Eyelids with a noticeable arch-shaped crease on the upper eyelid are called double eyelids, while eyelids without this crease are monolids. Your chance of having double eyelids is primarily based on genetics.

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How to Tell If You Have a Double Eyelid

“Double eyelid” is the common term for the presence of an arch-shaped crease on the upper eyelid, known as the supratarsal fold or palpebral fold, located between your eyebrows and eyelashes.

A double eyelid has a crease that gives the appearance of two eyelids. The crease may be obvious and well-defined or only slightly visible. A double eyelid typically looks larger, more alert, and more expressive than eyes without a double eyelid. If you don’t see a crease, you have a monolid.

Causes of Different Types of Eyelids

Different types of eyelids are caused by several factors that include:

• Genetics: A double eyelid crease is primarily caused by inherited genetic factors.
• Age and hormonal changes: With age, the skin around your eyes can lose elasticity, and the fat in the eyelid area can diminish or shift. A double eyelid crease can appear when there was previously none.
• Environmental factors: Frequent eye rubbing or squinting can cause the formation of a double eyelid over time. Trauma or injury can also contribute to changes in your eyelids.
• Medical conditions: Medical conditions can cause upper eyelid drooping and excess skin.

Why Do Some People Want a Double Eyelid?

Functional reasons:

• To correct drooping of the eyelid skin due to the natural age-related loss of collagen and elastin in the skin
• To correct congenital (present from birth) or acquired ptosis that interferes with normal vision

Cosmetic reasons:

• A preference for the appearance of a double eyelid
• Adherence to cultural standards of beauty (a preference for double eyelids among many East Asian cultures)
• Easier application of eye cosmetics

How to Get Double Eyelids Without Surgery

You can create the temporary effect of double eyelids without surgery, including with:

• Eyelid cosmetics: Strategically placed eyeshadow and mascara can create the appearance of a fold on the upper eyelid.
• Double-sided eyelid tape or liquid glue: Strategically attaching crescent-shaped strips or adhesive lifts your eyelid and any sagging skin around it. The strip is placed where your eyelid folds over. A thin, stick-shaped instrument makes your eyelid adhere securely to the tape. It can be cleaned off with makeup remover.
• Eyelid glue: Eyelid glue is applied to the eyelid fold to lift it temporarily. A stick-like instrument is used to push the eyelid up for about 60 seconds. The glue is cleaned with makeup remover.

Cosmetic Surgery (Blepharoplasty)

Blepharoplasty, a surgical eyelid lift, can create double eyelids. The procedure is sometimes referred to as Asian eyelid surgery or Asian blepharoplasty since it is popular among people of Asian descent.

During this procedure:

• The surgeon makes small incisions in the natural creases and contours of the upper eyelids.
• Excess skin and/or fat is removed and reshaped as needed.
• Stitches (tiny sutures) close the incision.

Pros

Blepharoplasty can have the following benefits:

• Elimination of puffiness on your upper eyelids
• Redefine droopy or hooded eyes
• Smooth wrinkles around your eyes
• Improvement of your visual fields impacted by overhanging eyelids
• Improved self-confidence and self-image
• A more restful and youthful appearance

Cons

Consider the following cons:

• It can take months for scars to heal and visible improvement to occur.
• Complications could affect your appearance, eyesight, or overall health.
• Medical insurance typically does not cover the cost of cosmetic blepharoplasty.
• You may have to combine a blepharoplasty with an eyebrow lift to achieve your desired results if you have creases in your forehead or drooping eyebrows.
• Depending on your type of work, you may have to take up to two weeks or more off.
• While blepharoplasty provides long-lasting results, it does not delay the natural aging process.

Risks and Recovery

Blepharoplasty involves the following risks:

• Hematoma (a collection of blood outside blood vessels, causing bluish or purplish discoloration)
• Infection
• Dry eyes
• Blepharoptosis, also known as ptosis (drooping of the upper eyelid)
• Retrobulbar hemorrhage (a collection of blood in the retrobulbar space, or behind your eyeball)
• Asymmetry (eyelids with uneven height or shape)
• Multiple creases of the upper eyelid
• Excessively high double eyelid fold
• Disappearance of the double eyelid crease
• Everted eyelashes (eyelashes turn outwards rather than downwards toward the eye)

Recovery from blepharoplasty depends on the extent of the surgery performed, but typically includes:

• During the first week or two after surgery, your eyelids may have bruising and swelling and feel tight and sore. Applying cold compresses and continuing head elevation can help relieve discomfort.
• You will not be able to drive until your surgeon clears you. About a week after your surgery, you may feel well enough to make short trips for errands.
• Most people return to work about 10 to 14 days after a blepharoplasty.
• During the first few weeks after surgery, your eyelids are likely to tire faster than usual. Gradually increase your time in front of a computer.
• Wear dark sunglasses with frames that fully cover your eye area to protect from the sun and wind. Consult your surgeon about using sunscreen.
• Avoid straining, lifting, and bending down to pick up things for up to four weeks after a blepharoplasty. This prevents a sudden increase in blood pressure until the incisions fully heal.

Key Takeaways

• Double eyelids have a noticeable outer crease and are seen in people of many ethnicities, while monolids are seen in many East Asian populations.
• Eyelid shape is primarily determined by genetics, but eyelid shape can change with age or medical conditions.
• Surgery or temporary cosmetic fixes (such as with eye tape or eye glue) can create the appearance of a double eyelid.