Although full length incisionis the gold standard for double eyelid surgery, in patients who don't have excess skin and fat a small incision approach can create as good a double eyelid as the full length approach. As the incision is small, the down time is shorter. Below show the steps of small incision double eyelid surgery.
a. After deciding on the desired height for the double eyelid, a horizontal line of about 10mm is drawn on the skin;
b. The skin is incised to expose the underlying muscle; c. the muscle is trimed to expose d. the orbital septum;
e. the orbital septum is in turn open to expose f. the fat which is removed to reveal the underlying g. levator aponeurosis; h. the orbicularis is sutured to the aponeurosis at a few points; i. the skin is closed with nylon suture;
j. at the end of the operation.
Before (picture above) and 6 weeks after small incision double eyelid surgery.