About 50% of Asians do not have a double fold. The presence of a double fold will give the perception of a bigger and more attractive eye. There are generally two ways to create a double fold namely the stitch method and the open cutting method.

The stitch method involves putting 3 stitches to hold up the fold through small puncture holes. It has the advantage of faster recovery and almost unnoticeable scar. It is suitable for the young people who has thin upper eyelid without excess skin.

The open method involves making an incision along the intended fold, cutting away some skin, muscle and fat and anchoring the skin to the levator to create a double fold. For older patients who have excess skin or fat that is drooping and covering the fold, it may be removed to reveal the double fold and give a more youthful appearance.

We use a laser-assisted technique in the open method to reduce bleeding and swelling, thus shortening the recovery time. The procedure takes about 1 hour under local anaesthesia. The recovery time is about 1 week.

Anciliary procedure like Epicanthoplasty may be done at the same time to enhance the double eyelid fold. Epicathoplasty reduces the prominence of epicanthic fold by releasing the medial web-like fold with modified z-plasties.