Case 1. A patient who had double eyelid surgery done
elsewhere. Left skin crease higher than the right.
Case 2. Another patient with a higher left skin crease
As mentioned in the previous blog double eyelid (skin crease) asymmetry is one of the most common complaints from the patients undergoing double eyelid surgery. Unequal skin markings before the operations is an important cause of the asymmetry and to avoid this:
a. It is important to mark the skin prior to any anaesthetic injections to avoid distortion of the tissue.
b. In addition, double eyelid surgery should be postponed if there is any eyelid swelling which again can distort the tissue for symmetrical markings.
c. During the markings, the measurement should be precise and ideally a caliper (as shown in the picture) should be used rather than a ruler.
d. Another important thing to remember during markings is to ensure that the skin of the eyelids are under equal tension (see pictures below).
The marking is done with a caliper with the eyelid skin
under tension by pulling on the eyebrow.
Marking with a caliper with the eyelid relaxed. Note that the
marking, even though marked at 6mm as the picture above,
produce a line higher than when the skin is under tension.