Often during double eyelid surgery, some amount of skin, muscle, and eyelid fat should be removed. This is because patients without natural double eyelid have some amount of soft tissue hooding. And this soft issue is comprised of skin, muscle, and some eyelid fat. These tissues add weight to the eyelid. Therefore, by removing some of the weight off of the eyelid, the eyelid elevating muscle, the levator muscle can open eyes more easily. The effect is that the patient’s eyes will feel lighter and the patient will appear more refreshed and bright.
The way to determine how much skin, muscle, and fat to remove during double eyelid surgery is by lifting the upper eyelid skin and letting it fall to its natural position. This is done preoperatively before the surgery and confirmed intraoperatively during the double eyelid surgery. It is important to remove enough medial (inward) skin. If this medial skin is not adequately removed, then the double eyelid fold will appear smaller than what is ideal. A small double eyelid fold will prevent someone from looking open, balanced, and glamorous. It is also just as important not to create unnaturally high double eyelid fold as well. As high double eyelid fold will appear puffy and unnatural.
In patients with monolids (without double eyelids), removing excess or redundant skin, muscle, and fat of the eyelid decreases the weight burden on the eyelid elevating muscle (levator muscle). The effect is not only a cosmetic improvement of a beautiful double eyelid but also functionally lighter eyelid. The patient will feel the comfort after the double eyelid surgery from the decrease in the weight reduction of the eyelid.