What is the Double-Line Method? Principles of Lowering Sausage Eyes and Criteria for Successful Revision Rhinoplasty

What is the Double-Line Method? Principles of Lowering Sausage Eyes and Criteria for Successful Eye Revision Surgery

Hello. This is Gangnam Seoyeon Plastic Surgery.

When a double eyelid line is set too high after surgery, or looks puffy as if the swelling never went down, it is commonly referred to as ‘sausage eyes.’ When visiting a clinic to resolve this, the term you will hear most often is ‘Double-Line Method’ (Dujul-ttagi).

Hearing the name alone, many people get scared, wondering, ‘Will I have two lines on my eyes?’ or ‘Will the surgery leave double the scars?’

Today, we will explain in detail exactly what the ‘Double-Line Method’ is—a core eye revision technique for naturally lowering sausage eyes—and its principles and effects.

■ What exactly is the Double-Line Method?

The Double-Line Method is an eye revision technique that lowers the height of the double eyelid by designing a completely new line below the existing high and thick line, while leaving the old line as is.

It became widely known among plastic surgeons and patients as ‘Dujul-ttagi’ (literally ‘picking two lines’) because the surgery involves handling both the existing line and the new line—two lines in total. The essence of this surgery is to precisely release the adhesions (scar tissue) that were strongly tied to the upper tissue from previous surgery and fix a slim new line below it.

■ Core Principles and Process of the Double-Line Method

The anatomical surgical process of the Double-Line Method can be summarized in three steps:

• New Line Design and Incision: A new line is designed and micro-incised at the natural height desired by the patient, below the existing high double eyelid line.
• Dissection of Existing Adhesions: Approaching upward through the new incision, the firm adhesions (scar tissue) between the tarsal plate and the skin—the main culprit behind the high eyelid—are delicately severed.
• Fat Relocation and New Line Fixation: Surrounding tissues are appropriately rearranged to create a barrier so the released space does not re-adhere and cause the old high line to recur. Then, the new lower incision is naturally fixed to create a new crease.

■ Differences: Standard Incision Revision vs. Double-Line Method

The biggest difference between the two surgeries lies in ‘whether skin is excised (cut away).’ If a standard revision is performed when there is insufficient eyelid skin, side effects such as the inability to close the eyes properly may occur, so caution is required.

• Standard Incision Revision: The skin between the existing line and the new line is cut away and stitched together (only possible if there is plenty of extra skin).
• Double-Line Method: No skin is cut away at all; only the internal adhesions are released (can be performed safely even with insufficient skin).

■ Core Q&A on Double-Line Eye Revision

Here are clear answers to the three most common questions from those considering the Double-Line Method to escape sausage eyes.

Q1. If I get the Double-Line Method, will I be left with two lines (triple folds) on my eyes?

A. No. Because the internal adhesions of the existing high line are completely released, it will not fold again and will flatten out. Once the scar fades over time, only the one newly created, low, and natural line will remain.

Q2. Is surgery possible even if I lack eyelid skin due to previous surgeries?

A. Yes, it is. Unlike standard incision revisions, the Double-Line Method is a skin-preserving surgery that only releases internal adhesions without cutting any skin, making it safe to lower the line even with limited skin.

Q3. Can I get ptosis correction along with the Double-Line Method?

A. Yes, they can be performed simultaneously and are often recommended. Many people with sausage eyes have weak eye-opening muscles, which makes the double eyelid look even thicker. Combining the Double-Line Method with ptosis correction ensures the pupils are clearly exposed, allowing the double eyelid line to settle much more slimly and naturally.

■ Why Choose Gangnam Seoyeon for Failure-Free Eye Revision

The Double-Line Method is among the most difficult of all eye surgeries. Since internal tissues are already heavily scarred and the structure is distorted, success depends on how cleanly and precisely the adhesions are dissected. If dissection is incomplete, the old line may fold again.

Located near Serosu-gil at Sinsa Station, Gangnam Seoyeon Plastic Surgery features experienced specialists who perfectly understand the structure of tissues, muscles, and fat around the eyes.

• Precise measurement of individual eyelid skin thickness and remaining skin volume
• Expertise in fat relocation to create a barrier that prevents the old line from re-folding

• A 1:1 responsible system with the Chief Surgeon (no ghost doctors)

If high double eyelids and sausage eyes have been a source of stress every time you look in the mirror, resolve them with the Double-Line Method, which safely lowers the line without skin damage. If you need an accurate diagnosis for your eye condition, please feel free to contact us at any time.

Location: 20 Gangnam-daero 154-gil, Gangnam-gu, Seoul (Near Sinsa Station / Serosu-gil)

Consultation & Reservation: 02 - 535 - 8889 / KakaoTalk Plus Friend: @GangnamSeoyeonPlasticSurgery

Gangnam Seoyeon Plastic Surgery Clinic complies with medical laws. The photos in this post were taken under identical conditions with the patient’s prior consent. Please note that side effects such as bleeding, infection, and inflammation may occur after plastic surgery or procedures depending on the individual.

Feel free to visit for a 1:1 consultation with a plastic surgery specialist :)

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

Frequently Asked Questions

Will a double eyelid line remain after the double-line revision surgery?

No, ultimately only the newly created low and natural line will remain. During the surgery, the internal adhesion of the existing high line is completely released, so it does not fold again and flattens out. Over time, as the scar fades, only one line will be maintained.

Is double-line revision surgery possible even if there is not enough eyelid skin?

Yes, it is possible. Unlike general incisional revision surgery, double-line revision surgery is a skin-preserving surgery that does not cut any skin. Since only internal adhesions are meticulously released, the double eyelid line can be safely lowered even if there is insufficient remaining skin.

Can I undergo double-line revision surgery and ptosis correction at the same time?

Yes, simultaneous procedures are possible and even recommended. Many people with 'sausage eyes' have weak eye-opening strength, and combining double-line revision and ptosis correction can clearly expose the pupils, allowing the double eyelid line to settle much slimmer and more naturally.

What is the difference between general incisional revision surgery and double-line revision surgery?

The biggest difference is whether skin is excised. General incisional revision surgery involves cutting and rejoining the skin between the existing line and the new line, so it requires ample skin. In contrast, double-line revision surgery is performed by releasing adhesions internally without cutting the skin.