Out-Line Double Eyelid - SM Plastic Surgery

Where the lid is thin and there is room between brow and eye, a high, wide outer line settles clearly. Where the lid is thick or eye opening weak, the line can look excessive, so its height is designed carefully.

The outer line sits high and wide for a clear, open impression from the front; the inner line low and narrow for a restrained, natural one. The height is decided by the eye and the image you want.

Lid thickness, the distance between brow and eye and the strength of eye opening are considered together, and the height and width of the line are designed within a restrained range. Harmony with the proportions of the whole face comes first.

It differs with whether the line is made by buried suture, natural adhesion or incision. With incision, the scar sits inside the line, so it tends not to show when the eyes are open, and fading takes time.

Incision is not always needed; where the lid is thin, the buried-suture or natural adhesion methods can also make a clear line. Where the lid is thick or fat and skin sag, incision can favour holding power.

The procedure takes roughly 30 minutes to an hour and is performed under local or sedation anaesthesia. It varies with which fixing method is used, buried-suture, natural adhesion or incisional, and whether ptosis correction is done at the same time. The exact range is explained after a detailed examination.

How well it holds depends on the fixing method used to create the line. If the eyelid is thick or there is fat and skin laxity, the line can be pressed down and fade, so the incisional method may hold better. How long it holds varies from person to person.

With thick eyelids a high line can be pressed down, looking heavy or failing to hold. In that case we may design a lower line, or consider trimming fat and skin as well, and the incisional method may suit better. Whether it is possible is judged after checking eyelid thickness.

The higher and wider the line, the clearer the impression; but if it is excessive relative to eyelid thickness and the distance between brow and eye, it can look heavy. We therefore give priority to overall facial proportion and design a height and width that is not overdone. The range that suits you is confirmed at the detailed examination.

Most people can resume daily activities from about five to seven days afterwards. The higher the line, the more the appearance shifts as swelling subsides, so it can take longer for a natural impression to settle. Recovery speed varies from person to person.

The line you use day to day is a useful reference for the impression you want, but that height does not necessarily fit the condition of your eyelid. With differing eyelid thickness and eye-opening strength, the same height can give a different result, so adjustment may be needed. We look at the line you want together in consultation and explain what is achievable.

When that gap is narrow, setting the line high can make the lid look cramped or the impression stronger. We then adjust the height, or also consider a design closer to an inner line. The height that suits you is decided while looking at overall facial proportion.

If weak eye-opening due to ptosis is also present, raising the line alone may not make the eyes look clearer and the line can feel excessive. In that case we consider combining ptosis correction. Whether it is needed is advised after assessing eye-opening strength.

Men do not usually soften the crease with make-up, so a high line can read as artificial, and we generally start by considering a lower height. If you want a distinctly clearer eye, we may adjust the width of the line or combine ptosis correction instead. The height that suits you is confirmed together in consultation.

As eyelid drooping progresses, even a high line can be covered by loose skin and fail to look defined. In that case we consider addressing the loose skin as well, judging by the condition of the eyelid and eye-opening strength rather than by age. The suitable approach is advised after examination.