Q. Can men have surgery to get rid of a double eyelid crease?
Yes, they can. It is not a matter of cutting away skin to erase the crease. Instead, we lower the fold, or advance the muscle that opens the eye so the eye opens wider, so that the existing crease is naturally covered by the overlying eyelid skin. In my practice, I get this question from male patients more often than people would guess.
There are broadly two reasons patients want the crease gone.
The cases I have seen have almost always fallen into one of two groups.
First, patients whose natural crease is inherently deep and high-set, so their eyes look heavier and more intense than they ever wanted.
Second, patients who had double eyelid surgery years ago and whose crease has settled into an awkward position over time.
In both groups, patients tell me they often hear from people around them that their features look too strong, or that they look slick.
Q. Does getting rid of the crease mean cutting skin away?
No. Excising skin carries risks such as scarring and lagophthalmos (an eyelid that permanently fails to close completely), so it is not an approach I readily recommend. Instead, I mainly lower the fold so that the old crease is covered. Even when the goal is the same, the result differs completely depending on the approach, so I always point this distinction out during the consultation.
Q. How do I tell whether this applies to me?
If two or more of the following apply to you, I would recommend coming in for an assessment.
- Your natural crease is deeper and higher-set than you would expect
- A crease from previous surgery has become awkward over time
- You are often told that your eyes look too strong or heavy
- You want an understated eye, such as a monolid or an inner fold
That said, the same technique is not right for everyone. The options change with the thickness of the eyelid skin and with how much the existing crease overlaps, so I do not settle on a technique before examining the patient.
Q. I am worried it will look like I have had work done.
In my experience, a monolid or inner-fold design keeps the crease itself from showing while still giving a well-defined look, and satisfaction has been high among patients who want a natural change.
Q. Is double eyelid reversal in men the same operation as in women?
The principle is the same, but the design goal is different. Women often prefer a crease that shows, whereas men tend to want the opposite, an inner fold or a monolid, so I confirm this difference first at the consultation stage.
To sum up
▶ Double eyelid reversal in men covers the crease by adjusting muscle tension, not by excising skin.
▶ It is mainly considered in two situations: an inherently deep natural crease, and a surgical crease that has become awkward.
▶ The technique varies with the condition of the eyelid, so diagnosis comes first.