The double-eyelid operation without supratarsal fixation.

Among the considerations in the formation of the double eyelid, two factors are considered to be important. They are the levator insertion into the skin and the amount of soft tissue between the levator aponeurosis and the skin. The author assumes that the amount of soft tissue may be more importantly related to forming the double eyelid than the levator expansion. Based on this assumption, the author undertook a modified operation to create the double eyelid by removing excessive soft tissue without any fixation to the levator aponeurosis or the tarsal plate.