Double eyelid surgery is a very apt lay term

Dear Oishii

Double eyelid refers to the appearance of two upper eyelid contours: The actual eyelid margin where the eyelashes are and the upper eyelid fold that distinctly breaks above the actual eyelid margin.  A double fold exisits when there is a low attachment between the upper eyelid skin and the tendon that raises the eyelid called the levator aponeurosis. The line in the upper eyelid that accounts for this attachment is called the eyelid crease. When there is no upper eyelid crease a distinct fold in the upper eyelid will not be present.  This anatomic situation is fairly common in Asian eyelids.  Without a crease and a fold, there will be no eyelid platform which is the eyelid skin below the crease extending to the eye lashes. This is where women put eye shadow.

Double folds are also a common eyelid configuration in Asians.  However if there is no crease, and therefore no double fold, one can be created with eyelid surgery.  This surgery is commonly mischaracterized as "Westernizing" an eyelid. This is not accurate. Certainly one can "Westernize" an eyelid by creating a very high eyelid crease and removing all of the eyelid fold but this type of appearance is usually seen as being over-surgical or operated. The goal of double fold surgery is to create a natural second eyelid fold by making a low crease and removing a limited about of skin and very little else.

It is an odd term, I agree. It refers to the upper lid crease that is not present in many Asian eyelids. A double eyelid surgery means to create the crease by producing a connect between the underlying levator muscle that raises the eyelid and the overlying skin, thus causing the skin to fold in when the eyelid is raised. Curiously enough, most Asian have a double eyelid naturally even though we think of creaseless upper eyelids as symbolic of the Asian eyelid.

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