Patients with a pre-existing infold double eyelid may wish to change their infold to an outfold. Patients may choose to do so for various aesthetic purposes. An outfold gives a more “non-Asian” appearance to the eyes. It can also give a more “glamorous feel” to the Asian eyes. It is worthwhile to mention that an infold does make the eye appear more “natural” for Asians as Asians tend to have more infold than outfold double eyelids.
One of the ways to change an infold double eyelid to an outfold double eyelid is to release the banding in the inner corner of the eye. This is called an epicanthoplasty. By excising the inner corner banding or fibrous tissue, the restriction of the inner corner is eliminated and allows the fold to occur as an outfold double eyelid.
Another way to change an infold double eyelid to an outfold double eyelid is to excise the inner aspect of the eyelid skin.
This can be done in conjunction with the epicanthoplasty or separately. By removing this inner upper aspect of the eyelid skin, the hooding of the skin is eliminated and creates a space for the outfold double eyelid to occur.
It is important not to make the outfold double eyelid too high. A high outfold will appear puffy and swollen. In addition, this puts extra weight on the eyelid elevating mechanism. Therefore, the patient’s eyes will appear tired and the patient will feel the heaviness of the eyelid.
Often, an in-out double eyelid is a great alternative when trying to convert an infold double eyelid to an outfold double eyelid. The reason is that it will look very natural but still give a more open feel to the double eyelid.