Hello. As the title suggests, today's post covers the double-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 double-line technique, where we leave the original scar (A) intact, mark a new crease (B) below it, and release 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.