Double Eyelid Surgery

An Example of Intradermal Stitch Blepharoplastry

Before the surgery	Immediately after the surgery There was a slight swelling on the patient’s eyelids.
1 week after the surgery	1 month after the surgery

We videotaped the surgery.
Please click here to see the video clip. (Japanese only)

Double Eyelid Surgery Methods

Intradermal Stitch Blepharoplastry

This is a procedure to create a fold on eyelids by tucking skin with a medical suture thread. This double eyelid surgery method was formulated in Japan in 1920’s. This procedure is widely practiced throughout Asia. It requires skilled techniques of an experienced cosmetic surgeon to successfully perform this surgery.

[Advantage of This Method]
This is a simple procedure to create a double eyelid fold. The post-operation swelling is kept minimal.

[Disadvantage of This Method]
Not all patients have physiological adaptability to this procedure. 5 to 10% of the patients who received the intradermal stitch blepharoplastry experience disappearance or thinning of a fold created by the surgery. [See “(2) Partial Incision” for an alternative double eyelid procedure.]

[Reasons for a Disappearing Fold]
Double-fold eyelid is created by eyelid skin attaching an organic tissue called a tarsal plate. Double eyelid fold created by this method tends to disappear over time among patients with droopy, thick or flabby eyelids and muscular men. Distance between eyelid skin and a tarsal plate created by fat or muscle tissue sets a double eyelid fold apart in some of these patients’ cases.

[Complications]
Our clinic adapts a method of raising eyelid muscles. This method ensures a high level of safety for patients’ eyes. Unlike a method often used by large cosmetic clinics, our procedure does not expose suture threads inside the eyelids and risk damaging the cornea.

[Droopy Eyelids (Blepharoptosis)]
This condition is known as “droopy and sagging eyelids”. Some people are born with weak muscles for eyelid opening. Contact lenses also weaken the muscles for eye opening. Eyelids also sag with aged and weakened muscles. If you answer “yes” to any of the following questions, you might have Blepharoptosis.
(a) Do you raise your eyebrows when you open your eyes?
(b) Do you have a constant headache and stiff shoulders?
(c) Do you have narrow eyes and people have a wrong impression of you due to the appearance of your eyes?
Insurance is accepted for the treatment of droopy eyelids at our clinic. The purpose of the droopy eyelid operation is to improve the function of eyelids, but you will also receive a bonus of a newly created double-eyelid fold after the surgery.

Partial Incision

This method is recommended for patients with thick and/or flabby eyelids and muscular men. In this method, a natural double eyelid fold is created by making a 10 mm incision on the corner of eyelids under a surgical microscope made in Germany. We boast our highly acclaimed techniques to stop bleeding from little blood vessels using a high precision microscope. We properly treat bleeding to minimize post-operation swelling and promote natural healing of a surgical scar. As a result, patients’ skin is kept flawless after the operation. Our method received high recognition at an international academic conference.

This patient received a microscopic partial incision operation.

	Before the operation.
	Immediately after the operation (with patient’s eyes open). Her skin was incised about 1 centimeter, but swelling and bleeding are minimal since bleeding was stopped with utmost care using a microscope.
	Immediately after the operation (with patient’s eyes closed). There are suture threads on the patient’s eyelids, but they are thin and invisible
	One week after the operation. The incision line is invisible because it merges with a double eyelid fold. Suture threads are removed in 5 days to a week after the operation.

[Disappearance of Double-eyelid Fold]

Some clinics guarantee that they repeat intradermal stitch blepharoplastry procedure every time a double eyelid fold disappears. It may sound easy and harmless to do so, but your eyelids and cornea may be damaged with suture threads if you repeat these procedures. In some extreme cases, patients have 5 or 6 pieces of threads under their eyelids. Patients whose double eyelid fold disappears after the operation performed by a skilled cosmetic surgeon, lacks adaptability to the intradermal stitch blepharoplastry. We recommend partial or total incision procedures for patients with droopy eyelids, thick or sagging eyelids.

[Our Policy on Additional Surgery]

If a double-eyelid fold disappears after an intradermal stitch blespharoplastry performed at our clinic, the patient can receive additional surgery (partial or total incision surgery) within one year of the initial surgery. Patients who request additional surgery are required to pay the difference between the initial surgery fee and additional surgery fee. (Costs for the droopy eyelid treatment covered by insurance are to be paid fully by the patient.)

Some patients request that a subtle double eyelid fold created for a confidentiality reason. Some want to change the location of the line after the surgery. Some cosmetic clinics advertise “free eyelid fold redo”. They seem to add suture threads without removing the original threads. It is medically harmful to insert multiple threads under your eyelids. It takes much more time and skilled work to remove original threads than adding new ones. We place our patients’ safety first and responsibly remove original threads when we perform additional surgery for a fee.

Please refer to my journal article, “Intradermal stitch blepharoplasty for orientals: does it disappear?” in Aesthetic Plast Surg. 24 (4): 289-91, 2000 if you are interested in the treatment of a disappearing double-eyelid fold.Aesthetic