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What Is an Attractive Double Eyelid?!

There is no fixed standard for what makes an attractive and beautiful double eyelid line.

But let’s look at what is generally considered an attractive double eyelid line.

Please refer to the following content ~

A natural and beautiful double eyelid that does not look surgically altered can be said to be an attractive double eyelid.

A double eyelid line that is too large is not good.

In general, when the line is large, it often gives an awkward impression.

Depending on the view of beauty, a large and distinct line can give an artificial and awkward impression.

The most beautiful and ideal double eyelid line is one that is just slightly visible by about 1–2 mm when the eyes are open.

It is better if the double eyelid line clearly extends to the inner corner of the eye.

In some cases, East Asian eyes have an epicanthal fold (medial canthal fold), and if this is overlooked during surgery, the inner eye line may disappear, creating a feeling of heaviness.

Whenever possible, the line should be made visible all the way to the inner part of the eye. If the line does not appear properly because of the epicanthal fold, an epicanthoplasty should be performed. If there is no epicanthal fold, the design must be done carefully so that the line does not break off on the inside.

There should be no visible surgical marks after double eyelid surgery.

The biggest disadvantage of the incision method is scarring.

How much scar remains depends on the surgeon’s skill and the individual’s physical tendency.

In particular, people with thicker skin and orbicularis oculi muscle tend to develop more scarring relatively often.

Once a scar forms, there is no way to remove it completely, although in severe cases scar correction can be performed to make the scar less noticeable.

Therefore, during the first surgery, it is important to minimize scarring by removing an appropriate amount of skin and performing precise suturing.

The eyelids should appear thin.

Reasons why the eyelids look swollen include thick skin or orbicularis oculi muscle, or excessive orbital fat or preaponeurotic fat.

It is best to solve these issues while performing double eyelid surgery.

The most common cause is excessive orbital fat.

This can be addressed by removing orbital fat during the double eyelid surgery.

Or, if the orbicularis oculi layer under the skin is thick, part of the orbicularis oculi layer can be removed. Orbicularis oculi beneath the incision line can be partially removed, while it is difficult to remove the orbicularis oculi above the incision line.

If there is an epicanthal fold, it is better to remove it.

In some East Asians, there is an epicanthal fold (medial canthal fold), which can make the skin at the inner corner of the eye cover the eyeball and create a constricted appearance. Removing it increases the horizontal width of the eye and makes it look more open, allowing the double eyelid line to appear clearly toward the inner side as well.

However, surgery must be performed carefully with consideration of the eye shape to avoid unsatisfactory results.

If the eyes do not seem far apart and there is little to no epicanthal fold at the inner corner, performing epicanthoplasty can instead make the eyes look too close together or create a sharp appearance, so it should only be done when indicated after an accurate physical examination.

If there is ptosis, it should be corrected at the same time.

Ptosis refers to a condition where the upper eyelid droops because the levator palpebrae superioris, which lifts the eyelid, is weak and covers the pupil, making the eyes look sleepy. If this is overlooked during surgery, the double eyelid line may not look beautiful.

Before double eyelid surgery, the eyes should look larger and more refreshed for the double eyelids to look beautiful as well.

If, depending on the degree of ptosis, ptosis correction is deemed necessary, it is better to correct it together by the incision method.

Double Eyelid Surgery Guide

What are the indications for double eyelid surgery?

Eyes that appear small
Eyes with wrinkles on the eyelids
Eyes that appear droopy
One-sided double eyelids only

Examples of eye shapes that may need double eyelid surgery

What are the basic principles and concept of double eyelid surgery?

People often mistakenly think that double eyelid surgery is only a procedure to create a double eyelid line.

That is not the only purpose of double eyelid surgery.

The goal of double eyelid surgery is to make the eye shape larger and brighter, so the overall impression looks more intelligent and beautiful.

Surgery performed solely to create a double eyelid line sometimes creates a somewhat unpleasant impression.

The goal of double eyelid surgery is to create a natural and beautiful eye shape.

What Is the Incision Method for Double Eyelid Surgery?!

It refers to a method of making an incision along the entire design line for creating a double eyelid and forming the double eyelid line.

What are the indications for the incision method?

① When the skin is sagging and needs to be removed

② When the skin is thick and the line is likely to come undone with the partial incision method or buried method

③ When an existing double eyelid line needs to be revised

④ When ptosis needs to be corrected

What are the advantages of the incision method?

① If the skin is sagging, the skin can be removed.

② It is less likely to come undone.

③ The shape of the double eyelid line can be designed as desired.

④ Muscle can be removed below the incision line, allowing a refined line to be created.

What are the disadvantages of the incision method?

① If you do not like the double eyelid line, it is difficult to revise.

② A scar remains.

③ Swelling lasts a long time.

What is the surgical process for the incision method?

▶ Steps 1 to 3: Local anesthesia along the planned incision line -> incision along the planned line -> removal of the orbicularis oculi muscle

① Design is marked with special ink before anesthesia, and local anesthesia is administered under sedation.
② After local anesthesia, the skin is incised along the design line.
The orbicularis oculi muscle is a structure that interferes with double eyelid formation, so it must be removed when performing surgery by the incision method.

▶ Steps 4 to 6: The thread exits the skin again -> the thread is tied on the outside and buried -> cross-section photo of the buried thread

④ If the eyelid is thick because of a lot of fat, orbital fat may also be removed. Eyes without orbital fat may not need fat removal.
⑤ A three-point suture is performed to form the double eyelid line. By suturing the skin below the incision line and the levator palpebrae superioris, the thread is buried at three points to create the double eyelid.
⑥ The skin is precisely sutured with fine thread. After suturing is complete, the area is disinfected and the patient goes home. Stitches are removed after 4–5 days.

What are the post-operative care instructions after incision double eyelid surgery?

Use the cold pack provided by the hospital for cold compresses. Do this for 2 hours a day for only 3 days. If you apply cold compresses for more than 3 days, the swelling may not go down as well, so be careful. Cold compresses can be done continuously for 2 hours or divided into 20–30 minute sessions. It is usually convenient to do them before sleeping.
Follow-up visits after surgery are usually about two times: the day after surgery and on the day the stitches are removed. Stitches are removed on day 3 or 4.
Makeup and face washing are allowed after the stitches are removed. Until then, cleanse the face with a wet towel.
After the incision method, no bandage is applied, and daily life can resume immediately.
Postoperative swelling varies from person to person. Usually, swelling subsides to a large extent in about 7 days, but it takes about 1 to 3 months to settle completely.

What Is the Buried Method for Double Eyelid Surgery?!

Instead of making an incision along the entire design line for creating a double eyelid,

this method creates the double eyelid line at the buried thread site by burying only the thread.

What are the indications for the buried method?

① When the skin is thin and there is little fat

② When you do not want to leave a surgical scar

③ When you need to return to daily life immediately after surgery

What are the advantages of the buried method?

① The surgery time is short, and there is no incision at all.

② There is little swelling, and daily life is possible immediately.

③ There is no scar, and it looks natural.

④ If you do not like the double eyelid line, correction is easy.

What are the disadvantages of the buried method?

① When the skin is thick, the double eyelid line easily comes undone.

② Orbicularis oculi muscle or fat removal is not possible.

③ It is difficult to apply when the skin is sagging.

④ The double eyelid line may partially come undone, making an awkward line more likely.

What are the types of the buried method?

1. Multiple-knot interrupted suture method

The multiple-knot interrupted suture method is a method in which two to three, or in many cases about five, non-absorbable threads are buried and tied at each buried point.

2. Single-knot continuous suture method

The single-knot continuous suture method is a method in which the thread is buried continuously and tied only once at the end.

What is the surgical process for the buried method?

▶ Steps 1 to 3: Minimal incision at the buried thread site -> pass the thread from the outside -> the thread passes through the conjunctiva

① The design line is drawn and local anesthesia is administered. About three small incisions are made along the design line so the thread can be buried.
② The thread is passed through the conjunctiva through the outer incision hole.
③ The thread that exits through the conjunctiva is passed back toward the skin.

▶ Steps 4 to 6: The thread exits the skin again -> the thread is tied on the outside and buried -> cross-section photo of the buried thread

④ The thread that exits toward the skin is passed through the hole again and moved outward.
⑤ The thread is tied at the outer hole and buried.
⑥ The buried thread creates adhesions between the skin and the levator palpebrae superioris, forming the double eyelid.
⑦ Immediately after surgery, almost no marks are visible except for the small holes, so a bandage is not needed and daily life can resume right away.

What are the post-operative care instructions after buried-method double eyelid surgery?

Use the cold pack provided by the hospital for cold compresses. Do this for 2 hours a day for only 3 days. Cold compresses can be done continuously for 2 hours or divided into 20–30 minute sessions. It is usually convenient to do them before sleeping.
After surgery, make one follow-up visit the next day to disinfect the surgical site and observe the progress.
Makeup and face washing are allowed starting the next day.
Postoperative swelling varies from person to person. Usually, swelling subsides to a large extent in about 7 days, but it takes about 1 to 3 months to settle completely.

What Is a Beautiful Quick Double Eyelid?!

Quick double eyelid surgery is a procedure with minimal incision and minimal swelling,

allowing immediate return to daily life after surgery.

Our clinic’s quick double eyelid surgery is performed using the minimum-incision partial incision method.

Because skin suturing is not needed, daily life is possible,

there is almost no swelling immediately after surgery,

and it is characterized by a natural appearance.

It also has the advantage of being less likely to come undone.

What Are the Four Principles of Double Eyelid Surgery?

♥ Swelling should be minimized

Quick double eyelid surgery is one of the methods with the least swelling among all methods.

♥ The double eyelid line should not come undone

By removing the orbicularis oculi muscle and orbital fat, the double eyelid line is almost never undone.

♥ Double eyelid scars should be minimized

With a minimum 2 mm incision, scar formation is almost nonexistent.

♥ The double eyelid line should look natural

The most natural double eyelid line is found in advance while sitting, and the surgery is performed based on that line.

Why Does Quick Double Eyelid Surgery Not Cause Swelling?

Swelling occurs when exudate produced by surgery accumulates in the tissue.

The reason quick double eyelid surgery causes almost no swelling is that through micro-incisions, swelling-causing tissues such as the orbicularis oculi muscle and fatty tissue are removed, and the exudate from surgery is immediately drained through the micro-incision site, leaving no room for swelling to develop.

For example, it is the same principle as how a bruise without an open wound swells, while a cut wound hardly swells.

A bruise without a wound swells because exudate forms inside and cannot drain, so it accumulates. A cut wound does not swell because the exudate drains out immediately.

How Much Swelling Occurs After Quick Double Eyelid Surgery?

The degree of swelling varies by individual, but in general, there is not much swelling even immediately after surgery, and it is usually okay to resume daily life right away.

What Is the Surgical Process for Quick Double Eyelid Surgery?

▶ Steps 1 to 2: Design the double eyelid line -> choose three incision points

① The desired double eyelid line is designed. The design is made according to the height and shape the patient wants, or the surgeon determines the most suitable line and designs it. The line height is usually designed between 5 and 8 mm from the eyelashes, and the design direction changes depending on whether an out-fold or an in-fold is chosen.
② Three points are marked with design ink for the incision locations. The positions are lightly marked on the inner, middle, and outer parts.

▶ Steps 3 to 4: Local anesthetic administered -> 2 mm minimal incision

③ Under sedation, when the patient has slept for about 5 minutes, local anesthetic is injected into the three marked points. The local anesthetic is administered in the smallest amount possible to avoid swelling as much as possible.
④ A very small incision of about 2 mm is made at the three marked sites. If the incision is made too large, there will be more scarring, so the surgery is performed with the smallest possible incision to leave almost no scar.

▶ Steps 5 to 6: Removal of the orbicularis oculi muscle -> exposure of orbital fat

⑤ Through the incision, the orbicularis oculi muscle is first pulled out and removed with scissors. The orbicularis oculi muscle is the muscle layer covering the eyelid and is a tissue that interferes with double eyelid formation, so it must be removed for the double eyelid line not to come undone. Along with removal of the orbicularis oculi muscle, preaponeurotic fat beneath the muscle layer is also removed.

⑥ If there is a lot of orbital fat, it is pulled out and exposed through the outer incision site. Fat removal is mainly done from the outer side.

▶ Steps 7 to 8: Removal of orbital fat -> hemostasis of orbital fat

⑦ The fat is held with a hemostatic forceps, and the base of the protruding fat is cut with a scalpel. Removing too much fat can cause the eyelid to become sunken, so it is better to remove only as much as has come out.
⑧ After fat excision, electrocautery is used to stop bleeding so that no bleeding occurs. If hemostasis is not performed properly, orbital hemorrhage may occur, leading to severe bruising and swelling, so it is important to achieve good hemostasis.

▶ Steps 9 to 10: Process of forming the double eyelid line -> burying the suture thread

⑨ Through the three incision sites, a very fine absorbable thread is used to connect the levator palpebrae superioris and the skin, creating the double eyelid line.
⑩ After burying the thread, ointment is applied and the surgery is finished. Makeup and face washing are allowed from the next day. Cold compresses are applied with the cold pack provided by the hospital for 3 days. If cold compresses are applied for more than 3 days, the swelling may not go down any further, so it is best to do them for exactly 3 days only.

What are the post-operative care instructions after quick double eyelid surgery?

① Use the cold pack provided by the hospital for cold compresses. Do this for 2 hours a day for only 3 days. Cold compresses can be done continuously for 2 hours or divided into 20–30 minute sessions. It is usually convenient to do them before sleeping.
② After surgery, make one follow-up visit the next day to disinfect the surgical site and observe the progress.
③ Makeup and face washing are allowed starting the next day.
④ Postoperative swelling varies from person to person. Usually, swelling is almost gone in about 7 days, but it takes about 1 to 3 months to settle completely.

Examples of Quick Double Eyelid Surgery Applications

Let’s look at the differences between quick double eyelid surgery (partial incision method) and the buried method~

​	Quick double eyelid surgery (partial incision method)	Buried method
Use of thread	Absorbable thread	Non-absorbable thread
Degree of incision	About 2 mm, 3 incision points	About 2 mm, 3 incision points
Postoperative swelling	Slight	Slight
Degree of loosening	Almost never comes undone	Tends to come undone or become thin more often
Line definition	Maintains the same definition as the incision method	Often comes undone or is not clearly defined
Fat removal	Possible	Not possible
Removal of stitches	Not necessary. Can be removed if desired	Impossible or very difficult
Scar formation	Almost none	Almost none

http://www.doublefold.co.kr

Compared with the pure buried method performed at our clinic,

double eyelids made with the partial incision method (quick double eyelid) have several advantages.

The difference is that the buried method has the disadvantage of easily coming undone, so the partial incision method was developed to compensate for that.

By making the partial incision as small as 2 mm, it is differentiated from other partial incision methods.

The partial incision method (quick double eyelid) is a method that uses very small incisions of about 2 mm at each site.

Like the buried method, it is natural and allows immediate return to daily life, and it is generally characterized by almost no swelling.

It also leaves almost no scar.

If there is a lot of fat, fat removal is also possible.

In the buried method, when swelling occurs, there is no route for tissue exudate to drain,

so people who swell a lot may swell as much as with the incision method.

In the partial incision method, tissue exudate drains directly through the incision holes,

so swelling and bruising are less than with any other method, which is a major advantage.

It also has the advantage of not coming undone easily like the incision method.

Because anesthesia is painless anesthesia, there is no pain at all.

The surgery takes about 30–40 minutes.

There is no need to remove stitches after surgery, and daily life can resume immediately.

http://www.duhans.com