyond online reviews and cost and also consider the surgeon's experience with revision double eyelid procedures and the thoroughness of the diagnostic process.

Dr. Lee Jun-hee, Chief Director of Realee Plastic Surgery, explained, “Revision eye surgery is not simply a procedure to recreate a double eyelid crease. The first priority is to accurately understand the changes in the tissue caused by the previous double eyelid surgery and the current structure of the eyes.”

He added, “Problems such as sausage eyes and uneven eyes can require different correction methods depending on their underlying causes. Rather than focusing solely on revision surgery costs or online reviews, patients can work toward natural and stable results through a thorough diagnosis and an individualized approach.”

He further advised, “Since revision double eyelid surgery is often more complex than the initial procedure, it should be approached carefully based on an accurate analysis of the existing double eyelid crease and extensive experience with eye surgery. Rather than pursuing excessive correction, developing a revision plan that considers overall balance and a natural appearance can help improve patient satisfaction.”

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