I was wondering what the height of the incision line for very small double eyelids should be (measured from the incision to the lashline when eyes are closed)? And what is the height for a medium crease and also a high crease?
Height of Incision Line for Small Thin Double Eyelids?
Doctor Answers (2)
Double fold height determination
The key to setting the proper height in double fold Blepharoplasty is good communication between surgeon and patient. If a patient tells me he or she wants a medium crease height , how do I know that my idea of a medium crease is exactly what he or she wants? I find that patients have a difficult time describing what they want in words, but they have a clear picture in their minds.
This observation has led me to perform a simple simulation during the consultation to show a patient how they would look like with various crease heights. It is painless, shows the results simultaneously in both lids, and easy to reproduce at home if the patient desires. Based on the patient's preferred simulated result, the exact position of the incision is determined. Using the simulation clearly communicates what crease height the patient desires, and this in turn determines the incision position, not the other way around. The simulation is done again right before surgery so that the incision line can be marked, and both surgeon and patient are clear as to the desired result. For me this method has taken out the 'variability' involved in these cases.
There can be no fixed height for every person.
Generally all upper eyelid incision are made too high. The text books often describe an upper eyelid blepharoplasty incision at 10mm and with healing this can end up at 11.5 or 12 mm. This is too hight even for a Western eyelid. For double eyelids the incision height becomes the crease height and the other consideration that is essential is the fold height: how does the fold drape over the crease which is what makes the double fold. Generally, the incision height for double eyelid should be about 5.5 to 6.5 mm high. However, this is only half of the consideration. The other is how much skin should be removed about the incision. This is determined by how much platform show is desired. Bottom line, you need to find a surgeon who understands all of these issues. Lowering a crease or recreating a fold is essentially impossible.