Recently a girl came to the clinic and said that she and a classmate had a buried eyelid at an out-of-town beauty clinic. After the surgery, her classmate’s eyelids were quite good, but her eyelids were very shallow and seemed to be gone. How could the results be so different when they were done by the same doctor? The patient was examined and it was found that the strength of the muscles that lift the upper eyelids was poor and that he suffered from congenital bilateral ptosis, so double eyelid surgery using the buried wire method would not achieve its goal. What is ptosis? Ptosis is a condition in which the muscles that lift the eyelids are weak. Clinically, the lower edge of the upper eyelid normally covers about 2 mm below the upper edge of the cornea, and if it covers more than 2 mm, it is called ptosis. Ptosis is mostly congenital and can occur unilaterally or bilaterally. Unilateral ones are easily detected at once, while bilateral ones are not easily detected. Some patients are just told that their eyes are not looking good and they can’t open their eyes until they go to the hospital. In such patients, if the doctor is inexperienced and does not detect this condition beforehand there will be unsatisfactory results after the surgery and even disputes. So how do you do double eyelids in patients suffering from ptosis? The first half of the procedure is the same as the incisional eyelid procedure, in that a line is drawn before surgery, the upper eyelid skin is incised, and an orbicularis oculi muscle is removed, but then the levator muscle needs to be shortened to strengthen the muscle. This is the next step in the process to make double eyelids in patients with ptosis.