Monolid vs Double Eyelid: Should You Add a Fold, and Which Method Fits Your Lids?

Hello, I'm Dr. Im Young Min, chief director and a board-certified plastic surgeon at VG Plastic Surgery in Gangnam, Seoul. I did my internship and residency at Seoul St. Mary's Hospital, where I'm an adjunct professor of plastic surgery, and eyelids are one of the areas I operate on.

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Im Young Min

Chief Director · Board-certified in Plastic Surgery

• — Ph.D. in Medicine
• — Internship and residency, Seoul St. Mary's Hospital
• — Board-certified plastic surgeon, Seoul St. Mary's Hospital

In our eye center we check lid thickness, fat and lifting strength before deciding whether to cut at all, and three plastic surgeons share that center. A medical interpreter for your language is provided at no extra charge, so a conversation about millimeters doesn't depend on your Korean.

If you can't tell which side of that line you're on, send two photos on WhatsApp: eyes open looking straight at the camera, and eyes gently closed, both without makeup or tape. Ask one thing with them: does my lid have room for a fold? Your own lids are a better starting point than any description of them.

What actually makes a lid single or double?

A crease is a connection, not a wrinkle. In a double eyelid, fine fibers from the tendon that lifts the lid (the levator aponeurosis) reach forward into the skin. When you open your eye, they pull the skin in along that line and the skin above folds over it, like a curtain tied back at one height.

In a monolid, those fibers stop short of the skin. The fat behind the lid's thin inner membrane often rests lower and further forward too, so the whole lid rises as one smooth surface, more like a roller blind. Many monolids also carry a little more soft tissue between the skin and the muscle, which is why they can look fuller.

This is the part most comparisons skip. Creating a fold means building a new attachment and asking it to hold against the weight of whatever tissue sits above it. The fuller the lid, the more that attachment has to carry. If you want to know how common each lid type is, the figures are in our post on how many Asian eyelids really have no crease.

Is a monolid something to fix?

No. Most monolid vs double eyelid comparisons online treat the crease as the goal, yet a monolid is one of the ordinary shapes of a healthy eye. I see plastic surgery as a form of self-care, something people choose because it makes daily life a little happier, and that only works when the change is one you want for yourself.

These are the situations where I'd tell you to leave your lids alone, or to wait:

• Your eyes open fully, you like them, and the push comes from a photo filter or someone else's opinion.
• You want a high, wide fold on full lids. A tall crease forced onto heavy tissue tends to look thick and set, and it's hard to undo.
• Your eyes look tired because the lid itself sits low over the iris. A crease alone won't change that; the lift has to be addressed.
• You're still deciding. A fold is much easier to add than to remove. Taking a crease away is revision surgery, and a fully smooth lid is rarely what you get back.

If you're in that last group, eyelid tape or glue for a few weeks lets you live with the look before committing. One caution: years of daily tape or glue can stretch and irritate the thin lid skin, so if you've used them for a long time, that history matters when a surgeon plans your lid.

Which method fits which lid

Once a fold makes sense, the monolid vs double eyelid decision becomes a question of method. Our eye center's menu covers a natural-adhesion (non-incisional) fold, an incisional fold, and either one combined with ptosis correction when the lid's lift is weak. You can see how the eye center lists its procedures on the VG Plastic Surgery homepage.

A natural-adhesion fold uses sutures passed through tiny openings to link the skin to the lifting tendon. No skin is removed. It suits thin lids with little fat, good opening strength and no extra skin. The trade-off is durability: on thicker lids the stitches carry more weight, and the fold is more likely to loosen or fade over the years. If a short trip is your main constraint, fitting a non-incisional fold into one week of leave covers that version in detail.

An incisional fold is made through a cut along the planned crease. Excess skin, fat or a strip of muscle can be removed, and the skin is fixed to the tendon directly. It suits full lids, extra skin, people who want definition that lasts, and most revisions; revision cases are reviewed together by the eye center's surgeons before anyone operates. You trade a longer swelling period and a fine line that sits inside the fold once healed. The two approaches are set side by side in double eyelid surgery in Korea: incision or not, recovery and stay.

When the lid covers part of the colored ring of the eye, or you catch yourself raising your brows to see, a crease is paired with ptosis correction, which tightens the lifting mechanism so the eye opens wider.

The method is also what moves the quote most, which is why the cost of double eyelid surgery in Korea follows the method your lids need.

What does an inner double eyelid mean for your options?

An inner double eyelid is a crease that exists but stays hidden. You may see it only when you look down, or only toward the outer corner, because the skin above folds over it or the inner-corner fold (the epicanthal fold) covers where it starts. Look down into a mirror in daylight: a faint line there means some of those fibers already reach the skin.

That changes the plan. A low fold that tapers into the inner corner, often called an in-fold, may only need to be made visible, and that is where a non-incisional fold has its strongest chance of holding. A parallel fold that runs separate from the inner corner needs more height and sometimes inner-corner surgery (epicanthoplasty), which brings a scar of its own to weigh. If you already have an inner crease, mention it and include a photo looking down.

How high should the new fold sit?

Lower than the tape suggests, in most cases. A taped fold sits wherever you press it, with no swelling. A surgical fold looks higher and puffier for weeks while it settles, and a crease set high on a full lid can stay heavy-looking. Many people who ask for a dramatic fold end up happier with one a little lower.

Say your lids are full, you've worn tape every day since college, and the fold you love sits high. I'd look at how much skin and fat sits above your lashes, because that points toward an incisional fold. I'd check whether the tape has been hiding a weak lift, since some taped lids open less once the tape comes off. And I'd suggest a line slightly lower than your taped one, because a fold that suits your face once healed counts for more than its shape in the first weeks.

A photo with the fold you like taped in place, next to one of your bare lid, shows the distance between the look you want and the lid you have. Send both on WhatsApp with the dates you could travel, and ask whether that taped height would suit your lid.

Asymmetry, a fold that fades, and the other risks

Swelling, bruising, a tight feeling and a fold that looks too high are expected at first, along with mild dryness or watering. They usually settle over the following weeks, sooner after a non-incisional fold, and the crease keeps softening for months. How each lid heals differs from person to person, which is one reason the method is settled at the in-person exam rather than from photos alone.

Less common problems include folds that end up uneven, a non-incisional fold that loosens, an extra crease line, a scar that stays visible, or briefly finding it hard to close the eye fully. The American Society of Plastic Surgeons also lists infection, bleeding and, rarely, changes in vision among the risks of eyelid surgery.

As general medicine, some people should wait or talk it through first: untreated dry eye, thyroid eye disease, blood-thinning medicines or supplements, an active eye infection, pregnancy or breastfeeding, and recent eye surgery.

Three board-certified anesthesiologists work here full time and don't perform cosmetic surgery; one of them watches your blood pressure, pulse and breathing through the operation, so the surgeon does nothing but operate.

Once you're home, keep your operation notes with you. Pain that gets worse instead of better, swelling that grows on one side, a change in vision or a fever are reasons to see a doctor locally the same day. Before you book, ask on WhatsApp how follow-up works after you've flown back.

Your first message

On WhatsApp, send three photos: eyes open looking straight ahead, eyes closed, and eyes looking down, all without makeup or tape. Add how long you've used tape or glue and the dates you could be in Seoul. Then ask the question the whole monolid vs double eyelid comparison comes down to: is my lid suited to a fold, and which method would it need? When you're here, we check lid thickness, fat and lifting strength before anyone decides whether to cut, and that is where your answer starts.

Related pages:

• Eyes surgery at VG Plastic Surgery