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The Ideal Crease

Different Types of Folds

There are various types of folds a patient can achieve through double eyelid surgery. An ideal crease is one in which the patient prefers and one in which will complement the overall appearance of the patient. At times, the type of crease preferred by the patient is not always the suitable size as it may not be proportional to the patient's eyes and/or face. In such instances it is important that the patient rely on a knowledgeable plastic surgeon's aesthetic abilities when determining the type of fold that is most natural for one's overall look. During the consultation the surgeon will consider factors of patient's overall facial features, such as the presence of an epicanthal fold, size and shape of the eyes, visibility of the iris, etc. in assisting patients to choose their ideal folds.


An infold starts below the nasal corner of the eye and is lower in height compared to the other types of folds. Patients that desire an infold tend to be younger, more conservative individuals that seek a more subtle change. Although infolds are more natural and subtle, they lack the starker appearance which some of the other types of folds can provide. In some cases, patients have an existing smaller infold and desire a larger infold, an in-out fold, or an outfold.

In-out Fold

An in-out fold begins in the inner corner of the eye. This type of fold is not as conservative as the infold but creates a natural looking fold without a drastic change. It provides most natural folds for patients undergoing the open incisional double eyelid procedure.


An outfold begins above the inner corner of the eye and is higher than the infold or in-out fold. The fold will be created parallel to the curvilinear edge of the eye, and this type of fold is most commonly found in Non-Asian eyes. Thus, patients who seek an outfold tend to desire a more dramatic change in their appearance.