When most people think about double eyelid surgery, they focus on the idea of having a crease. What they often do not realize until they are sitting across from a surgeon is that the shape of that crease matters just as much as its presence — and that choosing the wrong shape for your facial structure can produce results that look artificial, asymmetric, or simply off.
At EyeFACE Institute, Toronto’s leading specialized eyelid and facial plastic surgery practice, this conversation happens in every Asian eyelid surgery consultation. The two primary crease shapes — tapered and parallel — are not interchangeable. Each suits a different anatomy, a different aesthetic goal, and a different face. Understanding the distinction before you book your surgery is one of the most empowering things you can do as a patient.
What Is a Tapered Crease?
A tapered crease — sometimes called an “inside fold” — begins very low or nearly invisible at the inner corner of the eye and gradually rises as it moves toward the outer corner. Rather than running in a consistent arc across the entire lid, it converges toward the inner canthus, following the natural downward slope of the epicanthal fold.
The result is a crease that looks organic, deeply rooted in the natural anatomy of Asian eyelids. It does not dramatically alter the inner corner of the eye, which means the epicanthal fold — the small skin fold that covers the inner corner, common in many people of East and Southeast Asian descent — is preserved rather than exposed.
Who it suits best:
The tapered crease is generally the more harmonious choice for individuals who have a pronounced epicanthal fold, a rounder or flatter facial structure, or eyes that are closer together. Because it works with the existing anatomy rather than against it, the tapered fold tends to produce results that read as natural — as though the crease was always there. It is the more commonly recommended shape for patients who want a subtle enhancement rather than a dramatic transformation, and for those who are concerned about maintaining the ethnic integrity of their appearance.
What Is a Parallel Crease?
A parallel crease — also called an “outside fold” — runs in a consistent arc across the entire upper eyelid, maintaining roughly the same height from the inner corner to the outer corner. Instead of tapering inward, it arcs evenly, creating a crease that is visible across the full width of the lid, including at the inner corner.
This shape typically creates a more open, wide-eyed appearance. It exposes more of the upper lid platform, making the eye appear larger and more elongated from corner to corner. For some patients, this is precisely the aesthetic they are seeking.
Who it suits best:
The parallel crease tends to be more flattering on individuals who have minimal or absent epicanthal folds, wider-set eyes, a more angular facial structure, or a narrower upper lid. It can also be appropriate for patients who have already had epicanthoplasty — a procedure that modifies the inner corner of the eye — since the inner corner is already more open and can accommodate a crease that begins at a consistent height.
It is worth noting that a parallel crease placed on anatomy that calls for a tapered fold can produce a result that looks too round, too wide, or incongruent with the rest of the face. This is precisely why the decision should never be made based on a photo reference alone.
The Variables That Matter More Than Preference
Aesthetic preference is important, but it is only one input in a complex equation. The oculoplastic surgeons at EyeFACE Institute assess several anatomical factors before recommending a crease shape:
The epicanthal fold. Its presence, depth, and angle largely determine whether a tapered or parallel crease will sit naturally against the inner corner of the eye.
Lid height and skin thickness. Thicker, heavier upper lid skin — characteristic of many Asian eyelids — responds differently to crease formation than thinner skin. A higher parallel crease on a heavy lid can look stiff or unnatural.
Eye width and spacing. Wider-set eyes can often carry a parallel crease without it appearing too round. Closer-set eyes generally benefit from the inward taper that visually balances the face.
Facial proportions overall. The eyes do not exist in isolation. A crease shape that looks beautiful on one face can appear incongruous on another — even when the eyelids themselves are identical.
Why This Decision Requires a Specialist
This is not a choice to make from a Pinterest board. The surgeons at EyeFACE Institute — including founder Dr. Harmeet Gill, MD FACS FRCSC — perform over 1,500 procedures annually, with a practice dedicated exclusively to the intricate structures of the eyelids and face. Unlike general cosmetic clinics, EFI’s oculoplastic surgeons bring a deep understanding of Asian eyelid anatomy and the microsurgical precision required to translate the right crease shape into a result that genuinely complements your face.
The right fold is not the most popular one. It is the one designed for you — your anatomy, your proportions, your vision of yourself.
Curious which crease shape suits your facial structure? Book a personalized consultation at eyefaceinstitute.com or call +1 (647) 351-6501. EyeFACE Institute is located at 4789 Yonge St, Suite #318, Toronto.