Correction of a high double eyelid fold can be relatively simple if there are excess upper eyelid skin. However, many revision double eyelid patients do not have excess upper eyelid skin. In these patients, lowering a high double eyelid fold can be difficult. Simply releasing the prior high fold will lead to recurrence of the prior double eyelid fold.
Prior techniques have utilized applying various grafts to be placed between the high double eyelid folds. The grafts included fat grafts, regional tissue grafts, or even an implant. Autologous grafting such as fat grafting or regional tissue grafting can lead to resorption (your body absorbing part of it). Or, these grafts can cluster together and create a lump. Either way, it leads to tissue irregularities. And putting an implant in a thin eyelid will lead to eyelid fullness and palpability.
Furthermore, a lower double eyelid fold design is typically limited to the prior double eyelid fold design. However, we have created a technique where a dissection is made in two planes under the eyelid tissue. The first plane is below the eyelid muscle. The second plane is below the eyelid fat. By making two separate planes, the prior high double eyelid fold does not occur as the fold scars are separated from each other. This way, the eyelid remains smooth as there is not a need for grafting. Furthermore, a new lower double eyelid fold can be designed with the desired shape.