Double eyelid fold or Asian eyelid fold can loosen over time. In order to understand why the double eyelid fold has loosened or disappeared, one must understand what double eyelid fold is. Double eyelid fold is an attachment of the skin to the eye elevating muscle known as levator aponeurosis. When this connection is lost or weakened, then the double eyelid fold will loosen or disappear. Therefore, double eyelid fold strength or durability is largely dependent on how the fixation of the double eyelid fold is performed.
Suture technique double eyelid fold relies purely on the non-absorbable nylon suture to create the double eyelid fold. However, there is no fibrous connective tissue to fibrous connective tissue connection by the inflammatory process. Therefore, the double eyelid fold loss occurs because the dermis or the levator disconnects from frequent wear and tear. The concept is called cheese-wiring effect.
For the incision technique double eyelid surgery or the open technique double eyelid surgery, the double eyelid fold can loosen or the fold can disappear if the suture connecting the dermis to the levator muscle becomes disconnected before the fibrous connection sets in. Another case is if the patient rubs one’s eyes too excessively. This movement can also disrupt the connection of the double eyelid fold.
Lastly, if the patient has eyelid ptosis, then the double eyelid fold does not occur as the levator or the eyelid elevating muscle does not fully engage with the dermis when the patient opens one’s eyes.
Therefore, there are many factors that lead to double eyelid fold loss. It is important to find out the cause of the double eyelid fold loss or loosening during the consultation with the board-certified plastic surgeon prior to undergoing revision double eyelid surgery.
In the next blog, we will discuss high double eyelid fold.