南国の美容クリニック

　　This is a procedure to widen the folds of the upper eyelid by incision to achieve a permanent result. Removal of the excess skin and fats to reconstructure wider new folds will show your eyes bigger, meaning not only for cosmetic reasons but for younger looks and improved eyesight.

incision method upper blep.(eyelift) before




after

downtime: swelling&bruises for 1to2 wks., puffiness&overdone looks for around 2 mos.


　　Wound scar is done on the fold line, and detailed suturing is performed to enhance more natural outcome. Strong adhesion to a cartilage structure called tarsus must be secured by this sutures inorder to obtain a permanent effect.

　　Stitch removal is on the 5th day, make-up is already okay on the 6th, obvious swelling is observed from 1 to 2 weeks, and unnatural overdone appearance might lasts for a month or up to 3 months.

　　With this method, the wound is done along the fold line as long as the eye width. The longer the wound the stronger the fold holds. The scar heals well on this area, but if a shorter and fast healing is the choice, Partial Incision Method is the option. The scar goes half-size of the full incision, folds might be weaker but still are stronger than those of Suture Method, and excess fat removal is also possible with this procedure. But if the excess skin is the issue, full incision eye lift is recommended.

＜cosmetic surgery tips＞In this procedure, some surgeons might advise you to do the under-the-brow approach instead of along -the-fold incision. But this approach is not that effective enough that sometimes surgeons might extend the scars to the temple, that is not good to see, or sometimes just perform the suture method (mentioned above) together to have a new fold which is not permanent. So be aware of this when you are considering to undergo this surgery.

　 Pricing

		without tax	with tax
Incision Method Upper Bleph	both sides	\240000	\264000
Partial Incision Method Upper Bleph	both sides	\150000	\165000

　A procedure to reduce the puffiness of the upper eyelid is done with a 4 to 5 mm slit on the eyelid to tear apart the orbital fat bag and release fats out of the lid.

　Frankly speaking, it is hard to show satisfactory effect with this method alone. The swelling of upper eyelid observed when getting up from bed in the early morning might be lessen by this procedure, but it takes months to see such effect. That subtle is the outcome, so usually this is performed with suture method double eyelid procedure (mentioned above) that widens eye in order to emphasize or hide puffiness, as well as to promote the hold of the non-permanent effect of suture method.

fat removal+suture method eyelift before






after

downtime: swelling/tenderness for few days to1 wk., if bruise noticed, needs 1to2 wks.



　　To achieve a more effective puffiness reduction of the eyelid, besides deeper orbital fats, removal of a shallower bulk of subcutaneous(under skin) fats is necessary, which is not possible to be done with a minute slit, the reason why incision method is needed for this issue.

＜cosmetic surgery tips＞
Removing deep orbital fats from a small slit needs a strenuous training for a beginner cosmetic surgeon. We sometimes take this as the first barrier in the first year of the training. A brilliant one might master this with just few cases, but some may take a year or two. And there are a few with whom several years are not enough.
Doctors who do not recommend orbital fat removal might have some issue of this. Removing fats may sunken your lids in your elderly days, is their excuse of not doing it. Maybe it is true, but it is also true that even without surgery, sunken lids get sunken.
As mentioned, this procedure is not that effective, so I think you have nothing to worry about your older eyes in the far future. Just suggesting that this fact may help you how to tell if your surgeon is a more precise one or not.
Don't miss the 2nd or the 3rd barrier coming ahead.

And, be sure to check the removed fats after surgery！





removed orbital fats



　　Pricing

		without tax	with tax
Upper Orbital Fat Removal	both sides	\120000	\132000
	+suture method 2threads each	\150000	\165000

　　Incision wound is only half of the length of full incision method (mentioned above) to achieved a fixed double eyelid and thorough fat removal.






partial incision upper blep. before 　　　　　　　after
downtime: swelling & bruises take around 1 wk., puffiness & overdone looks for around 1month

　　Might be weaker than the full one but far more effective than orbital fat removal + suture method combined.
　　This is an alternative for those who are not fan of longer wounds but needed a stronger permanent effect than suture method.
　　Swelling and other downtime factors are almost the same with the full incision or maybe less. Stitch removal will be on 5th day, be able to start make-up on 6th, noticeable swelling around 1 week, about 1month of puffiness and a little unnatural overdone upper lid folds.

　　　Pricing

		without tax	with tax
Partial Incision Upper Blepharoplasty	both sides	\150000	\165000

　　Tired of looking at your tired-looking baggy lower lid? This aggressive incision method is still the most effective remedy for such complaint
.





lower blep. before 　　　　　　　　　　　　　　after
downtime: swelling & bruises for 1to2 wks.,scar redness for around 2months observed

　　Wounds below the eyelashes recover easily, forming unnoticeable scars. For this reason, incision blepharoplasty is still the first choice in treating baggy lower lids, instead of temporary fillers and lasers.

　　The most well-known method for this issue is called Hamra Method, named after an American plastic surgeon who developed this method in 1995. Dr. Hamra has announced this year(2019) his retirement from a 45-year successful career.

　　Recently, some young cosmetic surgery staffs here in Japan considered Hamra Method as the name of the lower orbital fat removal and transfer (be mentioned after this ). Terminology is sometimes an issue when time flies so fast, that sometimes it is hard to correct them. So, to differentiate one from the other , lower orbital fat surgery is sometimes called ' back Hamra' here in Japan since it is done with a slit at the back of the lid.

　　Hamra Methos is very effective that after these years it is still very popular among cosmetic surgeons around the globe. Specifically, this procedure goes as follows:

　　　First, incision just under lashes










　　　After dissection of skin-orbicularis muscle flap, orbital fat partially removed, partialy transfered underneath lower lid sulcus(circle)











　　　Orbicularis muscle suspension to rim








　　 Closing stitches










　　Postsurgically, a night of tape compression, stitch removal on the 5th day, then make-up can be resumed on the 6th. Wound scar redness may last for about 2 months but can be covered with make-up.

＜another cosmetic surgery tips＞Hamra Method seems to be the 2nd barrier in training in cosmetic surgery. After a year or two of studying the course, the doctor might feel so fulfilled performing breast enhancement or liposuction in the peak of enjoyment in his shallow career, but that is not the case in Hamra Method.
Performing lower eye lift simply with an old procedure, that is removing fats and excess skin, can be done in about 30 minutes but with a not-so-satisfactory outcome.
In Hamra Method, many issues are to be dealt with in that narrow limited small space that really eat up a lot of your time. Even a trained surgeon might need almost 2 hrs to finish, and some who do not have that much experience sometimes take the whole work day.
So, asking a doctor how long he/she can do this might be a good indicator of the surgeon's experience.

　　　Pricing

		without tax	with tax
Lower Blepharoplasty	both sides	\240000	\264000

　　　With no excess lower eyelid skin but noticeable orbital fats that create baggy eyelids, this procedure will be your remedy. By removing the fats from the back of the lid, you can get the fresh younger looks, without any visible scars on skin.

lower eyelid fat removal before



after

downtime: puffy for about 1 wk., if bruises noticed, takes 2 wks. to subside

　　　By the approach from the back of the eyelid, orbital fats are partially removed and other parts are transfered along the orbital bone rim which is underneath the disturbing dark circle present at the lower eyelid called lower lid sulcus.
　　　
　　　As you might have noticed, this method performs orbital fat transfer that is also done in Hamra Method, the reason why it is sometimes called Back Hamra in Japanese terminology, suggesting that its approach is from the back instead of the front skin.

　　 The actual treatment :
　incision at lid back side　　removal & transfer of orbital fats










　　Orbital fats from the lower eyelid have the same appearance with the upper ones as shown above. Upper and lower orbital fats actually are connected to each other forming a cushion-like formation to protect the eyeball. To be more specific, lower fat pads are divided into three bags; outer and middle which are yellowish in color, and an inner whitish bag. These 3 compartments must be excised with fats evenly so that remaining bumpy areas cannot be noticed from the skin.

　　Since no wound on skin observed, if bruises are not present, even the next day swelling might not be noticeable. If bruises are observed, see it for a week, while doing make-up covering beginning the next day. To avoid bruises, tape compression for a night is recommended.

　　　The vertical size of an eye can be increased simply with a double eyelid procedure which is performed on the upper eyelid. But if the upper eyelid is already at its limit or upper eyelid surgery is not the choice, one has to focus on the lower eyelid for widening the eye vertically, aiming of making it look rounder.

　　　Recently, surgery of enhancing the eye size in the lower direction called Slanted Eye Correction is definitely the craze among the new generations in Japan and maybe in the other Asian countries.

slanted eye correction before





after

downtime: swelling&bruises take about 1 wk., wound redness lasts about 1to2 mos., coverable with make-up

　　Slanted Eye Surgery, sometimes called Lower Eyelid Retraction Surgery, is often performed with Lateral Canthoplasty (widening of outer eye corner, mentioned below).By doing so minute effect of each procedure can be enhanced altogether because of the pulling and relaxing factors provided by both methods.


　　Specific Process：
　　　　　4-5mm width of skin removed along half side of lower eyelashes










　　　　　shortening of fascia(tissue sheet) at back of lower lid










　　　　　closing stitches(less than half length of Hamra Method)










　　A night of compression tape, stitch removal on the 5th, and then make-up can be resumed from the 6th day. Redness of scar might be noticed from 1-3- month period but can be covered with make-up.

　　　Pricing

		without tax	with tax
Slanted Eye Correction	both sides	\180000	\198000
	＋Lateral Canthoplasty both sides	\300000	\330000

Inner Canthoplasty

　　　A procedure of cutting the folds(Mongolian folds) of the inner corner of an eye to show it wider horizontally.

inner canthoplasty before





after

downtime: swelling&bruises take about 1 wk., wound redness lasts about 1to2 mos., coverable with make-up

　　　Simply cutting and removing of the fold does not show a good outcome, making it look crooked and unnatural and the worst not even widen your eye appearance. There are clinics that actually are still doing this, so be aware.
　　　

　　　The method that is popular among the cosmetic surgeons is called Uchida Method, after a Japanese doctor who suggested this procedure. A W-shape wound and skin flap is made at the inner eye corner to retract the Mongolian fold in the inner direction.

　　　In our clinic, Uchida method is adopted but not completely similar. It is somewhat modified a bit to lessen wound scars, so we call it a Modified Uchida Method.

　　　The actual Uchida Method :

　　　　　W-shape wound marking














　　　　　retraction with flaps
















　　Our Modified Uchida Method：

　　　　　modified W-shape wound marking















　　　　retracting folds with flaps　













　　　W-shaped wound's lower part is simply shortened by changing the method design. Upper part of the W is combined to the fold,also a technique adopted to our clinic's method. Both strategies are to minimize scar's appearance when it becomes obvious in certain individuals who have keloid tendency since inner eye corner is a common area of this issue.

　　Stiches are removed on the 5th day, make-up begins on the 6th.
　　Inner canthoplasty's scar redness might stay for awhile for some cases, so mastering to hide it with make-up is a must.

　　　Pricing

		without tax	with tax
Inner Canthoplasty	both sides	\180000	\198000

　　　Making a slit at the end of the eye to make it wider. Likewise the inner canthoplasty, this procedure widens the horizontal length of the eye.

lateral canthoplasty before





after


downtime: swelling&bruises take 1to2 wks. to recover, wound scar is not that obvious but 1 wk. of taping needed

　　　This procedure is not as effective as inner canthoplasry but necessary if the inner widening is not the treatment of choice.

　　　To show an excellent effect, conjunction of this treatment with Slanted Eye Correction (mentioned above) may strengthen the effects of both procedure more.

　　The actual outer canthoplasty goes as follows：

　　　creating a ５ｍｍ slit at the end corner, then trimming of upper & lower lids












　　　suturing of the lids while cutting stitches longer for tape pulling












　　　1 week of tape pulling is required to prevent reattaching of the edges. Outer canthoplasty usually creates non-noticeable scars.

　　　Compared to outer canthoplasty, this procedure's wound scar is not that obvious, but if bruises appear, covering with make-up is necessary.

　　　Pricing

		without tax	with tax
Outer Canthoplasty	both sides	\180000	\198000
	＋Slanted Eye Correction both sides	\300000	\330000

　　　Ptosis is a medical term for droopy eyelid. This symptom can occur from muscular or nervous issues of the upper eyelid levator muscle. Rolling upward and shortening of this muscle is the technique performed to open the eye wider.

　　　By doing so, it can improve not only the eye's cosmetic appearance but also the sight and vision field of the troubled eye.

　　　Congenital (inborn) and acquired (occured later in life) types exist in this problem, and since levator muscle did not grow that much in congenital type, satisfactory outcome maybe hard to achieve.

　　Acquired ones include those that occur from medical issues such as nerves or muscle dysfunctions and senile issues which come from weakness of muscle through aging process. The former usually occurs at a single side while the latter at both. Either type is curable with a repair surgery.

acquired neuropathic ptosis correction
before



after

downtime: swelling&bruises for 1to2 wks., puffiness&overdone looks for around 2 mos.



acquired senile ptosis correction before






after

downtime: swelling&bruises for 1to2 wks., puffiness&overdone looks for around 2 mos.




　　The method is to roll upward the levator muscle to shorten its length, making the eyelid to open much easier. This process is the only difference between this method and the incision double eyelid surgery, and the remaining techniques are similar on both.

　　So also the healing process of ptosis repair is not that different from incision double eyelid procedure which stitches are to be removed on the 5th day, after that, make-up on lids is already okay, redness and a bit puffiness of the lid might stay for 1-3 months depending on everyone's recovery manner.
　　　
　　　Pricing

		without tax	with tax
Ptosis Correction	both sides	\250000	\275000
	one side\	\125000	\137500

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