Incisional double eyelid surgery is often well suited to men with thick eyelids.
This article covers everything from crease design principles to recovery time, scarring, and how it differs from the non-incisional (buried suture) method.
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■ The Short Answer
For men with thick eyelid skin and fatty tissue, incisional double eyelid surgery
is often a better choice than the non-incisional method.
With the non-incisional method, the sutures can loosen, and the crease may not hold well in thick eyelids, whereas
the incisional method directly removes excess fat and skin, giving a more durable crease.
For a natural result, the key is to set a low crease height
and to design a width and shape that suit the male eye.
The scar sits within the double eyelid crease and, in many cases, becomes naturally concealed over time.
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■ Why Is the Incisional Method Often Better Suited to Men's Eyelids?
Compared with women, men tend to have thicker eyelid skin and more fatty tissue.
These characteristics influence the choice of surgical technique.
[ Limitations of the Non-Incisional Method in Men ]
The non-incisional method creates a crease by securing the eyelid tissue with sutures, without making an incision.
In thin eyelids with little fat, the crease forms well, but
in thick eyelids, the crease may not show clearly or
is relatively more likely to loosen over time.
This is because the heavy eyelid tissue continuously pulls on the sutures.
[ Advantages of the Incisional Method in Men ]
In the incisional method, the eyelid skin is incised directly, and the fat and orbital septum are addressed at the same time as needed.
Because the tissue can be refined directly in men with thick eyelids,
the crease is more durable, and it is easier to achieve a more natural shape.
In addition, ptosis correction can be performed at the same time through the same incision,
so weak eye-opening strength can be corrected in the same operation.
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■ Incisional Double Eyelid Surgery for Men Follows Different Design Principles
In male double eyelid surgery, the most important question is "How natural does it look?"
Different design principles apply than for women.
[ Crease Height ]
In women, the crease is usually set at a height of around 6–8 mm.
In men, a low crease of around 3–5 mm is better for creating a natural look.
A higher crease makes the eyes look larger and more defined, but it can look unnatural on men.
[ Crease Shape ]
In men, a crease that begins at the inner corner of the eye (the medial canthus),
in a tapered (inside-fold) or semi-tapered (in-out fold) shape, often looks more natural.
A parallel (outside-fold) crease that is clearly visible across the entire eye
can look unnatural on men or make it obvious that surgery has been done.
[ Adjusting Eyelid Thickness ]
Appropriately reducing thick eyelid fat (orbital fat)
helps thin the eyelid and allows the crease to form more clearly.
However, removing too much fat can instead create an unnatural hollowed appearance,
so it is important to determine the appropriate amount.
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■ Incisional Double Eyelid Surgery for Men — What About Scarring?
Scarring is one of the biggest concerns for men considering incisional double eyelid surgery.
This is because, unlike women, they cannot easily cover it with makeup.
The incision line is placed where the double eyelid crease folds.
When the eyes are open, the incision line is hidden within the crease,
and although it may be visible when the eyes are closed, it gradually blends with the surrounding skin tone over time.
[ Scar Healing Timeline ]
Immediately after surgery to 2 weeks: The incision site looks red and slightly raised. Swelling is present around the time of suture removal.
2 weeks to 2 months: The scar begins to fade to pink. It starts to become hidden within the crease even when the eyes are closed.
2 to 6 months: The scar color approaches the surrounding skin tone and is often naturally concealed.
After 6 months: The final result stabilizes. In many cases, the scar is barely visible when the eyes are open.
[ Factors That Help Minimize Scarring ]
- Sun protection after suture removal: helps prevent hyperpigmentation of the scar.
- Avoid rubbing your eyes: irritating the eyes during early recovery can affect scar formation.
- Use scar-softening products as prescribed: silicone gel or sheets can help in some cases.
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■ Incisional Double Eyelid Surgery for Men — Recovery Timeline by Stage
In male patients, swelling tends to last longer than in women.
The thicker the eyelid tissue, the more the degree and duration of early swelling may vary.
[ Day of Surgery to Day 3 ]
This is when swelling and bruising are most noticeable.
Cold compresses (within the first 48 hours) can help reduce swelling.
[ Days 4–7 ]
This is when the sutures are removed (usually 5–7 days after surgery).
Swelling begins to subside gradually but is still noticeable.
At this point, it can be covered with sunglasses or glasses.
[ Weeks 1–2 ]
Many patients can return to light daily activities and office work.
The crease begins to settle, but this is not yet the final result.
[ 2 Weeks to 1 Month ]
Much of the swelling subsides, and in many cases it becomes difficult for people around you to notice.
The crease may still become narrower than it first appeared, so it is too early to judge the final result.
[ 1 to 3 Months ]
The crease stabilizes and the scar fades.
Strenuous exercise and drinking are generally resumed gradually from this stage.
[ 3 to 6 Months ]
The eyes approach their final result.
In many cases, the scar is naturally hidden within the double eyelid crease.
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■ Ptosis Correction May Also Be Needed
Some men not only lack a double eyelid crease but also have weak eye-opening strength
due to coexisting ptosis.
In such cases, creating a double eyelid alone may not open the eyes sufficiently,
or the crease may turn out differently from what was intended.
When incisional double eyelid surgery and ptosis correction are performed at the same time,
eye-opening strength can be improved while the crease is created.
Whether your eye-opening strength is sufficient can be assessed during the preoperative evaluation.
In the field of ptosis correction for men with monolids, Chief Director Choi Dong-il of Gangnam Seoyon Plastic Surgery
published the world's first SCI-indexed paper on ptosis correction in men with monolids in 2018
in the American journal Aesthetic Plastic Surgery, demonstrating both the safety of the procedure and the surgeon's expertise.
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■ Frequently Asked Questions (FAQ)
Q1. Will people be able to tell I've had incisional double eyelid surgery as a man?
A. If the crease is set low (around 3–5 mm) and designed as a tapered or semi-tapered fold,
it is often difficult to tell at an everyday distance whether surgery has been done.
However, results can vary depending on the condition of your eyelids and the design,
so it is important to plan a design suited to your own eye anatomy through a thorough consultation before surgery.
Q2. For men, is the incisional method better than the non-incisional method?
A. In men with thick eyelids or a lot of fat,
the non-incisional method may not create a well-defined crease, or the crease may loosen over time.
In such cases, the incisional method may offer advantages in crease durability and a natural-looking result.
For men with thin eyelids and little fat, the non-incisional method can also be an option,
so it is best to decide after consulting a specialist based on the condition of your eyelids.
Q3. Will the scar from male incisional double eyelid surgery be noticeable without makeup?
A. The scar from incisional double eyelid surgery sits inside the fold of the double eyelid crease.
With the eyes open, it is hidden within the fold,
and after 3–6 months, the scar color approaches the surrounding skin tone,
so in many cases it becomes difficult to notice at an everyday distance, even without makeup.
Q4. When can men return to work after incisional double eyelid surgery?
A. For office work, many patients can return around 1–2 weeks after suture removal.
Because some swelling and bruising may remain, many people wear glasses or sunglasses.
For jobs involving physical labor or frequent face-to-face customer contact, it is best to discuss the timing of your return separately with the medical team.
Q5. Won't the crease look too pronounced after male incisional double eyelid surgery?
A. A crease usually looks pronounced when it is set high
or designed as a parallel (outside) fold.
Choosing a low crease suited to men (around 3–5 mm) and a tapered fold
helps maintain a natural appearance.
It is important to discuss crease height and shape thoroughly during the design stage before surgery.
Q6. Do I need ptosis correction as well?
A. If ptosis (reduced eye-opening strength) is present, creating a double eyelid alone
may not open the eyes sufficiently, or the result may differ from what was intended.
Checking during the preoperative evaluation whether your eye-opening strength is within the normal range
helps determine whether ptosis correction should be performed as well.
If needed, incisional double eyelid surgery and ptosis correction can be performed at the same time.
Q7. What if the crease is too high or I'm unhappy with it after incisional double eyelid surgery?
A. Unlike the non-incisional method, revision after the incisional method is more complex.
If you are dissatisfied with the crease height or shape, whether to undergo revision
is decided in consultation with a specialist after an adequate recovery period (at least 6 months).
Thoroughly discussing and planning the result you want before the first surgery
is the most important step in reducing the need for revision.
Q8. When can men start exercising after incisional double eyelid surgery?
A. Low-intensity aerobic exercise such as walking is often possible from 2–3 weeks onward.
Strenuous exercise such as weight training, martial arts, and swimming is generally resumed gradually from 1 month onward.
Because increases in blood pressure and blood flow can affect swelling and bleeding,
it is safest to resume only after your surgeon gives clearance.
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* This article is intended to provide general information,
and results may vary depending on individual eyelid condition and surgical technique.
Decisions about whether to have surgery and which technique to use should always be made through an in-person consultation with a specialist.
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[Hashtags]
The photographs in this post were taken under identical conditions with the patient's prior consent.
In addition, side effects such as bleeding, infection, and inflammation may occur after plastic surgery or procedures depending on the individual, so caution is required.