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Background Double-fold operation is one of the most common types of surgery in Korea and can be divided into two major surgical techniques, incisional and non-incisional methods. Each method has its own advantages and disadvantages. Therefore, the author describes a new procedure to take advantage of both methods. Methods This procedure was performed in 127 consecutive patients (106 primary cases, 21 secondary cases) whose ages ranged from 19 to 65 years. First, a double-fold was made using the non-incisional method, and then excessive fat and redundant skin were removed using the incisional method. Fat was removed if necessary. For patients with blepharoptosis, before removing the redundant skin, this condition was corrected with the non-incisional Muller tucking ptosis method. Results Of the 127 patients, 122 patients were satisfied with the result. Edema and scarring were less than with the incisional method, and the postoperative result was easier to predict than with the secondary double-fold operation. Three cases had shallow eyelid lines, and one case had a complete loss of the fold. One secondary case patient had asymmetry that was corrected with revision. Conclusions Because satisfactory results can’t be achieved easily with the double-fold operation, a challenge for plastic surgeons is choosing the best method for the doublefold operation, especially in secondary cases. This new method that uses a hybrid technique that combines the incisional and non-incisional methods may be an effective choice when performing the double-fold operation in both primary and secondary cases.

The New Method of Double Fold Operation Using Hybrid Technique: Combined Incisional and Non-incisional Method