Indication for a suture (non-incision) double eyelid surgery – When to do a suture technique double eyelid surgery

One of the most common questions patients have during a consultation is whether they are a

candidate for a suture technique double eyelid surgery. This is actually a simple question that

patient can also determine for her or himself.

Suture technique double eyelid surgery should be done when

1. Patient has eyelid symmetry

2. Patient does not have excess upper eyelid skin

3. Patient has eyelid elevating muscle (levator muscle) symmetry.

4. Patient has relatively thin eyelid skin

5. Patient has excellent eyelid elevating muscle function (no eyelid ptosis)

As you can see from above, the key word is symmetry. This is because the suture technique

simply makes a fold from the skin at the desired fold height to the muscle that elevates the

eyelid (levator muscle). Therefore, it does not remove any excess upper eyelid skin and it does

not correct any eyelid asymmetry.

Patients can try to see for themselves by applying tape to the upper eyelids. If the double

eyelid fold looks even, then they have relative symmetry of their eyelids. And if the double

eyelid stays on for the entire day, then they have great eyelid muscle function. However, if not,

then they should undergo open, incision double eyelid surgery with possible ptosis correction

to resolve these issues of asymmetry of eyelid lids and weak eyelid muscle function.