Hello, this is Gangnam Seoyon Plastic Surgery.
Many people are troubled by a double eyelid line that sits too high or looks too thick — often to the point of hearing the term "sausage eyes" and feeling stressed about it. When these patients start searching, there is one word they always run into: the "two-line" technique — formally, the scar-preserving high fold correction.
But a similar term, the "one-line" technique, comes up in the same searches, and many people arrive at their consultation already confused about the difference. Today we will lay out exactly what the scar-preserving high fold correction is, how it differs from the one-line technique, and which patients actually need it.
■ What exactly is the scar-preserving high fold correction?
The formal description of the scar-preserving high fold correction is "line-lowering surgery that does not cut out the existing double eyelid scar." As the name suggests, the previous incision scar is left where it is, and a new line is created below it.
Think of it as a precise procedure in which the adhesion of the old line is released, and the new line is then made to settle in below it. The key is redesigning the line at a height that suits the individual, taking the overall proportions of the eye into account.
■ What is the difference between the one-line technique and the scar-preserving high fold correction?
Both methods share the same goal — lowering the line — but the approach is completely different.
▷ One-line technique
This method removes the strip of skin between the existing incision line and the newly designed line. Because the old scar itself is excised in the process, the line falls cleanly and the chance of a multiple fold forming is relatively low. However, since it involves excising skin, it is difficult to apply to patients without enough skin to spare. Unless the line was set high in youth and drooping has developed with age, the one-line technique alone may have its limits.
▷ scar-preserving high fold correction
This method leaves the existing incision scar in place and creates a new line below it. Because no skin is removed, it can be applied even to patients who lack skin, and it can also be chosen when the line needs to be lowered a great deal. Another advantage is that it can be attempted again in cases requiring several rounds of revision. That said, two lines of scarring remain, and re-adhesion can easily produce a multiple fold, so this surgery absolutely requires the precise technique of an experienced surgeon.
In short, patients with skin to spare suit the one-line technique, while patients who lack skin, who want the line lowered considerably, or who have a history of several previous surgeries suit the scar-preserving high fold correction. This judgment must always be made after a precise examination.
■ You may want to consider the scar-preserving high fold correction if you fall into these categories
- You want to lower a double eyelid line that sits too high
- Your line is high and a deep scar has been left as well
- Muscle or soft tissue has been excessively removed, leaving the eyelid with a sagging, "sausage eye" look
- Your line is excessively high relative to the distance between your eyebrow and your eye
- Ptosis makes the line excessively exposed, so it looks higher than it is
■ In closing
If you have been troubled by a high or thick double eyelid line, the first step is to work out whether your eyes call for the one-line or the scar-preserving high fold correction. The two methods differ clearly in approach, in the scarring they leave, and in whether further revision is possible, so we recommend deciding through a detailed consultation rather than by self-diagnosis.
In the next article we will go through the common misconceptions about the scar-preserving high fold correction one by one — "it is a last resort," "you must have ptosis correction along with it," and "a step-shaped scar is inevitable."
