How long can double eyelid surgery done by non-incision method (stitching method) last?
How Long Do Double Eyelid Surgery Results Last?
Doctor Answers (15)
Double Eyelid Surgery Duration
Double eyelid surgery for Asian patients typically last several years with the incision technique, if not permanent. Even though it may be less invasive, the non-incision or suture method is not commonly utilized in the United States, since the results are typically shorter lasting. Speak to an eyelid plastic surgeon to help determine the appropriate option for you.
Long lasting non-incision Asian eyelid surgery
The non-incision or suture technique of Asian eyelid surgery can be life-long but there are a couple of things to know.
1. If the sutures are placed with absolutely no deep (but narrow) cutting then those tend to pull out since there is little to no scar tissue formed to aid the sutures.
2. If you wear contacts and place them by pulling up your upper eyelid everyday you can loosen the sutures hold over time.
3. As Dr. Kim said, the aging process will continue and you can have loose skin, fat, etc. contribute to the loss or hooding of your new eyelid creases, but that would likely be years from now.
4. If you have very thick upper lids with a lot of fat I feel like the suture technique this case is less than great, but the patients tend to be happy anyhow.
Dr. Chase Lay
Double Eyelid Surgery: Incisional or Suture Technique?
There are variations when it comes to the incisional and suture techniques when it comes to 1) the final appearance of the fold 2) the final apperance of the upper eyelids in general 3) how long the fold lasts and 4) the recovery period.
To answer your question, the incisional technique should last longer, but also has a longer recovery period. The longer recovery associated with the incisional technique is often acceptible to patients since the results are more permanent and the surgeon has more control to remove extra skin and fat (useful when the patient has eyelids that are ageing or puffy), and design the crease height and shape (inside fold, outside fold, etc).
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Incision technique gives a longer lasting and more reliable result
The incision technique gives a longer lasting and more reliable result than a non incision technique in most hands. When done correctly the results should last 10-15 years or longer. Essentially most results should be indefinite and be there permanently. There are ways to make sure that the crease stays. One method that I employ is the orbicularis-levator fixation technique which entails using internal sutures that attach the eye muscle that closes the eye (orbicularis) with the muscle and fascia of the muscle that opens up the eyes (levator).
These internal sutures are created with small nylon sutures that take a very long time to dissolve and sometimes never dissolve. I also employ the more traditional skin to levator fixation sutures as well to ensure that the crease stays as long as possible. Non incision techniques have a long history of having less than reliable fixation and also less definite crease formation. The risks of incomplete creases, asymmetry, and loss of the fold are much higher with the non incision techniques. In my experience, it seems that most experienced surgeons lean toward doing more incision techniques after they have done non incision techniques for several years.
Non-incision Asian eyelid surgery can last a long time.
In general, non-incision Asian eyelid surgery has a higher risk of losing the crease definition compared to other techniques. However, when this technique is well executed on patients with low risk of this complication, the results can and should last for a long time.
Double Eyelid Surgery Results
The results from a non-incision double eyelid procedure can last several to many years. However, the results from an incision double eyelid surgery last considerably longer, if not permanently. Even though the non-incision technique is much less invasive, the incision method is still better at creating more of an eyelid due to the procedure actually taking more of the excess skin away, whereas the non-incision method does not do that. At my practice we see more patients wanting the incision method due to the longevity of the results and having a higher crease.
How long does the stitch method last
There are several types of suture techniques. The longest-lasting techniques involve interlocking the sutures to the firm cartilage structures of the eyelid. A published study of this technique (DST) shows a 98% success rate at 7 years. This study was from Japan, and in my experience japanese eyelid anatomy seems particularly optimal for the DST (thin skin, minimal fat, symmetric eyes). For eyelids with thicker skin or fat, the suture method does not seem to last as long - more in the range of 4-5 years. Although the crease does not fail, it does fade out. Finally, patients in the younger 20's without ptosis do best. Older patients or those with preoperatively asymmetry are not candidates.
It depends on technique and expertise
This is a very good question as it means you probably already know the 2 main types of surgery for the "double eyelid" procedure. Regardless of technique, we would want the procedure to last your lifetime, but this does not always hold true as we cannot stop the aging process or external events outside our control.
The incisional method is still the "gold standard" as it allows the surgeon to have full control and access to the anatomy (levator, tarsus, orbicularis, etc) to precisely place sutures. It allows the surgeon to address any ptosis and any needed skin and/or fat excision. It is the most "permanent" way to create the fold.
The non-incision/minimal incision method does not allow the surgeon to have access in the same way. The procedure is designed to "trade" the scar and exposure for slghtly faster recovery and minimal scar. In certain individuals, this procedure is adequate; but in others, skin, fat, levator, etc need to be addressed and the non incision method may not even be the right option for you.
It is important to see a plastic surgeon with significant expertise in Asian eyelid surgery before you embark on this face-altering path.
How long does the Asian Blepharoplasty last?
This is a very tricky question because there are several variables that go into the longevity of an Asian Blepharoplasty (Double Eyelid Surgery). For the most part, Incisional techiques are thought to be more permanent due to the fact that if done properly, you are exactly creating the attachments from the levator muscle to the eyelid skin by the way of sutures and its subsequent scarring. In the instance of the suture/folding technique, you are relying on more of the integrity of the suture to maintain the attachment and often the suture can loosen or break or get extruded out by the body over time. Now I have many patients in my practice who have had the suture technique done over 15 years ago and they look great! But on rare occasion, I have had some patients with sutures issues (breaking, loosening, being pushed out through the skin by the body) which need to be corrected with a revisional surgery to maintain the symmetry. I hope that helps.
Incisional techniques last longer and are more predictable than suture techniques
There are pros and cons to both techniques of Asian eyelid fold creation. The advantage of the suture technique is that it is quicker to do, and there are no incisions made. The disadvantages are: longer healing time (swelling), less reliable (higher rate of early fold loss), and a less long lasting result. The advantage of the incision technique are: more predictable result, less recovery time, and usually permanent result. The disadvantages are that an incisional scar is created, and it is a longer procedure to perform.
The issue of longevity and predictability hinges on the ability of the scar attachments to form between the skin and the underlying tissues. An incision (a cut in the tissues) tends to create a much more durable and stronger adhesion when compared to the suture technique, and thus the difference.
These are generalizations of both techniques, and it does not mean that the disadvantages of one technique never occurs for the other.
To answer your question specifically, the suture technique will generally last years while the incisions technique is tend to be permanent. Good luck.
Lawrence Tong MD FACS FRCSC
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.