Mechanism of deep and shallow double eyelid folds

As we mentioned in the prior blog, double eyelid fold is not only about the shape and height. What is also important is how deep or shallow the double eyelid fold is. In this blog, we will discuss how the deep and shallow double eyelid fold is created.

A deep double eyelid fold is created when the skin gets attached to the underlying tarsus (cartilage), or if the fold is connected to the upper aspect of the levator aponeurosis (eyelid elevating muscle). Deep double eyelid can also occur when the eyelid skin gets fixated to the deep layer of the levator aponeurosis. When a deep fold occurs, the fold appears pronounced or too noticeable. An indicator that a deep fold has occurred is when a person closes his or her eyes. The double eyelid fold appears not uniform and not smooth. Rather, the double eyelid fold will look irregular. This irregularity is caused by intermittent deep suturing that is attached to the tarsus (cartilage) or the high levator aponeurosis.

A shallow double eyelid fold is created when the skin is loosely connected to levator aponeurosis (eyelid elevating muscle). When this happens, the double eyelid fold will appear more like a double eyelid crease and therefore the fold does not fully invaginate. In addition, the double eyelid fold will appear smaller in size. Furthermore, the double eyelid fold or crease may loosen over time.

Therefore, it is important to calibrate the tension of the double eyelid fold. Although the double eyelid fold shape and height may be the same, if the tension is not the same, then the double eyelid fold will appear asymmetric.