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Different Types of Folds

There are various types of folds a patient can achieve through double eyelid surgery. An ideal crease will be based on the patient’s preference and will complement their overall appearance. 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. A skilled plastic surgeon will recommend the fold that creates facial balance and harmony.

During the consultation, the surgeon will take into account the patient’s overall facial features, such as the presence of an epicanthal fold, size and shape of the eyes, visibility of the iris, underlying bone structure of the eye, droopiness of the eyelid and brow, asymmetry, etc. in assisting patients to choose their ideal folds.


An infold starts below the nasal corner of the eye and is situated lower than an in-out fold or an outfold. 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 looking, they lack the starker appearance which some of the other types of folds can provide. For patients with a smaller infold who desire a larger fold, they can opt for a larger infold, an in-out fold, or an outfold.


An in-out fold begins in the inner corner of the eye. This type of fold is not as subtle as the infold but still creates a natural looking fold without a drastic change. It provides the most natural looking 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 and the in-out fold. The fold will be created parallel to the curvilinear edge of the eye. 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.