A triple eyelid (two folds) after double eyelid surgery is called a triple eyelid. The reason for this is that after the orbital septum is cut and the orbital fat is removed, the orbital septum is directly attached to the skin above the double eyelid incision. Prevention The subcutaneous tissue and orbicularis oculi muscle above the incision should be preserved as much as possible to avoid direct adhesion of the orbital septum to the skin. Repair 1. For mild and early trichiasis, the upper eyelid skin can be pulled to loosen the adhesions. In severe cases, surgical repair is required. The repair method is to cut the skin according to the original double eyelid line and peel it upward to loosen the adhesions; then suture the skin at the lower edge of the incision upward over the original lid suture point to the lid; and then suture and knot the skin at the upper edge of the incision.