Causes of Multiple Eyelid Folds (Triple Folds) and Correction Surgery Reviews

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This is Gangnam Seoyeon Plastic Surgery, where we always do our best to ensure high patient satisfaction :)

Today, we will take a look at the correction of multiple eyelid folds (triple folds) by Dr. Choi Dong-il of Gangnam Seoyeon Plastic Surgery.

We will explore why multiple folds occur and examine the causes through actual clinical cases :)

The following photos have not been edited in any way, except for brightness adjustments :)

1. Multiple folds occurring after incisional double eyelid surgery

The first case is when multiple folds appeared after an incisional double eyelid surgery.

In the photo, the lower line (blue line) is the original double eyelid line from the previous incision surgery, and the upper line (red line) is a new line formed due to adhesions.

Instead of the fold forming at the intended surgical site, a fold formed above the incision line, resulting in multiple creases.

The cause of these multiple folds is a combination of strong internal adhesions and a lack of volume between the eyebrow and the incision line.

This can sometimes make the eyelids look like ‘sausage eyes’.

3 Key Points of the Surgery

There are three key points to the surgery:

(1) Restoring upper volume

(2) Releasing adhesions

(3) Preventing re-adhesion

The goal is to release the adhesions where the upper fold is forming, prevent them from re-forming, and restore volume between the eyebrow and the incision line.

This is the appearance one week after surgery.

The patient mentioned that it felt like another line was forming. Upon checking, it wasn’t that the triple fold wasn’t corrected, but rather that a faint wrinkle remained because the skin had been folded in that spot for a long time.

It is similar to how people with small eyes who use their forehead muscles to open their eyes for a long time develop deep forehead wrinkles. Even after correcting the issue with ptosis correction so they no longer use their forehead, the existing wrinkles may remain.

Since this was taken immediately after stitch removal at one week, the bruising might make the wrinkle look more prominent.

However, re-adhesion rarely occurs when performed by an experienced surgeon, so there is no need to worry.

2. Multiple folds after a ‘double-line release’ (Dujulttagi)

The second case involves multiple folds appearing after a failed ‘double-line release’ (lowering the fold line).

This patient had the procedure at another clinic, but a crease formed at the old eyelid position above the new incision line.

This happened because of adhesions at the old scar site, meaning the previous adhesions weren’t fully released or re-adhesion occurred.

This is the appearance one week after early correction following the failed double-line release.

We thoroughly released the adhesions and implemented measures to prevent them from returning.

This is the appearance one month after the early correction.

The scar has not fully settled yet, but it is expected to improve significantly after six months.

3. Multiple folds caused by a loosening double eyelid

The third case is when multiple folds form because the double eyelid has loosened.

This patient had incisional ptosis correction and upper eyelid fat repositioning several years ago. They reported that triple folds and multiple lines appeared immediately after the first surgery.

They underwent revision surgery one year after the first operation, but the issue did not improve.

In the photo, the lower crease (blue line) is the original incision line, but an unwanted fold (red line) is forming above it.

This is the appearance one week after surgery, following stitch removal.

Up to one month post-surgery, the eyes are still settling due to swelling and scarring, so continuous monitoring is necessary. During this phase, the eyes may look slightly smaller, scars may appear raised, or the line may look higher.

This is the appearance one month after surgery.

A very fine line is visible above the double eyelid. This is just the old fold appearing slightly like a wrinkle as the swelling goes down; it will disappear as the swelling subsides and the scar tissue softens.

This is the appearance three months after surgery.

Today, we looked into multiple eyelid folds and triple folds.

As seen in these cases, the causes of multiple folds are diverse. Therefore, it is crucial to establish a proper surgical plan through a consultation with a specialist before the procedure.

Since multiple fold correction requires careful post-operative monitoring, we hope you achieve satisfactory results by maintaining continuous communication with your surgeon.

You can find more detailed information about multiple eyelid fold correction in the video below.

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Gangnam Seoyeon Plastic Surgery Clinic complies with medical laws. The photos in this post were taken under the same conditions with the patient’s prior consent. Additionally, side effects such as bleeding, infection, and inflammation may occur after plastic surgery and procedures depending on the individual, so caution is advised.

Feel free to visit us for a 1:1 consultation with a board-certified plastic surgeon :)

If you have any questions or would like a consultation, please leave a comment, contact us via KakaoTalk Plus Friend @GangnamSeoyeonPlasticSurgery, or call us at 02-535-8889 :)

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Frequently Asked Questions

What causes multiple folds after incisional double eyelid surgery?

The main causes are strong adhesion within the skin and lack of volume below the eyebrow. When the skin adheres above the incised line, new folds are created instead of the original line, making it appear as multiple double eyelids or 'sausage eyes'.

What are the key points of multiple fold double eyelid revision surgery?

The three most important key points are upper volume augmentation, adhesion dissection, and prevention of re-adhesion. The surgery corrects by releasing the adhesion in the area where multiple folds occur, taking measures to prevent re-adhesion, and filling the insufficient volume between the eyebrow and the incision line.

Can multiple folds caused by a failed 'two-line' surgery be corrected early?

Yes, early correction is possible. If multiple folds occurred because the adhesion was not sufficiently released due to existing scars or re-adhesion, the adhesion can be meticulously released again and a device to prevent re-adhesion can be created for correction.

How long is the recovery period after multiple double eyelid revision surgery?

It usually takes about 1 to 6 months for swelling and scars to settle. Stitches are removed one week after surgery, and as the swelling subsides, the subtle folds or scars that were previously present gradually fade and become more natural.

Can the existing multiple fold line remain slightly after surgery?

Yes, it may remain as a faint wrinkle immediately after surgery. This phenomenon occurs because the existing line has been folded for a long time, and it will gradually disappear as the swelling subsides and the scar heals, so there is no need to worry too much.