Incisional Double Eyelid Surgery in Seoul

What is incisional double eyelid surgery?

Incisional double eyelid surgery creates a crease by making a fine incision along the line where the fold will sit. Through this opening, the surgeon can adjust each layer of the eyelid: trimming excess skin, removing or redistributing fat, thinning bulky muscle where needed, and then connecting the skin to the eye-opening structures at a precise height. Because the fold is built through direct fixation rather than sutures alone, it is typically stable and long-lasting.

The incision sits within the new crease, so when the eyes are open, it is usually hidden in the fold. When the eyes are closed, a fine line can be seen close up in the early months and generally fades as the scar matures.

Who is a good candidate?

• Thicker or fuller upper eyelids
• Excess skin that overhangs the lash line, including hooded eyes
• A previous suture fold that has loosened
• Asymmetry that needs structural correction
• Mild ptosis that can be corrected at the same time
• A wish for a well-defined fold that holds reliably

It may not be necessary if your lids are thin with little excess tissue; natural adhesion surgery may be enough. It is not suitable when there is uncontrolled eye disease, significant dry eye, or when expectations cannot be met by eyelid anatomy alone, for instance if heaviness comes mainly from a low brow.

How Dr. Kim approaches design at Will Be

An incisional fold is a decision that should be made with care, because it creates scar tissue that shapes all future eyelid work. At Will Be, Dr. Kim Jun-young personally takes you from consultation to design, surgery and every follow-up. He examines how strongly your eyes open, how much skin and fat you have, where your brows sit, and how your eyes relate to your nose and cheekbones.

Fold height is chosen conservatively. A crease that is too high is one of the most common reasons people seek revision, and it is much easier to avoid than to fix. The aim is a fold that suits your eye width and face, whether that means a soft in-out crease or a gentle parallel line.

How is the procedure performed?

1. Design. The crease line and any skin to be removed are marked while you sit upright. Skin removal is measured in millimeters and kept conservative.
2. Anesthesia. Local anesthetic, commonly with IV sedation.
3. Incision and skin trimming. A fine incision is made along the design; excess skin is removed only if needed.
4. Soft tissue management. A thin strip of orbicularis oculi muscle may be trimmed in bulky lids. The orbital septum, a thin membrane holding back eyelid fat, is opened if fat needs to be reduced or redistributed.
5. Fixation. The skin edge is connected to the levator aponeurosis or the upper edge of the tarsal plate at the planned height. This mimics the natural attachment found in people born with a double eyelid.
6. Checking symmetry. You open and close your eyes so fold height and eye opening can be compared side to side.
7. Closure. Fine sutures close the skin; they are removed after about 5–7 days.

If eye opening is weak, ptosis correction can be performed through the same incision.

Anesthesia and surgery time

Surgery typically takes about an hour, longer when combined with ptosis correction or epicanthoplasty. It is done under local anesthesia, often with IV sedation, and you go home the same day.

How long does recovery take?

For practical tips see the day-by-day recovery guide and how to reduce swelling and bruising.

Risks and how they are minimised

Possible risks include bleeding and bruising, infection, asymmetry, a fold that is higher or lower than intended, prolonged swelling, a visible or thickened scar, multiple folds, temporary dry eye, and difficulty closing the eye fully in the early period. Individual results vary, and a small minority of patients need an adjustment.

Risk is reduced by conservative skin removal, careful fixation height, meticulous control of bleeding, and consistent follow-up with the same surgeon. See eyelid surgery risks for more detail.

Combining with other procedures

Incisional surgery is commonly combined with ptosis correction, epicanthoplasty for a prominent inner-corner fold, or lower-lid procedures. Combining can reduce total recovery time, but it is only recommended when each part is justified by your anatomy. If the heaviness above your eye comes mainly from a descended brow rather than the lid itself, a brow-level procedure may be discussed instead of removing more eyelid skin.

Why fold height matters so much

The height of a double eyelid crease is measured from the lash line, usually in millimeters. Small differences are visible. A fold only one or two millimeters higher than suits your eye can make the face look surprised, heavy or "done", and can create a deep line that shows even when you look down.

There is also an anatomical reason for restraint. When the fixation point is set high on the levator, the skin below it is pulled up, and the lid must work harder to open. Over time, this can make the eye look tired. A lower, well-proportioned fold usually moves more naturally with the eye and is easier to adjust in the future if needed. For many people of East Asian descent, a modest fold that respects the shape of the eye reads as refined rather than altered. You can read more about this idea in what natural results actually mean.

Fold shapes and your eye shape

Folds are commonly described as in-out, tapered or parallel. An in-out fold begins inside the inner-corner skin and emerges toward the outer eye; a parallel fold runs at a steady height across the lid. With an incision, the surgeon has more freedom to create any of these shapes, but freedom is not the same as suitability. A prominent epicanthal fold(the web of skin over the inner corner) makes a parallel crease look forced unless the inner corner is also adjusted. Wide-set eyes, a long brow-to-lash distance, or a heavy brow each change which shape will look balanced. Dr. Kim uses a thin probe to simulate each option on your own lid, so the decision is made by looking rather than imagining.

Preparing for surgery

In the week or two before surgery, your surgeon may ask you to pause medicines and supplements that can increase bleeding, such as aspirin, some anti-inflammatory painkillers, fish oil, ginkgo and vitamin E. Do not stop a prescribed medicine without advice from the doctor who prescribed it. Stop smoking as early as possible and avoid alcohol for several days. On the day, arrive without makeup or contact lenses and bring sunglasses and a companion if you are having sedation.

Aftercare at home

For the first 48 hours, use cold compresses in short intervals and keep your head raised, including while sleeping. Clean the incision line gently as instructed and apply prescribed ointment. After suture removal, your surgeon may recommend scar care such as silicone gel and strict sun protection. Avoid rubbing your eyes, and hold off on saunas, swimming, alcohol and intense exercise for about two weeks. Small differences between the two sides are common while swelling settles and usually even out over the following weeks.

Staying in Korea as an international patient

Plan about 7 days: consultation, surgery the following day, suture removal around day 5–7, and a final check. If you can stay 10 days, you will fly with less visible swelling. Before travelling, you can send photos for a preliminary opinion, which helps confirm whether an incisional approach is likely to be recommended and whether anything should be combined. Try to avoid scheduling a long-haul flight on the day of suture removal; a day or two of rest afterwards is kinder to healing tissue. Once home, keep up scar care and sun protection, and share photos at the intervals your surgeon suggests so healing can be reviewed from a distance.