There Is No Large, Natural Double-Eyelid Line for Sausage Eyes

Hello. I am Dr. Ahn Byung-jun, the director of Ahn Byung-jun Plastic Surgery.

There is something I have said tens of thousands of times in consultations.

"There is no such thing as a large, natural double-eyelid line."

This may sound disappointing, depending on how you hear it, but it is also a limitation of the eye's structure.

Once you properly understand the relationship between sausage eyes and the double-eyelid line, you will understand why this statement is important.

Why do sausage eyes occur?

The position where the double-eyelid line is fixed is the tarsal plate on the inside of the eyelid—in other words, the area made up of firm cartilage-like tissue.

The average height of the tarsal plate is about 8 mm.

If the line is created at 9 mm, 1 mm of excess skin remains above the tarsal plate. This area folds thickly and comes to look like a sausage.

As the line becomes larger—10 mm or 11 mm—the sausage-like appearance becomes more pronounced, and the possibility of left-right asymmetry also increases.

If the eyes have a large, open structure, a 10 mm line may still look natural, but this is not common.

In my experience, the safe upper limit for a double-eyelid line is around 8 mm. If you want a line higher than that, it is advisable to undergo surgery accompanied by skin excision.

Line size and naturalness are not proportional

Many people think that the larger the double-eyelid line, the larger and more open the eyes will look.

In reality, however, the opposite is more often the case.

As the line gets larger, the skin between the eyelashes and the line piles up thickly, pressing down on the eyes and making them look more cramped instead.

In consultations for revision surgery for sausage eyes, I often hear people say, "I don't want an inner double eyelid," or "Please make it a completely hidden double eyelid."

Unlike the first surgery, revision surgery does not allow a new line to be created however you want while disregarding the existing line.

This is because tissue has already been fixed once, and adhesions and scars remain, so the approach is to improve the appearance within those existing limitations.

The standard for what looks natural needs to be broadened in revision surgery

The important thing in revision surgery to improve sausage eyes is to lower the line.

When the excess skin that has piled up thickly is reduced, the eyes can actually look more defined and clear.

It may seem strange that the eyes look larger even though the line becomes smaller, but this is because the eyes open more comfortably once functional obstacles have been removed.

Looking at people who are satisfied with the results of revision surgery, most of them have accepted a somewhat broader range of what looks natural.

The results were better when they changed their direction from pursuing the line they initially wanted to finding a line that suited their eyes as they are now.

Immediately after revision surgery for sausage eyes, considerable swelling remains, making it difficult to judge the result right away.

It takes some time for the line to stabilize and the tissue to settle into place, so it is best to assess the result afterward.

For those considering revision surgery for sausage eyes and double eyelids, the first step is to find a board-certified plastic surgeon and have the size and structure of the current line analyzed.

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