2026-06-04
Sausage Eyelid Revision: Lowering the Double Eyelid Line
Learn about revision surgery for sausage eyelids and techniques for lowering high eyelid lines, even when skin is scarce.
Sausage Eyelid Revision: Lowering the Double Eyelid Line
During double eyelid revision consultations, many patients come in seeking to fix ‘sausage eyelids’.
There are various ways to lower the double eyelid line.
Generally, if there is enough skin, lowering the line is relatively straightforward.
However, it becomes a challenge when there is a lack of skin.
This is the cover slide from my recent presentation.
A photo with Singaporean surgeon Wong Chin Ho.
Looks like I’m passionately explaining something. haha.
This photo was taken while I was serving as a chairperson in another session.
This method involves leaving the existing line as is, making a new incision below it, and releasing the previous adhesion.
This is an example of an actual patient. It’s only been about 10 days, so some swelling remains, but the eyes look larger and the line has been lowered.
A lateral canthoplasty (under-eye lowering) was also performed, so the lower lid looks a bit pulled down, but it will settle slightly higher over time.
This was the conclusion of the presentation.
The key points were to release adhesions thoroughly, prevent re-adhesion, and perform the surgery as late as possible (after sufficient healing).
Frequently Asked Questions
When is the most challenging case for sausage double eyelid revision surgery?
The most challenging cases are when there is insufficient excess skin on the eyelid. If there is ample skin, it's easy to lower the double eyelid line, but if there isn't enough skin, a special surgical method is required where an incision is made below the existing line to release adhesions, leaving the original line intact.
How do you lower the double eyelid line when there isn't enough skin?
The line is lowered by leaving the existing double eyelid line as is, making a new incision below it, and releasing the existing adhesions. This allows for larger and more natural-looking eyes even when skin is insufficient.
What are the key points of sausage double eyelid revision surgery?
It is most important to thoroughly release existing adhesions and prevent them from re-adhering. Additionally, delaying the revision surgery as much as possible to allow the tissue to stabilize sufficiently is a key point for successful results.
When does the swelling subside after double eyelid revision surgery?
About 10 days after surgery, some swelling may remain, but you can see that the line has been lowered. Over time, the swelling will further subside, and if canthoplasty was performed together, the lowered outer corner of the eye will slightly lift, becoming more natural.