There are people who have natural double eyelids or surgically created double eyelid folds that would like to have excess skin removed. In these patients who have pre-existing double eyelids, there are three ways to evaluate and correct the problem. One is to determine if the patient would like to have a higher double eyelid folds. The other method is to remove skin just above the double eyelid fold. The third method is to remove skin underneath the brow region.
The first method of creating a higher double eyelid fold is a great option if the higher fold looks better than the prior lower double eyelid fold. The way to check is to create a higher fold while the patient is looking at the higher fold. The surgeon and the patient would instinctively tell if the higher double eyelid fold looks better or whether it would look unnatural. In Asian eyelid surgery, higher fold does not necessarily mean that the patient would look better. Sometimes a high double eyelid can create a puffy fold appearance that looks very unnatural. Therefore, double eyelid fold height must be checked carefully to make sure that it does not look swollen, puffy, and unnatural.
If the higher double eyelid fold looks better, then creating a higher double eyelid fold would be an excellent option to help resolve the excess skin from aging or inappropriately created lower double eyelid fold.