Everything You Need to Know About Double Eyelids

What is a Double Eyelid?

A double eyelid is a visible crease, unlike a single or monolid with no crease. Both double and single eyelids are normal and require no medical intervention.

Even though single eyelids are normal, some people undergo cosmetic surgery to change their appearance. Double eyelid surgery is a type of blepharoplasty that creates an upper eyelid crease. 

Double eyelid surgery is the most common plastic surgery procedure in East Asia.⁸ Sometimes, it’s referred to as Asian eyelid surgery or Asian blepharoplasty.

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What Does a Double Eyelid Look Like?

Double eyelids feature a crease on the upper lid. For some, it’s a well-defined crease and very noticeable. For others, it’s slight and invisible without a close examination.

As someone’s face ages, the delicate skin surrounding their eyes loses elasticity and relaxes. This causes their large eyes with well-defined creases to develop hooded lids or partial creases.

What Causes Double Eyelids? 

For most people, their genetics are the reason they have double eyelids. Double eyelids might also be caused by:

• Aging
• Ptosis
• Fat accumulation
• Underdevelopment or weakening of the eyelid muscles 

What is Double Eyelid Surgery? 

Double eyelid surgery is a safe and effective way to create a double eyelid fold. It creates an upper eyelid crease, which makes the eye appear larger and more almond-shaped.

A double eyelid procedure usually involves just the upper lid. It’s sometimes performed with medial epicanthoplasty, which extends the inner corner of the eye towards the nose.

Who is a Candidate for Double Eyelid Surgery? 

Anyone with a monolid can consider undergoing blepharoplasty for cosmetic reasons. Typically, people who are healthy and have realistic expectations for the results are good candidates for eyelid surgery.

However, you can also get it for medical reasons. For example, you can get the procedure for ptosis, which occurs when a droopy eyelid interferes with vision.

Other reasons for getting double eyelid surgery include: 

• Correcting vision problems
• Improving eyelid symmetry
• Enlarging eyes
• Making makeup easier to apply
• Fatty deposits or puffiness in the upper lids
• Loose or sagging skin that causes folding that impairs vision
• Having excess skin and/or fine wrinkles

Who Should Not Have Double Eyelid Surgery?

Certain conditions may make you ineligible for this procedure. Eyelid surgery is not a good option for people who:

• Smoke
• Have a condition that affects healing and recovery
• Want to improve uneven eyes
• Want to lessen the appearance of crow’s feet
• Have dry eye symptoms
• Have drooping eyebrows
• Have an eye infection or disease
• Have other severe illnesses or infections

How to Prepare for Double Eyelid Surgery

Knowing what to expect before cosmetic eyelid surgery can help you decide if the procedure is right for you. Topics to discuss with your plastic surgeon include:

• Your medical history
• Your aesthetic goals and expectations from surgery
• Any vision problems you’re having related to your eyelids
• Whether an incisional or non-incisional procedure is best for you
• What to expect from the procedure, including anesthesia, risks, and cost
• What you should know about recovery after the procedure

What Happens During Double Eyelid Surgery?

The surgical procedure varies based on the incision method used. Talk to your doctor about your eye shape, facial structure, and goals for the surgery. There are full-incisional, partial-incision, and non-incisional techniques.

Full Incision

This surgical technique is best for people with excess upper eyelid skin and fat. The results are more permanent than the other two techniques listed below. However, it creates a visible scar.

The steps of incisional double eyelid surgery include:

1. Your surgeon measures and marks your eye with a pen based on the desired outcome
2. You receive the agreed-upon anesthesia
3. Your surgeon creates an incision along the marked skin
4. They remove excess skin and fat as needed to achieve the desired effect
5. Your surgeon attaches sutures that mimic the natural fibers in double eyelids
6. They close the incision with different sutures that will be removed in 4 to 6 days

Partial Incision

This technique is better for people who don’t have excess skin in their eyelids. The results last longer than the non-incisional method.

A partial incision procedure follows the same steps but with a much smaller incision. The surgeon removes excess fat through this small incision but leaves the skin.

The scarring produced by such a tiny incision is virtually undetectable.

No Incision

This procedure is ideal for people who don’t have excess fat or skin in their eyelids. There’s no scarring and little-to-no swelling afterward. However, the results don’t last as long.

During an incision-less procedure, your plastic surgeon applies permanent sutures similar to those used in the incisional methods. They tighten the sutures to create a double eyelid crease.

The sutures remain hidden beneath your skin, and you don’t need to have them removed.

What is Recovery Like After Eyelid Surgery?

The recovery process and healing time for eyelid surgery varies based on whether you had an incisional or non-incisional procedure.

For both procedures, wear sunglasses outside until your eyes completely heal.

Recovery From an Incision

Basic healing occurs within approximately two weeks after incisional surgery. It can take several months to heal completely.

Many people experience the following side effects during the recovery period:

• Bruising
• Bleeding
• Pain
• Dry eyes
• Light sensitivity
• Swelling
• Changes in skin sensation

These symptoms are usually temporary. Use cold compresses and any prescribed medications to relieve irritation.

Your doctor may also prescribe antibiotics to prevent infection. Take all medications as prescribed, even if you feel fully healed.

Recovery Without an Incision

People who undergo non-incisional methods heal faster. You should expect to fully recover from this procedure within two weeks. 

Is Double Eyelid Surgery Permanent?

Double eyelid blepharoplasty may be permanent or reversible. The answer depends on the incisional method used:

• Full or partial incision: The procedure usually cannot be reversed
• No-incision procedure: Your doctor may be able to remove the permanent stitches to recreate monolids

How Much Does Double Eyelid Surgery Cost?

The average cost for cosmetic eyelid surgery can range from $5,000 to $6,000. However, this cost is only part of the total price. 

Factors that may affect the total cost include:

• Anesthesia
• The type of procedure
• Location of your surgeon’s office
• Your surgeon’s experience and reputation
• Surgical facility fees
• Preoperative tests
• Postoperative medications
• Medical care needed for potential complications

Does Insurance Cover Double Eyelid Surgery?

That depends on why you’re getting it. Most insurance companies don’t cover any part of cosmetic surgery. However, your insurance may cover the cost of surgery if you're getting it for medical reasons.

Nonsurgical Alternatives for Double Eyelids 

If surgery isn’t right for you, other options may help achieve a similar effect. These include:

Eyelid Tapes or Glues

Eyelid tapes and glues are alternatives to double eyelid surgery. These products are available without prescription and create a crease in the eyelid.

Here are the pros and cons of eyelid tape or glue:

Pros	Cons
Temporarily provide a crease in the lid	Need to be reapplied every day
Easily removable if you don’t like the result	Can shift or fall off while wearing
Allow you to avoid the risks of surgery	Can cause an allergic reaction
Give you an idea of what double lids look like before committing to surgery	Risk of getting glue in your eye, which can damage vision

To prevent infection, wash your hands before applying these products. Change the tape daily, and stop using it if your eyelids become puffy.

Makeup Tricks

People with single eyelids can create the illusion of double eyelids with makeup. This is an easy way to see how you’d look with double eyelids without making a permanent commitment.

Makeup tips include:

• Shaping your eyebrows to enhance the shape and size of your eyes
• Applying shadow in a horizontal gradient
• Avoiding dark eyeshadow over the whole lid
• Applying light shadow along the lower lash line
• Avoiding application of eyeliner in the inner corner of the eye
• Lining your lash line only halfway with a smudge-proof liner
• Highlighting the inner corner with a light shade of shadow
• Applying false eyelashes

Summary

A double eyelid has a visible crease, unlike a single or monolid. Both single and double eyelids are normal and don't require medical attention. 

Double eyelid surgery is a common plastic surgery that creates a double eyelid crease in a single lid or monolid. Some people choose to undergo double eyelid surgery for cosmetic reasons. 

Discussing the risks and benefits with a qualified plastic surgeon is important. There are also nonsurgical alternatives to create the appearance of a double eyelid crease.