Top 5 Reasons Your Double Eyelid Disappears After Surgery 

쌍꺼풀 풀림
Nk Park, Board-Certified Plastic Surgeon

Asian blepharoplasty is a surgical procedure that connects the eyelid and skin. Despite the procedure, it’s common for patients to experience a loss of their double eyelid crease over time. This article will explore the top five reasons double folds may disappear after surgery and offer suggestions for each.

background for plastic surgery patient education article


Q : What conditions make it more likely for double eyelids to disappear after surgery?

A : Double folds can easily disappear regardless of the surgical method if the patient has thick eyelids, deep-set eyes, severe skin sagging, or blepharoptosis.

1. Top 5 reasons for double eyelid fold disappear

1) Connection failure

The most common reason for a failed connection between the skin and the eyelid muscle (levator) is:

  • Tension issues during non-incisional surgery
  • Inadequate suturing or insufficient fixation during incisional surgery

This failure typically occurs within six months of the surgery and can result from individual differences in eye-opening power and skin thickness. The solution is to revise the surgery, ensuring more accurate fixation and appropriate tension. If the looseness persists, it may be necessary to change the surgical method, add ptosis correction, or adjust the fixation point. Choosing the wrong procedure for your anatomy can contribute to this issue. For more information, see the conditions that are suitable for non-invasive double eyelid surgery.

2) Low-Level Double Eyelids

Double eyelids positioned low are more susceptible to disappearing than higher creases. The reason is that the levator muscle’s power can’t effectively reach the skin if the double eyelid is low. To fix this, increase the number of fixation points for a more secure connection. Before the procedure, patients must understand that low-level double eyelids are more prone to looseness.

3) Epicanthal fold (Mongolian fold)

The double eyelid forms from the contradictory movement of two opposing muscles during eye-opening. This discrepancy is essential in understanding the basic mechanism of double eyelid surgery. The Mongolian fold, caused by a thick orbital muscle, can interfere with this interaction.

mongolian fold
The strong Mongolian folds in the inner corner of the eyes pull the eyelids down, making the double eyelid disappear more easily.

When the epicanthal fold strongly pulls down on the skin, it can lead to a short-lived crease. To address this, consider epicanthoplasty in conjunction with double eyelid surgery.

4) Rubbing or Eye-losing habit

Frequent rubbing or tight eye-closing after surgery can weaken the connections that form the crease. Patients should avoid these habits for at least two months after the procedure.

5) Adhesion in unwanted areas

If a double eyelid disappears after a second surgery, it could be due to faulty scar adhesion caused by excessive bleeding. To prevent this, it’s essential to remove hematomas during the early post-operative period actively. If a tight scar results in unnatural-looking high folds, revisional surgery may be necessary after the wound fully recovers (at least 6 to 8 months later). Removing the scar through multi-layered dissection is crucial in these cases.

2. Conclusion

This article has outlined the most common causes of double eyelid crease disappearance after Asian blepharoplasty. While there may be other factors at play, addressing the five reasons listed here can help improve the longevity of your double eyelid crease. We hope this information has been helpful.

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