The downsides or negatives of a suture technique (non-incision) double eyelid surgery and incision technique (open) double eyelid surgery
As with any procedures, there are negatives as well as positives to surgery. So in the case of the suture technique (non-incision) double eyelid surgery, a negative aspect is fold loss. A majority of suture technique double eyelid surgeries leads to fold loss for the following reasons: 1. The suture can cut through the tissue within the eyelid. 2. The suture itself can tear. 3. The patient has weak eyelid muscles so a connection between the eyelid muscle and the skin is not well formed. You can tell the cause of fold loss by observing the following: In the case where the suture has cut through the surrounding eyelid tissue (cheese-wiring effect), the fold loss is gradual. The fold height becomes smaller over time. So what used to be an ideal fold height becomes smaller, and now becomes a small infold. In the case where the suture itself tears, the fold loss is not gradual but you suddenly notice it. And in the case of weak eyelid muscles, the double eyelid surgery makes you look more sleepy or tired and your eyes feel heavy after surgery. These double eyelid folds lose their connection within a few months to a year.
The downside or the negative of the incision technique (open) double eyelid surgery is that there can be a visible scar. Another issue is the more prolonged swelling and healing time. We have seen patients who had incision technique (open) double eyelid surgery that looks unnatural. You can tell that the person had surgery. The characteristic sign of an unnatural double eyelid fold is a visible scar and fullness of the fold. The visible scar is especially noticeable when the person closes her eyes and the fold does not move with eye opening and closing. The fold and the visible scar is present all the time. A natural double eyelid fold moves with eye opening and closing. The other issue of fold fullness is called “sausage” (in Korean), as it looks like a sausage on top of one’s eyelid. This type of unnatural fold combined with prolonged swelling is the downside or negative of the incision technique (open) double eyelid surgery.
However, we mentioned in the previous blog that the indication for the suture technique double eyelid surgery is limited whereas the indication for the open technique is much greater. Yet we see a lot of patients who wishes to have the suture technique double eyelid surgery because of the negatives of the incision technique (open) double eyelid surgery. Unfortunately, many of these patients have the suture technique, then lose the fold, and then undergo suture technique again (for the fear of incision technique), and then finally get the incision technique because the suture technique does not work for them. These patients then develop the negative stigmata of the incision (open) technique just mentioned. These people may end up paying for 2 surgeries and lost time going through the surgery and recoveries. It is much wiser to have surgery one time by determining which procedure is best for you. And if you do need incision technique (open) double eyelid surgery, receive the dynamic open technique that does not leave the negatives of scar, fullness of the fold, and prolonged swelling. In the next blog, we will discuss how we can perform an incision technique (open) double eyelid surgery without the negatives mentioned above.