Double Eyelid Revision Surgery: What is ‘Double-Line Incision’ and How to Differentiate it from ‘Single-Line Incision’

Hello, this is Gangnam Seoyeon Plastic Surgery.

Many people are concerned about double eyelid lines that are too high or thick, often hearing terms like ‘sausage eyes’ and feeling stressed. When these individuals search for solutions, they often encounter a specific term: ‘double-line incision’.

However, a similar term, ‘single-line incision’, also appears in searches, leading to confusion about the differences even before a consultation. Today, we will clarify exactly what a double-line incision is, how it differs from a single-line incision, and for whom this surgery is truly necessary.

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■ What exactly is a double-line incision?

The formal name for a double-line incision is ‘line lowering surgery without excising the existing double eyelid scar’. As the name suggests, it involves leaving the existing double eyelid incision scar as is and creating a new line below it.

You can think of it as a precise procedure that releases the adhesion of the existing line and then creates a new line to settle below it. The core of this procedure is to redesign the line to a height that suits each individual, considering the overall eye proportions.

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■ What is the difference between a single-line incision and a double-line incision?

Both methods share the goal of ‘lowering the line’, but their approaches are completely different.

▷ Single-line incision

This method involves excising the skin between the existing incision line and the newly created line. Since it removes the existing scar itself, the line appears clean, and the possibility of developing multiple folds is relatively low. However, because it involves skin excision, it may not be suitable for individuals with insufficient skin laxity. Unless the line was high in youth and then sagged with age, a single-line incision alone might have limitations.

▷ Double-line incision

This method involves leaving the existing incision scar as is and creating a new line below it. Since no skin is excised, it can be applied to individuals with insufficient skin and can also be chosen when a significant lowering of the line is desired. Furthermore, it has the advantage of being re-attemptable even if multiple revision surgeries are needed. However, it can result in two lines of scars and is prone to developing multiple folds due to re-adhesion, thus requiring precise surgical skill from an experienced surgeon.

In summary, a single-line incision is suitable for individuals with sufficient skin laxity, while a double-line incision is appropriate for those with insufficient skin, those who wish to lower the line significantly, or those with a history of multiple surgeries. This decision must always be made after a precise diagnosis.

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■ You might consider a double-line incision if you are one of the following:

- Those who want to lower a double eyelid line that is too high

- Those with a high line and deep scars remaining

- Those whose eyelids feel stretched (sausage eyes) due to excessive removal of muscle or soft tissue

- Those whose line is excessively high compared to the distance between their eyebrows and eyes

- Those whose line appears excessively high due to ptosis

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■ Conclusion

If you are concerned about a high or thick double eyelid line, the first step is to determine whether your eyes are suitable for a single-line incision or a double-line incision. Since the two methods clearly differ in their approach, scarring, and re-operation possibilities, we recommend making a decision through a precise consultation rather than self-diagnosis.

In the next article, we will address common misconceptions about double-line incision, such as ‘it’s the last resort’, ‘it must be combined with ptosis correction’, and ‘a step-off scar is inevitable’, one by one.

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

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Frequently Asked Questions

What is a double-line incision?

A double-line incision is a surgical method that involves creating a new double eyelid line below the existing scar, without excising the original double eyelid incision scar. The core of this procedure is to release the adhesion of the existing line and precisely redesign a new line to settle at a height that suits the eye's proportions.

What is the biggest difference between a single-line incision and a double-line incision?

The biggest difference is whether skin is excised. A single-line incision involves excising the skin between the existing incision line and the newly created line, whereas a double-line incision leaves the existing scar as is and does not excise any skin. This allows a double-line incision to be applied even when there is insufficient skin laxity.

In what cases can a double-line incision be considered?

Individuals who wish to lower a double eyelid line that is too high, those with a high line and deep scars remaining, or those whose eyelids feel stretched due to excessive removal of muscle or soft tissue can consider a double-line incision. It is also suitable for those with insufficient skin or a history of multiple revision surgeries.

Can two lines of scars remain after a double-line incision?

Yes, they can. A double-line incision involves leaving the existing incision scar as is and creating a new line below it, so two lines of scars may remain. Additionally, re-adhesion can easily lead to multiple folds, thus requiring precise surgical skill from an experienced surgeon.

What is the most important factor when deciding on a double-line incision?

The most important factor is a precise diagnosis. Since double-line incision and single-line incision clearly differ in their approach, scarring, and re-operation possibilities, it is crucial to determine the method suitable for you through a precise consultation with a specialist rather than self-diagnosis.