"Sausage Eyes" After Double Eyelid Surgery: What Causes Them

It is easy to assume that a higher double eyelid crease means a more striking look. But if the crease is simply raised without regard to the eye's anatomy, you can end up with "sausage eyes," a puffy look as if the swelling never went down, which can be a real source of distress. This guide covers the causes and the right timing for revision surgery for anyone considering a high crease such as an in-out or outline crease for a glamorous, idol-style look, anyone planning to visit plastic surgery clinics around Sinsa Station in Gangnam, and anyone dealing with sausage eyes after a previous surgery.

What Causes Sausage Eyes?

It isn't just about crease height. Sausage eyes develop when the crease is set high without correcting ptosis (a weak levator muscle), or when the fixation point is placed too deep, which interferes with lymphatic drainage.

If the Eyelid Still Looks Puffy After 6 Months

Scar tissue and residual swelling usually improve between 3 and 6 months. If, after more than 6 months, the area below the crease still looks puffy and the skin is red, sausage eyes are likely.

Revision surgery is recommended at least 6 months to 1 year later, once the tissue has fully stabilized. Operating too early can lead to disappointing results because of scar tissue.

Choosing a Double Eyelid Crease by Skin Thickness

Key Takeaways

• Sausage eyes are caused less by crease height than by uncorrected ptosis and overly deep fixation points.
• If the eyelid is still puffy and red after 6 months, suspect sausage eyes; revision surgery is done 6 months to 1 year later.
• Choose your double eyelid crease based on skin thickness and whether you have ptosis.

The original article cites the Korean Society of Plastic and Reconstructive Surgeons' eye surgery guidelines and an analysis of clinical cases from major plastic surgery clinics in the Gangnam area.

※ This post provides general medical information, and results may vary depending on individual physical characteristics. Please consult a board-certified specialist for an accurate diagnosis.

---

Last reviewed: 2026-10-07 This article provides general medical information. Individual diagnosis and treatment plans are determined through an in-person consultation.