Eyelid Crease Too High After Double Eyelid Surgery
Eyelid Crease Too High After Double Eyelid Surgery: Can It Be Lowered?
An eyelid crease too high after double eyelid surgery is a common worry, and the first question is timing. In the early weeks, swelling often makes the crease look higher and heavier than it will end up. If it still looks too high once the eyelid has settled, double eyelid revision can often lower it, depending on the cause.
By Assoc. Prof. Dr. Preamjit Saonanon, oculoplastic ophthalmologist
Is it swelling or a truly high crease?
Swelling pushes the skin above the crease outward, so the fold looks wider and the eye can look surprised or heavy. Bruising and swelling usually settle over about 7–14 days, and the crease generally looks natural after about 1–3 months. If you are still within that window, it is usually too early to judge. Our guide to double eyelid surgery healing stages explains what to expect week by week.
Why is my eyelid crease too high?
A crease that stays high after healing usually has one or more of these causes:
The crease was marked or fixed higher than suits the eye.
Too much skin was removed, so little skin is left to fold over the crease.
Too much fat was removed, leaving the upper lid hollow and the crease deep.
Scar tissue (adhesions) holds the skin to deeper layers at a high level.
A weak eyelid opening muscle (ptosis) was not corrected, so the lid margin sits low and the crease looks wide, giving a tired look.
The last point is easy to miss. If your eye also looks sleepy, read about heavy eyes after double eyelid surgery.
Can a high double eyelid crease be lowered?
In many cases, yes. How much it can be lowered depends on the cause and on how much skin is left. Double eyelid revision usually includes:
Releasing the old crease
The old scar tissue that holds the high crease is released, so the skin can move freely again.
Creating a new, lower crease
A new crease is fixed at a height that suits the eye. Fat may be moved or grafted into the space to soften a hollow lid and help stop the old crease from reattaching.
Correcting ptosis if present
If the eyelid opening muscle is weak, tightening it raises the lid margin, which makes the crease look smaller and the eyes more balanced.
Revision is more complex than a first operation. Some eyes improve only partly, especially when a lot of skin was removed. Risks include asymmetry, a crease that fades or doubles, and the need for further surgery. Results vary from person to person.
How long should you wait before revision?
In general, the eyelid needs time for swelling and scar tissue to soften, often around 6 months. Your surgeon may advise earlier treatment in specific situations, such as being unable to close the eye. Learn more about double eyelid revision surgery at our clinic.
When should you see an eye doctor?
See an eye doctor soon if you cannot close your eye fully, if the eye stays dry, red or painful, if your vision changes, or if one eyelid is clearly lower than the other.
Frequently asked questions
Will a high eyelid crease drop on its own?
A crease that looks high because of swelling usually softens over the first 1–3 months. A crease that is high because of where it was fixed, or because of scar tissue, usually does not drop on its own.
Can every high crease be made smaller?
Not always. If too much skin was removed, there may not be enough skin to fold over a lower crease, so improvement can be limited.
Does double eyelid revision leave a new scar?
The surgeon usually works through the existing scar in the crease, so a separate new scar is not normally needed.
Book a consultation with Assoc. Prof. Dr. Preamjit Saonanon in Thong Lo, Bangkok
LINE: @saonanon
Phone: +66 90 946 3090
Opening hours: Thursday 16:00–20:00, Saturday 09:00–20:00
This article is general information and does not replace a medical examination. Results vary from person to person.
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