Long-term Progress of Double Line Fold Lowering Scars and Lateral/Lower Canthoplasty Case

A patient who underwent the so-called ‘double line’ technique (lowering the double eyelid thickness while leaving the existing scar) visited our clinic recently. The surgery was performed approximately two years ago.

Looking at the pre-operative state, it was a case where the double eyelid line was set quite high.

Because the double eyelid line was set high, it had become slightly loose, and the scarring caused the line to appear uneven and wrinkled.

In this patient’s case, the line was so high that if the scar tissue were excised, there would be a significant lack of skin, leading to an even worse aesthetic outcome.

The core of the surgical method is to find as much normal tissue as possible, create a new double eyelid line there, and thoroughly release the existing scar tissue to prevent re-adhesion.

Additionally, the goal is to prevent damage to the orbicularis oculi muscle, which could lead to an inability to close the eyes, and to avoid creating any further additional scar tissue.

This is the appearance two years after the surgery.

The patient recently returned to undergo lateral and lower canthoplasty together.

The shape is very good. The upper arrow indicates the existing scar (a faint line), and the lower arrow indicates the newly created double eyelid line.

All the photos above were cropped using screen capture without any Photoshop or editing.

I am also attaching a video for reference.

Frequently Asked Questions

What is the double-line revision surgery?

Double-line revision is a surgical method that lowers the thickness of the double eyelid while leaving the existing double eyelid scar intact. It is suitable for patients who may experience skin deficiency if the existing scar is excised, and it proceeds by creating a new line in the normal tissue and releasing the existing scar.

Why is the existing double eyelid scar not excised?

This is to prevent the eye shape from worsening due to insufficient skin. For patients with a very high double eyelid line, excising the scar would result in a lack of eyelid skin, so the double-line revision method is applied, which preserves the scar and creates a new line below it.

What is the most important key during double-line revision surgery?

The most important thing is to find as much normal tissue as possible to create a new double eyelid line and to thoroughly release the existing scar to prevent re-adhesion. It is also crucial to perform the surgery meticulously to prevent orbicularis oculi muscle damage, such as the inability to close the eye, and to avoid additional scar tissue formation.

How does the existing scar look after surgery?

After a long-term follow-up, the existing scar remains as a faint line. In the 2-year follow-up case in the main text, it can be confirmed that the existing scar above has faded, and the newly created double eyelid line below has naturally settled.