Thick Double Eyelid Creases: Can They Be Lowered?

A double eyelid crease may look too high, deep, or thick after surgery. Some early heaviness can improve as swelling decreases, but a persistent high crease may require revision treatment.

This guide explains why thick creases happen and how they may be lowered.

👁️ Is a Thick Crease Normal After Surgery?

Sometimes, Temporarily ✔️
• Swelling can make the fold look deeper
• The eyelid may feel tight or heavy
• Scar tissue can temporarily exaggerate the crease
• One side may settle faster than the other

👉 Early thickness does not always represent the final result

⏳ When Is It Too Early to Judge?

It may be too early when:

• You are still within the first few weeks
• Swelling remains above the crease
• The scar is red, firm, or raised
• The fold changes throughout the day
• The appearance is gradually improving

👉 Eyelid creases often become softer and more natural over several months

⚠️ Why Does the Crease Look Too High or Thick?

Possible causes include:

• The crease was fixed too high
• The attachment is too strong or deep
• Excessive skin or fat was removed
• Scar tissue pulls the eyelid inward
• The upper eyelid has become hollow
• Eyelid muscle weakness changes the fold

👉 The cause must be identified before choosing a correction method

🏥 Can a High Crease Be Lowered?

In Many Cases, Yes ✔️

Revision may involve:

• Releasing the previous high crease
• Creating a new lower fold
• Repositioning skin and soft tissue
• Restoring lost volume
• Correcting eyelid muscle weakness

👉 Simply adding a lower crease without releasing the old one may create multiple folds

🩹 Why Scar Release Is Important

The previous crease may need to be released when:

• It remains deeply attached
• The fold looks sharp or artificial
• The eyelid skin does not move naturally
• Multiple creases appear after blinking

👉 A stable lower crease usually requires control of the old scar attachments

📉 What If Too Much Fat Was Removed?

Volume loss may cause:

• A hollow upper eyelid
• A deep and harsh crease
• Several visible folds
• A tired or older appearance

Possible treatment may include:

• Fat repositioning
• Fat grafting
• Soft-tissue grafting

👉 Lowering the crease alone may not be enough when significant hollowing is present

🩺 Could Ptosis Be Involved?

A thick crease may appear worse when:

• The eye looks small
• The eyebrow lifts to open the eye
• One eyelid sits lower
• The crease becomes deeper when the eye opens

👉 Eyelid muscle function should be checked before revision

🔄 When Is Revision Considered?

Revision may be considered when:

✔️ The crease remains high after healing
✔️ The fold looks deep and unnatural
✔️ Multiple creases develop
✔️ The eyelid feels tight or difficult to open
✔️ Significant asymmetry remains

👉 Many surgeons wait several months for swelling and scars to stabilize

⚠️ What Can Limit Correction?

Results may be affected by:

• Excessive skin removal
• Severe volume loss
• Heavy scar tissue
• Multiple previous surgeries
• Thin or damaged eyelid tissue

👉 The goal may be a softer and lower crease rather than perfect restoration

❗ Red Flags

❌ Revision is recommended during major swelling
❌ The old crease will not be released
❌ More skin or fat removal is suggested without explanation
❌ Ptosis and eyelid closure are not checked
❌ Perfect symmetry is guaranteed

👉 Revision should preserve normal blinking, eye closure, and eyelid movement

✔️ Questions to Ask

• Is the crease truly too high or still swollen?
• Does the old fixation need to be released?
• Has too much fat or skin been removed?
• Will volume restoration be needed?
• Is eyelid muscle weakness involved?
• How low can the crease be moved safely?

👉 Choose a surgeon experienced in complex eyelid revision

Quick Summary

Early Thickness
• May be caused by swelling and firm scar tissue

Common Causes
• High fixation, deep scarring, volume loss, or ptosis

Possible Correction
• Scar release, lower crease creation, and volume restoration

Best Timing
• After swelling and scars have stabilized

Main Goal
• A softer, lower, and more natural eyelid fold

Final Thoughts

Thick or high double eyelid creases can often be improved, but revision requires careful planning:

• Temporary heaviness may settle naturally
• Persistent high creases may require release and repositioning
• Volume loss or muscle weakness may also need correction

👉 Allow enough time for healing and seek an in-person eyelid evaluation before deciding on revision surgery.