[RARI Plastic Surgery] Double Eyelid Revision Surgery: Two Ways to Lower the Crease Line (Excision Method, Two-Line Method)

Today, I’d like to talk about surgery for lowering the crease line among double eyelid revision surgeries.

There are broadly two ways to lower a double eyelid crease.

First is the excision method.

Second is the two-line method (a method that does not excise skin).

Simply put,

when lowering a high double eyelid crease, after designing a new crease line at the desired lower position from the existing high crease,

if the skin between the high line and the low line is excised, that becomes a crease-lowering surgery using the excision method.

If the existing high double eyelid line is left as is, and the desired lower crease line is incised,

then through that incision, the surgeon dissects upward, releases the existing double eyelid crease, and does not excise the skin.

That is the double eyelid lowering two-line method.

Viewed in cross-section from the side, the adhesion point of the high double eyelid crease is on top,

and the skin is slightly sunken due to that adhesion.

This depression at the adhesion site becomes the double eyelid scar.

If you incise the skin at the height where you want to lower the double eyelid,

and excise the skin in between,

that becomes a crease-lowering surgery using the excision method.

In the excision method, the skin is removed, the existing upper adhesion is released,

and the muscle, fat, and subcutaneous tissue above are newly brought down to the incision line at the desired lower height,

so it fills in the empty space completely. That is why it becomes a definite double eyelid lowering surgery.

So it shows clean results without side effects such as a triple fold forming or the double eyelid loosening.

Unlike the excision method, the skin between the existing crease line and the new design line is not excised.

Instead, the newly designed lower crease line is incised, dissected upward, and moved up,

and the adhesion between the inner skin and muscle is released. This is the two-line method.

(After filling the space where the adhesion has been released by bringing in the upper fat tissue as is,

the double eyelid line is lowered without excising the skin.)

Even if the fascial adhesion on the levator aponeurosis side is released well with the two-line method,

if the adhesion between the fat and subcutaneous tissue under the skin is not properly released,

the skin side still remains sunken even though the double eyelid line loosens.

So after a two-line procedure, the existing partially unreleased line, the newly designed line, and the sunken area may get pulled together,

and in some cases a triple-fold-like crease can form.

That is why the two-line method is not suitable when lowering a high double eyelid by more than 2–3 mm.

Case 1. Excision Method

This patient had an existing large double eyelid crease.

After designing a new line to lower it, the skin between them is excised,

then the double eyelid line on the upper line is released from the excised area,

and after creating the double eyelid line that matches the lower line, the two lines are connected and sutured,

as a result, it comes out as a newly created, lower double eyelid line.

When the eyes are open, the shape of the double eyelid also changed.

Before the lowering surgery, the crease was high, but after the revision surgery to lower it,

you can see that the double eyelid has naturally become lower.

You can also see that even with surgery using the skin excision method, the eyes close well.

Case 2. Two-Line Method

This woman had a thick double eyelid with a sausage-like appearance.

Because of this, there is a slight sunken side effect in the upper eyelid,

and when the eyes are closed, you can see that the design of the crease is quite large.

It looks to be almost around 8–9 mm, and when the eyes are closed, a slightly sunken scar is also visible.

In this patient’s case, rather than greatly reducing the line, the goal was to lower it slightly to remove the sausage-like look of the double eyelid,

so we planned to reduce the line by about 1–2 mm.

When reducing the line only a little like this, the two-line method is sufficient to lower the crease.

If the operation is performed by going from the new incision line up to the existing line with the two-line method,

the thick line from before surgery changes into a more natural line.

Because the surgery was performed without excising skin and while preserving the skin,

when the eyes are closed, the existing scar from the crease appears to be slightly visible, but it has improved relatively well,

and only the scar from the newly designed line remains,

so you can confirm that the double eyelid has been reduced well when the eyes are open.

Today, I explained the two methods for lowering a double eyelid crease: the excision method and the two-line method.

There is not only one surgical method,

but depending on the condition of the eyes, there is a more effective and better method,

and that is determined by the surgeon performing the operation.

Rather than focusing only on the advantages or disadvantages of each method,

it is better to find a more effective approach through an in-depth consultation before surgery

so that you can receive the procedure that best achieves the result you want. ^^

I believe everyone reading this has understood it sufficiently,

and I will come back next time with another topic.

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Clinic hours are 10:00 AM to 7:00 PM on weekdays, and 10:00 AM to 4:00 PM on Saturdays.

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