Sutured upper eyelid surgery is a specialized methods primarily marketed to young individuals of Asian descent who lack a double upper eyelid. The methods go by a number of names including closed blepharoplasty, suture method blepharoplasty, double suture and twisting (DST) method, threaded eyelid surgery, non-incisional or partial incision blepharoplasty. The method offers the promise of inexpensive, minimal down time, non-incisional eyelid surgery. The only thing that does seem certain about these procedures is that the results are not permanent and for many the effects are gone in less than a year. Having studied the effects of this surgery, it is the opinion of Dr. Steinsapir, a leading eyelid surgeon, it’s better to find a real eyelid surgeon who can perform permanent double-fold blepharoplasty.
How does sutured eyelid surgery work?
Double fold surgery with a threaded suture works by using stitches to create and maintain an eyelid fold. The crease is created by burying permanent, non-reactive sutures and pinching the undersurface of the eyelid skin to the deep soft tissue of the eyelid. The problems arise when the sutures break over time or start migrating through the skin. The recently developed method called Double Sutured and Twist (DST) technique purports a solution to this problem, however it does not solve the other problems created by this technique.
Problems with sutured eyelid surgery
Sutured double-fold surgery is often performed very quickly. In some parts of the world non-medical providers will do the work. As we have said so many times before on this blog, it is important to find an experienced medical professional to perform any cosmetic procedure, no matter how simple someone advertises it to be.
Sutured double-fold surgery and DST double-fold surgery are not a permanent solution. Not only do the sutures have a record of breaking or migrating, but the fold is often less distinctive than a fold created using an incision technique. Many patients who have undergone sutured double-fold surgery notice that their crease begins to lose definition over time and due to the lack of control this procedure is known for, asymmetry in the lids is also common.
The best double-fold surgery technique
To make a lasting crease, it is necessary to perform a surgery to make a strong attachment between the skin at the crease and the levator aponeurosis, the tendon that raises the upper eyelid. Although this method occasionally fails and the crease loses integrity, for most people, the result of surgery lasts a lifetime.
Although cosmetic surgery textbooks recommend the placement of the crease 2 millimeters to 4 millimeters higher than experience dictates. Physicians who specialize in Asian eyelid surgery are informed by experience; and experience indicates that the incision tends to migrate upward as the eyelid heals. For the best Asian blepharoplasty results, you need a minimally invasive treatment plan that preserves as much natural tissue as possible. A less aggressive, yet highly controlled surgery creates the fastest recovery time, natural improvements, and precise results.
Restoring the eyelid fold
When sutures fail, the defined upper eyelid crease begins to disappear. There can be changes to the fold that are unsatisfactory with asymmetry between the two eyelids. Careful incisional anchor blepharoplasty can be performed to restore the appearance of the eyelids despite prior suture procedures. Since these types of situations can present unique issues, there is no substitute for a personal consultation with an eyelid surgery expert like Dr. Steinsapir.
About Dr. Steinsapir
Dr. Steinsapir is a board certified eye surgeon and fellowship-trained in oculoplastic surgery and cosmetic surgery in Los Angeles where he specializes in balanced facial cosmetic surgery for natural results, with an emphasis on minimally invasive techniques, fast recovery time, and leadership in medical technology. Dr. Steinsapir has a private practice and also serves as an Associate Clinical Professor of Ophthalmology at the Jules Stein Eye Institute, at the David Geffen School of Medicine at UCLA. Contact us today to learn how Dr. Steinsapir’s experience and training make him an expert in cosmetic surgery, which can be a vital part of your evidence-based treatment plan.
To learn more about procedures and treatments performed by Beverly Hills | Los Angeles Facial Plastic Surgeon, Dr. Kenneth Steinsapir, contact us at 310-274-7422.
Services described may be “off-label” and lack FDA approval. This article is informational and does not constitute an advertisement for off-label treatment. No services should be provided without a good faith examination by a licensed physician and an informed consent with a discussion of risks, benefits, alternatives, and the likelihood of treatment success. Only you and your treating physician or surgeon can determine if a treatment is right for you.