What is the Cause of Triple Fold?

Question

1)what is the common cause of triple fold for those who had eyelid surgery done and those who didnt? 2)-those who did surgery: re-adhesion, fat loss? -without surgery: fat loss, extra skin? 3)then does that mean one with little fats on lids will definitely get triple fold? 4)is it possible that re-adhesion may occur to those who hadnt done any surgery? 5)what can be done? fat grafting? what if the grafted fat doesnt last? get triple fold again? 6) is fat loss the MAIN cause? thank you!

Andrew Choi, MD · Answer

Hello
You have to differentiate the fold versus depression.
If fold is just under the eyebrow then it is more likely depression rather than crease and is due to fat loss.
If the triple folds are presented on eyelid itself then it may be either due to multiple attachment between the skin and levator muscle or redundant skin.
First situation requires to release all attachment during eyelid surgery and create single crease and second situation requires to remove redundant skin.

I hope this will answer your questions.

Dr. Andrew Choi

Charles S. Lee, MD, FACS · Answer

To answer your question, the main cause of the triple fold is eyelid-muscle separation combined with lack of fat, or more commonly, a protruding eyeball.

	A triple fold will have some ptosis (sagging) of the eyelid and lack of fat between the skin and the muscle. Ptosis can be preexisting from birth; occur as a result of aging; or from trauma or surgery. Lack of fat can be due to aging, trauma or surgery, or when the eyeball protrudes, so that there is little space between the muscle and skin.

	Correction of the triple fold usually requires correction of the ptosis and placement of either fat or filler (restylane or juvederm) or a spanning suture to compress out the third fold.

What is the Cause of Triple Fold?

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