Although the sparrow is small, the double eyelid is a less invasive cosmetic procedure, but there are more details to pay attention to. The question in this article is, will I become a triple eyelid after having a blepharoplasty? This question is also asked quite a bit, especially by every girl with an inner double before surgery. The answer is that with the right operation it often does not. First of all, it is certain that some normal people have trichiasis, which is called “primary trichiasis”. Primary trichiasis is caused by a reduction in the volume of fat in the upper eyelid, resulting in more folds in the upper eyelid skin when the eye is opened. Some people experience some degree of atrophy of the fat volume in the orbital septum as they age. If previously single-lidded and fleshy-eyed, they may become double eyelids with age, or if previously double eyelids, they may subsequently become triple or quadruple eyelids. If you have 3 eyelids after eyelid surgery, you have “secondary trilobism”. Excessive removal of tissue under the skin above the lid line is the primary cause of secondary trichiasis. In particular, the removal of fat under the medial orbicularis muscle is most likely to cause this condition. In addition, sometimes the desire for better lid line fixation can occur if too much tissue is removed above the lid fixation line in front of the lid plate or in front of the levator aponeurosis. Take a look at Figure 6 of the article, although the drawing is generic and unclear. Figure 1 The black line represents the heavy lid fixation line. The red area represents the extent of soft tissue removal, and if the extent spans to the top, there is a greater probability of trichiasis. Figure 2 Also, trichiasis can occur when the eyelid line is too high and is reattached at the same height as the previous restoration. In fact, triple eyelids can sometimes be quite beautiful, as so many people have original ones! But the key is that if you are looking for a double eyelid, and you have a trilobite, you are not getting the right product, which is against your original intention. How to solve it? Figure 3 Figure 4 If the crease above is shallow, sometimes a simple fat injection may solve the problem. But most of the time it needs to be re-incised to correct it. The flap above the lid line needs to be loosened with the levator muscle and orbital septum to often solve the problem. If this is not possible, the fat in the orbital septum can be released downward or the orbicularis oculi muscle can be moved downward. Figure 5 Another option mentioned in the article is to suture the upper skin and orbicularis muscle together into a slight rolled structure with adhesive tape on the surface, which can also be effectively avoided. But personally, I think it is not necessary or quite troublesome. This is probably the story of triple eyelids, but there is still the question of “will the inner pair become triple eyelids after having double eyelids”, so I will write about it next time.