An epicanthal fold at the inner corner pulled on the eyelid line, preventing a double eyelid from forming at the inner corner and drawing it inward.

As the patient did not want epicanthal-fold correction, the in-line double eyelid was preserved while enlarging the eyes for a more open eye contour.

The upper lid covered the eye, so the double eyelid was present but not visible, remaining hidden within the upper lid.

Because the patient wanted a natural, non-prominent double-eyelid line, subtle medial epicanthoplasty was performed so the inner-fold double eyelid would connect and become naturally visible.

Weak eyelid-opening strength and thick skin indicated incisional ptosis correction, but the patient preferred buried-suture, non-incisional double-eyelid surgery.

Although an incisional approach was more suitable, the patient requested a non-incisional approach; therefore seven consecutive secure knots were used to create a durable in-out double eyelid less prone to loosening.

After buried-suture double-eyelid surgery five years earlier, the line had doubled, and the patient wanted the current out-line corrected to an in-out line.

Upper epicanthoplasty elevated the 45-degree inner corner and neatly refined the doubled double eyelid into an in-out line.

The eyes were horizontally long without a double eyelid, and the patient wanted an in-out double eyelid.

Because the inner corner turned downward, upper epicanthoplasty was essential to create an in-out double eyelid; without it, only an in-line double eyelid would have been possible.

Non-incisional ptosis correction ten months earlier had not produced the desired effect; for revision, a slightly higher line and more defined eye contour were requested.

Although a higher line was desired, the male patient did not want an overly conspicuous look; therefore a very thin but defined in-out double eyelid was created.

Double-eyelid surgery in an in-out line was performed two years earlier, but the patient wanted revision to a higher out-line.

Raising only the line could look unnatural with the current eye contour, so lateral and lower canthoplasty enlarged the eyes, and upper epicanthoplasty elevated the 45-degree inner corner so the double eyelid could settle into an out-line contour.

The patient had congenital multiple, loose-appearing double-eyelid creases.

Because eye size and eyelid-opening strength were adequate, without other procedures buried-suture double-eyelid surgery alone created a defined out-line.

Previous buried-suture double-eyelid surgery left a large gap between the inner corner and line, while the central line was low, creating an unnatural appearance.

Upper epicanthoplasty elevated the 45-degree inner corner, naturally connecting the double-eyelid starting point and correcting it into a defined parabolic out-line.

Buried-suture double-eyelid surgery performed three years earlier had loosened. The patient wanted to improve the short eye contour naturally.

As larger eyes were desired while preserving a natural result, subtle medial and upper epicanthoplasty were followed by buried-suture double-eyelid surgery to create a defined out-line.