Multiple or unstable eyelid creases—including double or triple crease deformities—most commonly develop after repeated surgeries, improper crease fixation, or excessive scar formation within the upper eyelid.
In double or triple crease cases, abnormal adhesions form at multiple levels between the skin, orbicularis muscle, levator aponeurosis, and residual scar tissue.
These competing fixation points create overlapping folds that appear fragmented, inconsistent, or intermittently visible depending on eye movement, gaze direction, or fatigue.
Unlike primary double eyelid surgery, double or triple creases cannot be corrected by simply recreating or reinforcing a crease. Additional fixation often worsens the condition by introducing further scarring and instability.
Dr. Ahn approaches these cases by first identifying the exact depth and level of each abnormal adhesion contributing to crease duplication.
Revision surgery focuses on meticulous release of competing scar planes, restoration of normal tissue layering, and reconstruction of a single, dominant, stable eyelid fold.
The reconstructed crease is designed to remain smooth and continuous at rest and during dynamic eye movement, without compromising eyelid closure, blinking mechanics, or ocular surface protection.
Surgical restraint is critical, as excessive fixation or aggressive dissection significantly increases the risk of recurrence or further crease fragmentation.