Only the outer end of an in-line double eyelid was visible; the patient wanted a clearer, slightly higher in-line contour.

Incisional double-eyelid surgery and upper epicanthoplasty created a defined parabolic double-eyelid line.

The eyes were horizontally long but vertically short, without a double eyelid.

Upper epicanthoplasty would have helped raise the line, but the patient wanted minimal surgery, so incisional double-eyelid surgery alone created a natural in-line double eyelid.

A year of double-eyelid adhesive use had caused upper-lid skin laxity, settling downward and concealing the double eyelid as an inner fold

Incisional double-eyelid surgery and upper epicanthoplasty lifted the lax, drooping lid, creating a defined in-line double eyelid.

A congenital in-out double eyelid was present but indistinct, sleepy and constricted-looking

To create a defined line, an incisional approach was used for ptosis correction and double-eyelid surgery. The iris became attractively visible and the eye contour more defined, with a natural in-line double eyelid.

An epicanthal fold pulled the upper eyelid downward, making an in-line double eyelid unavoidable.

Medial epicanthoplasty rotated the inner corner horizontally, while upper epicanthoplasty and incisional double-eyelid surgery made the previously hidden double-eyelid line clearly visible.

Although the preoperative photograph was taken with the eyes forcefully opened, there was significant skin laxity, causing heavy lids and marked eye fatigue.

Upper epicanthoplasty and incisional double-eyelid surgery removed lax upper-lid skin and created a defined double-eyelid line, reducing eye fatigue.

The eyes were narrow and long with a short vertical dimension, with reduced upper-lid skin elasticity for the patient’s age.

Because skin elasticity was reduced, incisional double-eyelid surgery was performed; as double-eyelid surgery alone could produce an in-line contour, upper epicanthoplasty was added to create a natural in-out line.

Two years of continuous double-eyelid tape and adhesive use had caused severe skin laxity. The patient wanted an incisional in-out double eyelid.

Because the eyelid skin was lax, incisional revision brought the overlapping creases together. Upper epicanthoplasty was added to create a smooth, natural in-out crease.

Drooping upper-lid skin covered the double eyelid, leaving only its outer end visible. The patient wanted a defined double eyelid and a more open eye contour.

Because the skin lacked elasticity and was lax, incisional double-eyelid surgery with medial and upper epicanthoplasty created an out-line double eyelid.

Although double-eyelid surgery had been performed previously, the line had lowered into an in-line contour.

Because the line had loosened previously, incisional double-eyelid surgery and ptosis correction were combined to strengthen eyelid-opening muscles; upper epicanthoplasty was also added to create a larger, defined out-line double eyelid.

Three years of double-eyelid adhesive use caused skin laxity, with a markedly short vertical eye dimension.

Because of the lax skin, incisional double-eyelid surgery was performed, creating a larger double-eyelid line within a natural range to maximize vertical eye dimension.

The patient had undergone double-eyelid surgery twice, six and seven years earlier. The out-line double eyelid had an unnatural shape.

The excessive gap between the inner corner and eyelid line was corrected, refining the out-line naturally by lowering it overall and softening the previously bent line.