1. Racial reasons
About 70~80% of Koreans are originated from the northern Mongolian race so they have single eyelids. The remaining 20~30% are from southern Mongolia and other mixed races. It is statistically shown that 70-80% of Koreans have no double eyelids. Northern Mongolian races having no double eyelids among the other various races provide a definite differentiation between people with double eyelids and those with Mongolian folds.
2. Anatomical reasons
An eyelid is anatomically composed of various different tissues (skin, muscle, fat, tarsal plates, conjunctiva (waterline) and so on). The tissues that help the opening of the eyes, called the levator muscle, is attached to the upper tarsal margin, and some parts of the muscle tissues are also attached to the back side of the eyelid skin. Based on this mechanism, a double eyelid is made simultaneously by the pulling up of the skin when the eyes open.
Cause 1.
In eyes with a double eyelid, parts of levator muscle are attached to the back of the skin. On the other hand, an eye without a double eyelid has a structure called an orbicularis oculi muscle which is thicker. Also, the fat tissue is drooped down and blocks the formation of the double eyelid.
Cause 2.
The Mongolian folds(epicanthus) add volume to the corner region, forming thick a fibrous band. This vertically acting tension band forms an adverse effect against a horizontal double eyelid crease. The Mongolian fold(epicanthus) delivers the power to the levator muscle toward the opposite direction when the eyes open, and it acts as a major disturbance of a double eyelid formation and often disrupts the ideal conditions for surgical completion.
Example) Only a double eyelid surgery performed on the Mongolian fold. They look severe.
Example) Structural double eyelid surgery combined with Magic epicanthoplasty in severe Mongolian folds.
Example) Revisional double eyelid surgery combined with Magic epicanthoplasty in severe Mongolian folds.
Although a double eyelid surgery has been the most popular and well-known procedures ever, the importance of the Mongolian folds or epicanthoplasty have been failed to be noticed because of the limitations of existing or conventional surgeries. Recently, the Magic epicanthoplasty proves its effectiveness on Mongolian folds. These two combined procedures (double eyelid surgery combined with Magic epicanthoplasty) become the new paradigm of the eyelid surgery.
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