These insertions are responsible for the formation of the upper lid crease, most notable when the eyelid opens and the levator contracts, dragging skin into the orbit. The distal end of the levator aponeurosis fans out into multiple fibrous extensions, which insert into the pretarsal orbicularis muscle and adjacent subcutaneous tissue. These features depend on the anatomical relationship between several structures of the upper lid: specifically, the skin, orbicularis oculi muscle, orbital septum, preaponeurotic fat, levator aponeurosis and tarsus. The external contour of the upper eyelid demonstrates variations, in part, based on the structure and position of the eyelid crease and the eyelid fold.

Additionally, surgical techniques to create a double fold and associated risks and complications will be reviewed. This article discusses the variations in eyelid anatomy, which transcend race, between a single fold and double fold eyelid. Philadelphia: Springer-Verlag 2002.ĭouble eyelid surgery is a procedure performed with the primary goal of creating an upper eyelid crease. Modified with permission from Katowitz JA, ed. Fewer fibrotic bands from the levator aponeurosis attach to the orbicularis muscle, subcutaneous tissue, and skin Adapted from BCSC. Eyelid morphology II (right): the fusion site of the orbital septum and levator aponeurosis occurs at a lower position, below the superior border of the tarsus.

Fibrotic bands from the levator aponeurosis attach to the pretarsal orbicularis muscle, subcutaneous tissue, and skin. Eyelid morphology I (left): the orbital septum and levator aponeurosis fuse superior to the tarsus. Figure 1: Anatomical variation of the upper eyelid.

Sims 4 double fold eyelid