1. The suture technique double eyelid surgery is by far superior to laser double eyelid surgery. The reason is that laser double eyelid surgery uses laser to cut the skin. There are many surgical devices that surgeons can use to cut skin in soft tissue as well as to stop bleeding. Those are either traditional electric cutter or they could even be sound wave cutter or laser. The problem with laser is that it burns and thus desiccates or dries/chars out the skin. Therefore, even though it sounds high tech, it is actually not always the best in surgery. Especially for double eyelid surgery, you would not want to make any incision because any incision will create a scar whichever method you use to cut skin or to coagulate, or to stop bleeding. Therefore, non-incisional suture technique will be the best.
2. In terms of suture technique having a 1% breakage rate, there is no significant research data confirming this. The sutures used in double eyelid surgery are permanent sutures, and a permanent suture should not break. Therefore, to even use the word breakage rate is a misnomer. What is more adequate is “loosening of the fold”. No matter how tight or strong a fold creation is made, it’s not that the breakage of the fold is occurring because the suture is breaking, but because it is because of physiologic reasons. Therefore, a thorough diagnosis and advanced suture technique utilizing the patient’s anatomy are extremely important.
3. A good suture technique where one suture is used to create the fold should create a full fold rather than a partial fold. Some people feel that because there are a few pinhole dots made to bury the suture, a fold will be made only where there is an underlying suture. This is not correct. A good suture technique will utilize one suture and will create a full fold across the eyelid.
4. Swelling does not have to do with whether laser, an ultrasound (a soundwave device) or an electro cutter is used. These are all methods to just coagulate the bleeding tissue or to cut tissue. In fact, swelling has to do with what kind of surgical technique is used and whether deeper structures were touched and operated upon. For example, if the deep underlying muscle is manipulated to strengthen the eyelid, then the swelling will be significantly greater. A good analogy is when somebody gets a simple scratch or a light bump on the arm then there won’t be a significant swelling. However, if there is a big hard hit to the bone, then there will be much more swelling. It has to do with how deep the surgery is performed, not which device is used.