Scars and Step-like Deformities After Double-Line Incision: Myths and Truths

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To ensure highly satisfying surgical results,

Gangnam Seoyeon Plastic Surgery always does its best :)

Today, we would like to talk about the scars that occur after the ‘double-line incision’ (DLI) technique.

The photos below have not been edited in any way,

except for brightness adjustments :)

Why Perform a Double-Line Incision?

First, let us explain the reason for performing a double-line incision.

The double-line incision is a method to lower the height of the double eyelid without excising the scar from the previous surgery.

It is performed when there is insufficient skin laxity.

If you cut out the existing scar, skin is removed, leading to a shortage of skin. Therefore, the double-line incision is used in cases where even the scarred tissue must be preserved and utilized.

Why does a convex bump appear immediately after double-line incision surgery?

Immediately after double-line incision surgery, there is a slight protrusion above the incision line. Some patients mistake this for a ‘step-like deformity’ (dancha) and ask about it, so we will explain.

First, this is a mechanism designed to prevent triple folds (multiple creases).

These are patients who developed triple folds due to adhesions after undergoing double-line incision surgery at other clinics.

When they open their eyes, a line forms at the site of the old scar, causing a triple fold.

We corrected these triple folds through early revision surgery.

To prevent this, we create several

internal mechanisms above the incision line to ensure triple folds do not occur.

This is a widely accepted method found in textbooks; it is not a peculiar technique used only by Director Choi Dong-il.

Because we must prevent these folds, you can see a slight protrusion above the incision line immediately after surgery, as shown in the photo.

This area improves as time passes.

This is a device to block triple folds. To remove it completely, one would have to excise the skin, but then the double eyelid line might not be lowered much at all.

Since the double-line incision is performed specifically because there is a lack of skin, this part cannot be cut away.

Of course, this is all explained to the patient during the consultation process before surgery.

In fact, the patient in the photo above mentioned they had surgery at another clinic to reverse a ptosis correction.

They said the levator muscle was released and even the Müller’s muscle was separated, but no correction occurred at all.

For eyelid retraction correction,

the levator muscle must first be separated from the tarsal plate to expose the Müller’s muscle,

and then the conjunctiva and Müller’s muscle must be separated to proceed with the retraction correction surgery.

The adhesions must be released by careful, step-by-step dissection.

The surgery itself involves many variables and is difficult for someone without extensive experience to perform.

When will the double-line incision scar disappear?

This part does not disappear completely, but it improves over time.

Looking at the photos, you can see the appearance one week after surgery, and even at one month, a slight protrusion is visible.

It varies by individual, but it can look like this for at least a year or more.

This is a photo from about two years later. The scar from the previous incision never truly disappears, but it gets better over time.

If you are considering a double-line incision, you must take this into account.

In what cases is the double-line incision scar more severe?

The scar from a double-line incision is heavily influenced by the existing incision scar from the previous surgery.

The better the condition of the existing scar—meaning, the more tissue that was left behind—the less noticeable the new scar will be.

If the existing scar is very severe or if not much tissue was left, the scar will inevitably be more pronounced.

Since revision surgery cannot create tissue that isn’t there, you must be very careful even with your first surgery.

Also, this specifically occurs when the line is lowered significantly.

For example, even in a man’s first surgery, if the double eyelid is set low, a folded part can be seen as follows.

This is not a step-like deformity; rather, while there is a double eyelid, the skin above the line is left sagging to cover it and make it less visible.

People born with ‘inner’ double eyelids or those who originally had double eyelids but experienced skin sagging over time will also look like this.

Today, we looked into the scars that are often mistaken for step-like deformities after a double-line incision.

I hope this cleared up some misunderstandings.

Surgical methods vary greatly depending on the patient’s condition, so if you have the chance to visit our clinic, we will suggest a treatment plan that is right for you.

Regarding double-line incision scars,

you can find more detailed information in the video below.

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

Feel free to visit and receive a 1:1 consultation from a plastic surgery specialist :)

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

In what cases is the double-line incision surgery necessary?

Yes, it is mainly performed when there is insufficient excess skin on the eyelids. If the scar from a previous surgery is cut, there will be even less skin, so the double-line incision method is applied when the height of the double eyelid line needs to be lowered while preserving the existing scar.

Is it a side effect if the area above the incision line is convex immediately after surgery?

No, this is not a side effect or a step, but an intentional surgical device to prevent the formation of multiple folds. It is created to prevent the line from forming multiple layers due to the existing scar, and it gradually flattens and becomes more natural over time.

When will the scar from the double-line incision completely disappear?

The existing incision scar does not completely disappear, but gradually fades over time. Although there are individual differences, it gradually improves to become less noticeable after at least 1 to 2 years post-surgery, so you should fully consider this aspect before surgery.

Are there cases where the double-line incision scar is particularly severe?

Yes, it largely depends on the condition of the scar from the previous surgery. If not much tissue was left in the first surgery, or if the existing scar is very severe, and if the double eyelid line is lowered significantly, the scar or folded area may appear relatively more severe.