Dr. Kenneth Kim, a board certified plastic surgeon who specializes in Korean aesthetic surgery will discuss issues regarding wearing eyelid tape or applying eyelid glue in an attempt to create a double eyelid crease.
Many young Asian patients try to create a double eyelid fold or a double eyelid crease by applying eyelid tape or glue. Tape and glue can create a double eyelid fold or crease in young patients because they lack excess skin; excess skin can hinder double eyelid fold formation. When patients wear either eyelid tape or glue, a temporary double eyelid crease may occur but negative consequences will start to occur. The negative consequences include thickening of the eyelid skin and loosening of the eyelid skin. We will address each of the components and the reasons behind why they occur.
Eyelid thickening occurs when one wears eyelid tape or glue, which results in the edges of the skin to become irritated from friction. Irritation creates micro inflammation within the skin. With inflammation, excess collagen becomes stimulated. There are many types of collagen in our body. However, the ratio of various collagens is determinant of whether healthy normal appearing skin formation occurs or thickened skin formation occurs. Micro inflammation induces the ration of type 1 to type 3 collagen balance to shift to a state where more type 3 collagen is produced than desired. This results in thickening of the eyelid skin. Our body does this as a defense mechanism to give more protection to the skin by thickening it, as the body believes that it is under chronic state of irritation. But aesthetically, it is more favorable to have thinner eyelid skin than thicker eyelid skin for various reasons in Asians. When it comes to double eyelid surgery, a patient with thinner eyelid skin will look more natural than a patient with thicker eyelid skin because a double eyelid fold in thinner eyelid skin does not create a significant depth discrepancy compared to a double eyelid fold in thicker eyelid skin. Thus, thinner eyelid skin will look more natural after a double eyelid surgery. One exception to this rule is if a tension calibration technique is applied so that a fold depth is adjusted to a specific eyelid thickness. More will be discussed about this tension calibration in the future articles as the 3D suture technique® (3DST®) and dynamic open double eyelid technique.
Another negative consequence of wearing eyelid tape or glue is that eyelid skin stretching will occur. Eyelid skin will stretch when tape is applied to create a double eyelid crease because the tape will rub against the skin. The act of tape being pressed down and rubbed against the skin, because a person opens the eye thousands of times per day, will consequently stretch the skin. Glue applied to where the skin is rubbing against skin will create a similar stretching effect. Our skin is elastic, where an elastin collagen will stretch in accordance to tension. In addition, these mechanisms outside will stimulate cells to induce more collagen formation for skin to stretch. One analogy to consider is if one looks at the progressively long necklaces worn by African tribal women to stretch their necks. The entire neck will stretch significantly to accommodate the tension that is being applied.
Therefore, applying eyelid tape or eyelid glue to create a double eyelid crease is not a wise decision. Asian patients will age their eyelid skin, make then thicker, and worsen their double eyelid fold appearance after surgery. Patients who apply eyelid tape or glue eventually receive double eyelid surgery for various reasons. One reason being that they are simply tired of applying tape or glue, or having to worry whether they are in tact. Therefore, it is prudent to simply not wear them at all or to receive double eyelid surgery by a plastic surgeon that specializes in double eyelid surgery.