There are two main types of double eyelid fold fixation methods. One is a non-incision method and the other is an incision method double eyelid surgery. The non-incision method involves passing a nylon suture from the skin to the deeper underlying tissue. There are variations in terms of how times the suture passes in and out of the skin to create the double eyelid fold.
When it comes to the incision double eyelid surgery, there are three types of fold creation methods. First is fixing the skin to the tarsus. This creates a firm, anchoring type of fixation. Therefore, the double eyelid fold invaginated deeply and the fold itself does not move. Therefore, it is a static double eyelid fold and does not look natural. The second type is fixing the skin to the levator aponeurosis. Levator aponeurosis is an eye elevating muscle. Therefore attaching the skin to the moving levator muscle creates a dynamic double eyelid fold. What this means is that the eyelid crease occurs with eyelid elevation but remains relatively flat when the eyes close. However, the plastic surgeon must calibrate the tension applied so that the double eyelid fold is not too strong or weak. The third method of double eyelid fold creation is attaching the skin to the underlying firm tarsus and the levator aponeurosis as a three ways suture. The advantage of this technique is that the plastic surgeon does not need to individually calibrate the tension to create the double eyelid fold. The disadvantage is that the fold is not as dynamic and as natural as attaching the skin to the levator aponeurosis.
Thus, in the future articles, we will discuss what it means to have an Asian eyelid and what entails Asian eyelid surgery.