Types of Skin Best Suited for Eye Plastic Surgery

Eugene Lee • November 16, 2025

Why These Two Procedures Are Often Confused

In Korea, many patients ask whether they need double eyelid surgery, ptosis correction, or both. The two procedures can look similar on the surface because both improve the appearance of the upper eyelids — but they treat completely different issues.

One procedure creates an eyelid crease.
The other strengthens the eyelid-opening muscle.

Choosing the wrong one can lead to:

  • Uneven eyes
  • Crease disappearing
  • Eyes still looking tired
  • Poor symmetry
  • Need for revision

This guide clearly explains the difference and helps you understand which procedure you may actually need.

What Is Double Eyelid Surgery?

Purpose

Creates a visible crease on the upper eyelid for a brighter, more defined eye shape.

How It Works

Depending on eyelid thickness and skin type, the surgeon uses:

  • Non-incisional (suture) method
  • Partial-incisional method
  • Full incisional method

These techniques attach the skin to the levator muscle so a crease forms when the eyes open.

Best For:

  • Monolids
  • Low or disappearing creases
  • Mild hooding
  • Patients with naturally strong eyelid muscles

What It Does Not Fix

  • Tired or sleepy eyes
  • Weak eyelid-opening muscle
  • Small-looking eyes due to ptosis
  • Asymmetry caused by muscle imbalance

What Is Ptosis Correction?

Purpose

Corrects weak eyelid-opening muscles (levator muscles) so the eyes open wider and appear more awake.

How It Works

The surgeon:

  • Tightens or shortens the levator muscle
  • Improves the eyelid’s lifting strength
  • Often performs this together with a crease design

Best For:

  • One eye looks smaller than the other
  • Eyes look droopy or half-open
  • Constantly using the forehead to lift your eyelids
  • Tired, sleepy appearance
  • Crease disappears because the muscle is weak

What Ptosis Correction Does Fix

  • Small-looking eyes caused by weak muscles
  • Hidden or unstable creases
  • Eyelids that droop over the pupil
  • Asymmetrical eye-opening

Key Differences Between the Two Procedures

1. Purpose

  • Double Eyelid Surgery: Makes a crease
  • Ptosis Correction: Strengthens how the eyelid opens

2. When Each Is Used

  • Double Eyelid: Cosmetic enhancement
  • Ptosis: Functional improvement + aesthetic enhancement

3. Eye Shape Outcome

  • Double Eyelid: Brighter, defined crease
  • Ptosis: Bigger, more open, more alert-looking eyes

4. Longevity of Results

  • Double Eyelid: Stable if muscle is strong
  • Ptosis: Provides long-term improvement if done properly

5. Difficulty Level

  • Double Eyelid: Less complex
  • Ptosis: More delicate + requires experienced surgeon

Which One Do You Need?

Here’s a simple way to tell:

Choose Double Eyelid Surgery If:

  • You simply want a crease
  • Your eyelids are strong
  • Your eyes open fully
  • You have monolids or low creases
  • You don’t look sleepy or tired when relaxed

Choose Ptosis Correction If:

  • One or both eyes look smaller
  • Eyelids feel heavy
  • Brows lift automatically to open your eyes
  • You look sleepy even when rested
  • Your crease disappears or folds over
  • You struggle to keep eyes open while taking photos

Choose Both Procedures If:

  • You have ptosis and want a double eyelid crease
  • You want a brighter, larger eye shape
  • You want improved symmetry
  • You need revision for failed previous surgery

In Korea, combining both procedures is extremely common for the best aesthetic and functional results.

Signs You Might Need Ptosis Instead of a Crease

1. You rely on your eyebrows to open your eyes

(You may see forehead wrinkles even when not raising your brows intentionally.)

2. One pupil looks more covered than the other

3. Your eyes look half-open in photos

4. Your eyelids feel heavy, even in your 20s or 30s

5. Previous double eyelid surgeries didn’t last

This is a major red flag for untreated ptosis.

Why Korean Surgeons Excel at Both Procedures

Korea is known for:

  • High-volume eyelid surgery experience
  • Natural, subtle crease design
  • Advanced “hidden ptosis” diagnosis
  • Incision skills leaving minimal scarring
  • Safe combination techniques

Many international patients come specifically for complex and revision ptosis correction because Korea specializes in eye muscle surgery.

Recovery Differences

Double Eyelid Surgery:

  • Recovery: 5–7 days
  • Final result: 1–2 months

Ptosis Correction:

  • Recovery: 7–14 days
  • Final result: 1–3 months
  • More swelling due to deeper muscle work

Which One Looks More Natural?

Both can look extremely natural —
but only when the correct procedure is chosen for your anatomy.

  • If your muscle is strong → double eyelid surgery looks natural
  • If your muscle is weak → ptosis correction looks more natural

Trying to “force” a crease on weak eyelids often fails.

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It’s more common than people think — after double eyelid surgery, the fold may fade, loosen, or disappear entirely over weeks or months. This is known as fold regression, and it can happen with both the non-incisional (suture) method and the incisional method. Understanding why the fold disappears can help determine whether the situation is normal healing or if revision surgery may be needed. Top Reasons Your Double Eyelid Fold Disappears 1. Weak or Loosened Fixation (Most Common Cause) The fold forms when the skin attaches to the levator muscle. If the fixation isn’t strong enough, or if the sutures loosen, the crease may fade. Most likely with: Non-incisional (suture) surgery Thick or oily eyelid skin Strong blinking habits 2. Swelling Masking the True Result Early swelling can temporarily create a crease that later softens as swelling disappears. This can make the fold look like it “went away,” when really it wasn’t strongly fixed from the beginning. 3. Thick Eyelid Skin or Excess Fat Thicker eyelids can push down on the crease, preventing a deep, stable fold. More common in: Patients with monolids Patients with chubby upper eyelids Those who did not receive sufficient fat removal (if needed) 4. Ptosis (Droopy Eyelid Muscle) Not Addressed If a hidden ptosis (weak levator muscle) isn’t corrected during surgery, the eyelid crease can: Look low Look heavy Disappear gradually This is one of the most overlooked causes. 5. Incorrect Crease Design If the fold was designed too low, too shallow, or not suited to the patient’s anatomy, it may not hold. Incorrect design leads to: Shallow folds Instability Regression within weeks to months 6. Excess Skin Not Removed (Incisional Method) If the surgeon did not remove enough skin during incisional double eyelid surgery, the excess skin may cover the fold and make it disappear. 7. Healing & Scar Tissue Variation Each person heals differently. Some bodies create stronger adhesion, while others create weaker ones. Scar tissue under the incision may loosen the fold over time. 8. Aging or Eyelid Drooping Over years, loss of elasticity or brow drooping can cause the eyelid fold to weaken or sink. When Is the Fold Disappearing Normal? Some fading is normal during the first 4–12 weeks as swelling decreases. But if the fold continues to weaken or vanish after 3–6 months, it may indicate: Loose fixation Incorrect height Missed ptosis Tissue not properly attached This can often be corrected with a revision procedure. How to Fix a Disappearing Eyelid Crease 1. Revision Suture Reinforcement For mild or early fold regression. 2. Incisional Double Eyelid Surgery Provides a more permanent fold, ideal for: Thick eyelids Sunken folds Repeated suture failures 3. Ptosis Correction (If Needed) Strengthens eyelid muscle to support the fold. 4. Fat Removal or Repositioning Helps fold stay stable in thick eyelids. 5. Crease Redesign Raises or lowers the fold for better definition.
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