Converting an Outer Fold to a Semi-Outer Fold (with Double-Line Excision)
Today's case: converting an outer fold to a semi-outer fold.
She had her original surgery two years ago. There's some mild facial asymmetry, and her crease was set as a full outer fold.
She wanted the medial portion brought down so it would read as a semi-outer fold instead.
This is roughly the crease height in the reference photo she brought. We typically save those into the chart as a visual target and work toward them in surgery.
A lovely photo, in any case.
The medial crease has come down nicely, and the result reads as semi-outer.
The underlying facial asymmetry leaves her left side slightly smaller (right on the photo).
I'm glad we were able to bring the medial section down to match her reference.
When facial asymmetry is in play, we evaluate the whole face, never just the eyes. The overall balance here is good. Patients sometimes notice afterward that their ears sit at different heights, one corner of the mouth lifts higher, or the nose looks tilted — those features were typically there before surgery and only become apparent once they start spending more time at the mirror.
Knowing your own face before surgery makes a real difference.