Before surgery: what to prepare
Stop aspirin, ibuprofen, naproxen, fish oil, vitamin E, ginseng, and ginkgo for 10–14 days before revision, slightly longer than primary cases because bruising is heavier. No alcohol for at least 5–7 days before revision (longer than primary cases, revision tissue is more vulnerable to bleeding). Arrive with a clean face: no makeup, no contacts, no false lashes, no extensions. Bring photos of your current lid from front, three-quarter, and side, plus reference photos of the fold you want. Be ready for the surgeon to tell you which aspects of the previous result are correctable and which aren't; some revision goals are not anatomically achievable and a good Gangnam revision surgeon will say so before booking.
The day of surgery
Revision DES is performed under local anaesthesia with sedation, runs 1–2 hours depending on whether scar tissue must be released, the fold raised or lowered, or a missing or asymmetric fold rebuilt, and discharges same-day. You leave with sutures, steri-strips, and clear instructions on the planned fold height, which will usually look higher than your goal for the first month. Vision is briefly blurry from ointment.
Days 1–3: peak swelling
Swelling and bruising are more pronounced than in primary DES because the surgeon is reopening scarred tissue. The lid feels tight and the fold looks unnaturally high. Cold compresses (10 on, 10 off) for the first 48 hours, head elevation, no bending, no lifting, no salty food. Pink oozing is normal in the first 24 hours; expect heavier bruising into the lower lid than first-time patients typically see.
Week 1: stitches out, bruising fades
Sutures come out around day 5–7. The incision line is more visible than in a primary case because it sits in or near the previous scar; it will fade but is at its most obvious around suture-removal week. Bruising shifts from purple to yellow-green and is concealable with makeup after suture removal. The fold is still well above its eventual height.
Weeks 2–4: back to public
Office work and public-facing situations are realistic from the end of week 2, sometimes day 10 for thinner-skinned patients. Residual swelling is greater than in primary cases and the fold continues to look higher and tighter. Contact lenses around week 2–3 depending on lid tenderness. Eye makeup once the incision is fully closed. No eye rubbing under any circumstances for at least 6 weeks since the revision tissue is more fragile than primary tissue.
Months 2–3: swelling resolves
Fold height drops noticeably from week 4 through month 3 as deep swelling and scar tissue resolve. This drop is more dramatic in revisions, which is why the surgeon set the fold high to begin with. Asymmetry may be more pronounced at this stage than in primary cases and usually equalizes by month 6, but not always, which is why revision results are assessed conservatively. Scar maturation continues and the incision colour begins to shift toward your skin tone.
Months 6–12: the final result
Final fold assessment for a revision is at month 12, not month 6. Revision tissue is less predictable; the fold can continue to settle subtly past month 6. Scar maturation runs the full 12 months and sometimes longer. If a second revision is being considered, surgeons almost universally wait a full year minimum and many wait 18 months. Repeat revisions become progressively less predictable because each pass adds more scar tissue.
Red flags: when to call the clinic
Call the clinic the same day for: sudden one-sided severe swelling, vision changes that don't clear, pus or yellow discharge, fever over 38.5°C, suture line opening (dehiscence), or a hard painful lump under the lid. Go to an emergency room for sudden severe eye pain combined with vision loss, this can indicate orbital compartment syndrome (retrobulbar haematoma), which is rare but sight-threatening and needs decompression within hours, not days. Mild oozing in the first day, asymmetric swelling between the two lids, and bruising tracking down into the cheek are not red flags.