Today's topic is surgery to remove an existing double-eyelid crease. But before I get to it, a question: why do you want to remove the crease? If your goal is to look like the patient below,
what we did with this patient is not actually removal. We hid the fold. True removal of a crease should really only be considered when the lid has so little skin that the lashes turn outward (ectropion) or the contour has gone bad. If you take a patient like the one above and surgically release the fold, the extra skin has nowhere to go. The lid hoods over, and the surgeon ends up cutting skin to compensate. The shape that comes out of that is not good.
This patient came in after having a fold-removal procedure at another clinic. Her lashes turned inward and were rubbing the cornea, and the previous surgeon had excised so much thin skin that the lid contour is uneven and rough.
Eyelid skin is layered, and the layers vary in thickness across different zones of the lid. If we excise too much from Zone I in an attempt to do a hidden double-fold ptosis correction, the result can be irreversible. https://youtu.be/VZIZIXzPsWc
The right move is to push the fold down and tuck it under the lid. Plenty of female patients want this look as well.