Secondary Blepharoplasty: Correction of the High Fold



Blepharoplasty is a common aesthetic surgery performed worldwide. In Asians, too high eyelid folds after blepharoplasty cause an unsatisfactory aesthetic outcome that is difficult to correct. In this article, the authors propose surgical techniques to correct the high eyelid fold after blepharoplasty.


During a 4-year period, 213 secondary blepharoplasties were performed to correct high folds. Postoperative results were reviewed, graded, and analyzed.


Of 213 cases of secondary blepharoplasty to correct the high eyelid fold, almost all could achieve reduction of the fold size (98.59 %). One hundred and nine cases (51.17 %), 69 cases (32.40 %), and 32 cases (15.02 %) were classified as excellent, good, and fair results, respectively. Only three cases (1.41 %) were classified as poor results.


Secondary blepharoplasty to correct a high fold is a challenging procedure for aesthetic surgeons. Surgeons performing this operation need to have a thorough understanding of eyelid anatomy and its dynamics together with familiarity with secondary blepharoplasty to avoid any further injury to the levator muscle. The key points of this surgery are levator advancement and intervening between the levator aponeurosis and the overlying skin by in situ tissue or fat grafting.

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The authors would like to thank Group Captain Apichart Ploysangwal MD from Clinical epidemiology unit for statistical analysis and Group Captain Kamol Srion from Academic Service Center, Bhumibol Adulyadej Hospital for illustrations.

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Correspondence to Kamol Wattanakrai.

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The authors declare that they have no conflicts of interest to disclose.

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Wattanakrai, K., Chiemchaisri, N. & Wattanakrai, P. Secondary Blepharoplasty: Correction of the High Fold. Aesth Plast Surg 40, 914–920 (2016) doi:10.1007/s00266-016-0713-y

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  • Secondary blepharoplasty
  • Correction of the high fold
  • Oriental blepharoplasty
  • Revision blepharoplasty
  • Eyelid ptosis
  • Fat graft
  • Ptosis correction
  • Asian blepharoplasty