Hello. As the title suggests, today's post covers the scar-preserving high fold correction (the "two-line" technique) for thick or sausage-shaped double eyelids. There are several names for the same idea: lowering a heavy fold, sausage-eye revision, double-eyelid revision. These are slides from the lecture I was invited to give at Dongguk University Hospital on Saturday, October 8, 2016. The actual title was "Revisional Blepharoplasty." The main topics were the sausage-fullness deformity, depth-related issues, and crease-height issues.
When the lid sits puffy and rounded like a sausage, it looks unnatural. Causes include thick lid skin, a high crease design with weak fixation, and heavy scarring that makes the crease bury too deeply. Here is another case.
This is a case with weak fixation.
Just by re-fixing the levator, we get a cleaner eye and a sharper crease. Crease thickness is, of course, adjustable. To make the crease higher, we excise additional skin or raise the line. How to lower a crease.
Here is the schematic. It is a little crude, but the idea is: leave the existing scar (line A), mark a new line below it (line B), excise the strip of skin between them (C), and release the underlying adhesions.
About the various names. The scar-preserving high fold correction — leaving the original scar (A) intact, marking a new crease (B) below it, and releasing the original line — is the same operation.
This approach is mainly for patients who do not have skin to spare.
These are slides presented at the symposium, and I drew on the incisional-method chapter I co-authored in the Korean aesthetic plastic surgery textbook.
After the talk.
And the obligatory group photo. A few of my closer colleagues, all good-looking guys, are on the left.