Young Korean female with heavy creaseless eyelids. Surgery entailed skin, muscle, fat, and orbital septum trimming with creation of a permanent eyelid crease. This example demonstrates an aggressive approach. Tissue removal is usually more conservative.
This operation is often called the "incisional technique" and effects a permanent internal rearrangement of tissue rather than a simple crushing together as used with the less stable "non-incisional, suture, and DST techniques."