Double eyelid surgery, also known as blepharoplasty for crease creation, forms a natural-looking fold on the upper eyelid to enhance definition and brightness in the eyes. Highly popular in East Asia, this procedure is suitable for individuals with monolids or droopy upper eyelids. By creating a customized eyelid crease, the eyes appear larger, more dynamic, and more expressive—enhancing both aesthetic appeal and overall confidence.
The appearance of double eyelids is closely related to the structure of the eyelid skin, muscles, and connective tissues.
The levator muscle is responsible for lifting the upper eyelid when we open our eyes. As the levator contracts and elevates the eyelid, it also pulls a portion of the superficial skin upward, creating a fold—this crease is what we recognize as a double eyelid. For this fold to form naturally, there must be a functional connection between the levator muscle and the overlying skin through connective tissue. This dynamic linkage allows the skin to fold inward when the eye opens, making it the key mechanism behind natural double eyelid formation.
Some individuals naturally possess this anatomical connection and therefore have double eyelids. Others may not, due to factors such as thicker eyelid tissue, weaker levator–skin connections, or orbital fat positioned lower in the eyelid, which prevents the formation of a stable crease. Double eyelid surgery works by creating or reinforcing the dynamic linkage between the levator muscle and the superficial tissue layers. This enables the skin to fold naturally during eyelid elevation, producing a stable and anatomically harmonious double eyelid that complements each person's unique eye shape.
In an Outfold-Type crease, the double eyelid line extends toward the inner corner of the eye without merging with the inner canthus. This creates a clear separation and typically results in a bright, expressive, and more defined eye appearance.
The Semi-Outfold type sits between the open and closed styles. The crease runs very close to the inner corner but does not fully connect. It offers a refined, natural, and elegant look.
In a closed-type crease, the double eyelid line merges seamlessly into the inner corner of the eye. This style is well-suited for individuals with a prominent epicanthal fold or those who prefer a softer and more natural-looking double eyelid.
In an open fan-shaped crease, the inner corner of the fold is narrow and gradually widens toward the outer corner, creating a fan-like expansion. This style gives the eyes a soft, gently lifted appearance.
The parallel fan-shaped crease is a transitional type between the open fan-shaped and the parallel-style crease. It is often paired with a semi-outfold inner crease for a balanced and natural look.
In a parallel-shaped crease, the fold runs parallel to the lash line from the inner to the outer corner, maintaining a consistent width throughout. This style enhances eye size most effectively, giving the eyes a rounder, brighter, and more defined appearance.
Also known as the suture or buried-suture technique, this method uses fine sutures to create a connection between the levator muscle and the superficial eyelid tissues, forming a natural double eyelid crease. The procedure is minimally invasive with virtually no visible scarring and offers a quick recovery. It is ideal for patients with thin eyelid skin, younger individuals, and those without excess eyelid skin.
Also known as the full-incision method, this approach removes excess tissue and skin through a surgical incision and then forms the double eyelid crease through suturing. It is suitable for individuals with thick eyelid skin or laxity and provides long-lasting results.
A hybrid technique that combines elements of the suture method and the full-incision method, suitable for patients with partially thick eyelid tissue.
One Week Before Surgery:
• Discontinue the use of eyelid tapes for at least one week.
• Stop taking anticoagulants (such as aspirin); please consult your prescribing physician before discontinuing the medication.
• Stop all dietary supplements (such as fish oil, ginkgo, ginseng, and vitamin E).
• Avoid smoking and alcohol from one week before surgery until one month after the procedure.
On the Day of Surgery:
• Arrive with no makeup and remove any eyelash extensions.
• Do not wear accessories or metallic items; remove any piercings in advance.
• If you are nearsighted, you may wear contact lenses to the clinic, but they must be removed before surgery. Please bring a storage case, glasses, or sunglasses for use afterward.
• Fasting is not required for local anesthesia; you may eat normally.
• Please do not drive or ride a motorcycle yourself after the procedure.
• Cold and warm compresses: Apply cold compresses for the first 72 hours after surgery to help reduce swelling and bruising. After 72 hours, begin warm compresses to promote circulation and healing.
• Wound care and dressing changes: Keep the incision dry at home and change dressings as instructed. If skin sutures are present, they are typically removed around day 6–10 depending on wound healing.
• How to change dressings: Clean the wound twice daily using sterile cotton swabs dipped in normal saline, then gently dry and apply the prescribed ointment. When using cold or warm compresses, cover the area with gauze to reduce the risk of infection.
• Medication and eye hygiene: Use all prescribed eye drops or ointments as directed to prevent infection and support proper healing.
• Eye use and daily habits: Avoid prolonged use of mobile phones, computers, or extended periods of looking downward to allow sufficient rest for the eyes.
• Diet and medication:
- Pain medication prescribed by your doctor may be taken as needed to relieve discomfort.
- Avoid irritating foods and substances such as smoking, alcohol, tea, coffee, spicy foods, and dietary supplements (including vitamin E, reishi, and traditional Chinese medicine).
- A light diet is recommended, with adequate hydration and increased intake of protein and vitamin C to support wound healing.
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2F, No. 263, Sec. 1, Dunhua S. Road,Da'an District, Taipei City 106, Taiwan
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