Crease Shape & Height with Double Eyelid Surgery
Video transcript: The height of the crease refers to its position relative to the base of the eyelashes.
A low crease is generally 5 or 6 millimeters below the lashes, a medium crease is 7 to 8 millimeters and a high crease graded at 9 millimeters. The shape of the crease refers to how the crease blends medially towards the nose and blends laterally towards the outside of the eye.
When we talk about the way the crease blends to the corner of the eye, we refer to that as an inside or outside fold. The corner of the eye often forms what's called an epicanthal fold. For an inside fold the crease will blend inside the epicanthal fold And for an outside fold, the crease will blend above the epicanthal fold. We call those inside or outside folds. That just refers to the shape of the crease as it approaches the corner of the eye towards the nose.
Laterally the shape of the crease can either be parallel to the lash line or as it proceeds outwards it can become slightly higher. We call that a flared crease. The option is for crease shape in terms of lateral flare or parallel fold are an option for the incisional technique, but we really don't know how the crease will form with a suture technique.
The suture is placed in the center of the eyelid and the crease forms on the outside of those stitches on its own. It's not secured by stitches or incisions so the anatomy of the underlying eyelid is what determines the shape of the crease when you use a stitch.