The aim of this study was to describe the manifestations of post-blepharoplasty high eyelid crease patients and to propose steps of clinical evaluation and corrective operations. High eyelid crease patients were categorized into 3 groups, including pre-existing ptosis (PP), surgical induced levator compromised (SI), and high eyelid crease alone (HC), based on their MRD1 and signs of compromised levator muscle. The primary outcomes were the type and success rate of the operative techniques. The secondary outcomes were the complications. A total of 131 patients were enrolled, 7 males and 124 females, with an average age of 39.7 years. The mean scar height in the HC, SI, and PP groups were 10.4 ± 2.2, 12.8 ± 2.6, and 9.0 ± 2.0 mm, respectively. The scar height in the SI group was statistically differently higher than the other groups (mean: 1.7 mm, 95% CI: [0.91, 2.43]; P < 0.001). In total, 117 eyes of 67 patients underwent corrective operations with significant lower eyelid fold height and an 83.6% success rate. There were 6 re-operation eyes, 5 in the SI group and 1 in the PP group. High blepharoplasty incision scar can lead to surgical induced levator compromise and ptosis. Systematical evaluation and optimal corrective operations are needed to achieve targeted outcome.