1. What is Double Eyelid Surgery?
Double eyelid surgery (also called blepharoplasty for crease formation) creates or reinforces the attachment between the levator muscle and the upper-eyelid skin, forming a defined supratarsal crease.
When you open your eyes, the levator pulls the skin inward and forms the fold. The right approach — incisional, partial incision, or buried suture (non-incisional) — depends on your skin thickness, fat volume, muscle tone, and degree of eyelid laxity.
Our Design Philosophy
A double eyelid is about proportion, not width. We design the crease in harmony with your eye shape, eyebrow position, intercanthal distance, and forehead profile.
Rather than forcing a heavy, exaggerated fold, we prioritize a natural impression, combining ptosis correction, epicanthoplasty, or upper blepharoplasty when needed for balanced results.
2. Three Methods — Incisional, Partial, Buried Suture
All three methods use the same underlying principle (creating adhesion between levator and skin) — they differ only in how much skin is incised. Selection depends on skin laxity, fat volume, and desired permanence.
Buried Suture (Non-incisional)
The lightest approach
No skin incision — fine sutures fix the levator to the skin at 3–6 points to form the crease.
- Pros: fastest recovery (swelling resolves in 3–5 days), virtually no visible scar, easier revision
- Cons: crease may loosen over time, cannot remove fat or excess skin
- Best for: thin eyelids without fat or skin excess, patients in early 20s–30s
Partial Incision
A balanced middle ground
A small 5–8 mm incision at the central eyelid allows partial fat/muscle removal and durable fixation.
- Pros: longer-lasting than buried suture, partial fat removal possible, minimal scarring
- Cons: slightly longer recovery than buried suture (swelling 5–10 days)
- Best for: mild fat puffiness, or cases where buried suture would be insufficient
Full Incision
The most definitive approach
The entire designed crease is incised, allowing removal of excess skin, fat, and muscle with permanent fixation.
- Pros: most defined and permanent crease, can address skin/fat excess, can be combined with ptosis correction
- Cons: longest recovery (swelling 1–2 weeks, final settling 3–6 months)
- Best for: skin/fat laxity, patients who want a definitive crease, revision after loosened buried suture
3. At-a-Glance Comparison
Key differences across the three methods
| Aspect | Buried Suture | Partial Incision | Full Incision |
|---|---|---|---|
| Incision extent | None (sutures only) | 5–8 mm | Full crease line |
| Swelling resolves in | 3–5 days | 5–10 days | 1–2 weeks |
| Suture removal | Not needed | Day 5–7 | Day 5–7 |
| Scar | Virtually none | Very small | Along crease (fades with time) |
| Fat / skin removal | ❌ | △ partial | ✅ full |
| Permanence | May loosen over time | Semi-permanent to permanent | Permanent |
| Typical candidate | Thin eyelid Early 20s–30s |
Mild fat puffiness | Skin/fat laxity, revision |
4. Good Candidates
Monolid / Inner fold
Patients who want a defined supratarsal crease
Asymmetric eyes
Patients with uneven creases who want symmetry
Loosened crease
After buried-suture loosening — wanting a defined fold again
Sleepy-looking eyes
Heavy eyelids needing a fresher impression (possibly with ptosis correction)
Aged crease
Crease flattened by aging skin (consider combined upper blepharoplasty)
Subtle natural fold
Patients preferring a soft inner or outer fold over a heavy line
5. Recovery Timeline (Full Incision baseline)
Buried suture recovers faster; partial incision falls between the two.
Day of Surgery
Local or sleep anesthesia. Cold compression all day to minimize swelling and bruising. Mild pressure sensation rather than pain.
Peak swelling passes
Swelling starts to subside. Gentle face washing is allowed. Bruising migrates downward and fades.
Suture removal + return to daily life
Sutures removed at the clinic. Large swelling gone; light makeup can cover residual signs. Most patients return to work.
Natural crease emerging
Residual swelling continues to subside; the crease looks increasingly natural. Scars fade from pink toward skin tone.
Final result
Micro-swelling fully resolves and scars fade substantially. This is the final settled result.
Side effects · Important precautions
- Possible side effects: swelling, bruising, transient dry-eye sensation, scarring, asymmetry.
- Buried suture may loosen over time and is not strictly permanent.
- Rarely: crease asymmetry, loss of crease, entropion/ectropion, suture exposure.
- Avoid alcohol, vigorous exercise, sauna, and contact lenses for the first week.
- Final result settles over 3–6 months; individual healing and skin condition vary.
- If ptosis is present, a simple double eyelid alone may be insufficient — combined ptosis correction is recommended.
Book a Double Eyelid Consultation
The best method depends on your eye and skin anatomy.
A 1:1 in-depth consultation will design the most natural crease for you.