Double eyelid (Asian bleph) techniques: I am confused about the differences.

Question

I am confused about the differences between the DST; 3 point suture; 6 point suture; and partial incision techniques (1-1.5 cm incision); and the micro-incision method. Could someone please kindly explain the differences in how these procedures are accomplished. Also, which lasts the longest, what are the pros/cons etc.

Charles S. Lee, MD, FACS · Answer

You're describing different types of suture-based eyelid surgery, which avoids a full incision. Regardless of which technique, the primary difficulty is that many if not most Asian eyelids have some measure of muscle weakness (ptosis) that needs to be addressed in order to avoid making the eyes look sleepy. Ptosis repair performed internally can be done at the time of a suture - based crease surgery, but it's much more straight forward and precise to do a classic full incision. I will do a suture method -3 point or 4 point fixation on the right candidate or if the patient really hates having an incision, but the results are less reliable both in durability and precision.

Elbert T. Cheng, MD · Answer

Hello and thank you for your question. The overall advantages to all of the different suturing techniques you have listed is that they allow doctors to avoid making an incision when performing a blepharoplasty procedure. While each of the suturing techniques has its own specific advantages, they also share a common disadvantage, a limited effectiveness compared to blepharoplasty procedures utilizing an incision. A blepharoplasty using an incision will provide most patients with a predictable and long-lasting result. However, if you will not tolerate an incision, consult with your board certified facial plastic surgeon about which specific suturing technique he/she has the most first-hand experience with, and which he/she feels most confident using with his/her patients. Best of luck!- Elbert T. Cheng, MD

Umeng David Thao, MD · Answer

Thanks for your question. The techniques you described may be done on a particular candidate and may not last as long as the incision technique.  Most of my patients prefer to do the full incision bleph because the result is more predictable and longer lasting.  I encourage you to visit a board certified plastic surgeon in person to discuss your options. Make sure the surgeon has extensive experience in Asian eyelid surgery.  Best wishes!

Karthik Ram, MRCS, DNB · Answer

Hello Thanks for your question. All of the methods you asked are non incision technique. There are certain disadvantages of the above techniques of non permanence of crease.  For bulky eye lid and more refined results better opt for excision/ open techniques.

Double eyelid (Asian bleph) techniques: I am confused about the differences.

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