Standards for Double Eyelid Design by Face Shape and Key Points for Revision Surgery

Even when the initial double eyelid surgery is successful, many people still feel dissatisfied with the crease and begin considering revision surgery. We summarized an interview with Director Koo Moon-geun of Made Young Plastic Surgery, discussing the ideal crease design for different face shapes and the various situations that lead patients to consider revision eyelid surgery.
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Double eyelid creases are categorized into inline, in-out line, semi-out line, and outline shapes. There are quite a few types, right? Each crease style suits different people depending on factors such as face shape, eye shape, and eyelid thickness. Let me explain these crease types and who they are best suited for in an easy-to-understand way.

The first type is the inline crease. The starting point of the crease is very close to the inner corner of the eye, creating a line that looks as natural as your original eyelids. It shows the least signs of surgery and gives the most natural overall appearance.

The inline crease suits people who want to maintain a more traditional East Asian look, those with soft and gentle eye shapes, or those whose professions require a very natural appearance. It works well with round, oval, and small face shapes. It is especially popular among office workers because it looks natural and unobtrusive. Since it barely shows in daily life, it has consistently remained a preferred choice over the years. 

The second type is the in-out line. It has a balance between naturalness and definition. The crease starts naturally near the inner corner like an inline crease, then gradually rises toward the outer part of the eye, giving a subtle but noticeable definition to the eye shape. 

The in-out line is recommended for those who want a natural look but also wish for their eyes to appear slightly larger. It is suitable for people whose eyes look a bit dull or heavy, and for those with oval, long, or slim face shapes. It has more presence than the inline crease but is less dramatic than the outline, making it one of the most popular choices today. Its balance between naturalness and definition leads to a high satisfaction rate.

The third type is the semi-out line. It creates a noticeable change in the eyes and gives a more defined look. Since the crease is slightly visible from the inner corner, the eyes appear noticeably larger, and the line becomes even more defined when makeup is applied. 

The semi-out line is suitable for people whose eyes look small or sunken, and for those who prefer a more glamorous or defined eye shape. It works better when the eyelid-opening muscle (levator function) is relatively strong. It also suits individuals with long face shapes or prominent cheekbones. Especially for those whose eyes don’t appear well in photos, switching to a semi-out line often creates a noticeable improvement. Even a small change can make the overall impression much sharper. 

The last type is the outline crease. It is the most dramatic and Western‑looking among double eyelid styles. Since the crease is clearly visible from the inner corner, it is often chosen by those who want a more glamorous or Westernized appearance. However, if the nose bridge is low, this style may not harmonize well. The outline crease suits people with strong eyelid‑opening power and naturally defined eyes. It also works well for those with large eyes, thin eyelid skin, and those who enjoy bold or glamorous makeup. It complements long, slim face shapes and facial features that are sharp and well‑defined. 

However, if the eyelid skin is thick or the eyelid‑opening strength is weak, the outline crease can look heavy and overly stuffy, so caution is needed. Therefore, it is important to check carefully whether this style matches your eye condition. 

Double eyelid creases and face shape naturally change over time due to aging. They can also change when you gain or lose weight suddenly. Many people consider revision eyelid surgery when they want to change the shape of their eyes. As a revision surgery patient, it is important to understand that if your crease has changed and requires ptosis correction, or if you previously had an incisional method to fix the inner crease more clearly, it may become more difficult to change the crease again later. Being aware of these factors is essential.

With the incisional method, the skin, fat, and muscle are adjusted and fixed so that the double eyelid crease does not collapse. Because of this, if fat has been removed, muscle has been partially excised, or the crease has been fixed multiple times, the internal structure naturally becomes more complex than during the first surgery. Many patients also wonder whether ptosis correction can be performed at the same time during revision surgery when eyelid‑opening strength is weak. In such cases, the existing scar tissue must be released, which can increase the difficulty slightly. However, this does not mean the procedure is dangerous or impossible. In fact, because the incisional method allows the internal anatomy to be seen clearly, revision surgery is often more stable when performed by an experienced surgeon.

The important thing is to find a plastic surgeon with the experience and expertise to accurately assess your eye condition and create a plan that suits you. I hope the information I’ve shared helps you better understand how to choose a double eyelid crease and what to consider for revision surgery. Thank you.