Chemical Decompensation for Frontalis-Driven Multiple Eyelid Folds After Revision Double-Eyelid Surgery

This study investigates the role of acquired compensatory frontalis activation in the development of multiple eyelid folds following revision double-eyelid surgery and explores the efficacy of a temporary intervention called chemical decompensation. The authors report a case where low-dose onabotulinumtoxinA was administered, resulting in reduced eyelid folding and improved patient perception, suggesting that dynamic frontalis traction may contribute to the deformity. They conclude that while chemical decompensation may aid recovery, further validation in larger cohorts is necessary to establish its effectiveness and diagnostic utility.