Your plastic surgeon can choose several techniques to create a permanent eyelid crease. They will discuss the best option based on your unique needs and goals.
This procedure is performed outpatient under IV sedation or general anesthesia. It’s common to have bruising and swelling after the surgery.
Preparing for the Procedure
Make sure to follow your doctor’s instructions to prepare for the procedure. You should avoid using contact lenses and limit your liquid intake before the surgery. You should also bring a friend or family member who can drive you home, as you will be under some anesthesia. It would be best if you also planned on staying home for a few days after the procedure because of the recovery process.
Your doctor will perform either an incision or non-incision technique for the double eyelid procedure. The incision method involves your surgeon creating a new crease and removing excess skin as needed in the upper eyelid. This method works best for patients with moderate to significant amounts of extra skin in the upper eyelid. It will leave a light scar along the length of the crease.
The non-incision method is the least invasive to perform double eyelid surgery. To achieve an eyelid crease, the surgeon will create small incisions in the skin and use permanent sutures. This option is ideal for patients without excessive fat or skin.
If you have a significant amount of loose skin or drooping (ptosis), your doctor may suggest a more intense procedure to help you achieve your desired outcome. They will likely combine the creation of a new crease with ptosis correction. This will help to strengthen your eye-opening muscles and create a more naturally appearing double eyelid.
During the Procedure
Your surgeon will numb your eyelids with local anesthesia. General anesthesia or IV sedation is optional and will depend on your preference. Then, they will make incisions along the double eyelid line marked before surgery. The procedure will involve the removal of both excess skin and fat. Then, they may insert sutures. These will need to be removed four or five days after the procedure.
The surgical incision is the most popular way to create a permanent eyelid crease. It allows the plastic surgeon to remove excess fat, control other tissues and ensure a long-lasting natural and defined eyelid crease. If needed, this method allows the plastic surgeon to perform concomitant procedures, like epicanthoplasty. It has the longest recovery time and is the most invasive of all the methods. However, it offers the best results that are difficult to revert to the original monoids.
Non-incision, double eyelid surgery can also correct unnatural-appearing high or deep folds. It is an alternative to the full incision technique, and it has fewer complications, such as unnatural-appearing crease heights and persistent high or deep fold incision scars. This type of procedure is only suitable for those who have surplus skin.
Post-Operative Care
Before the procedure, your eye care provider will do a complete eye exam. This might include tear production tests, a visual field test, or using an instrument to measure the thickness of parts of your eyelids. These tests can assist your doctor in determining if the operation is medically required, which can help you file an insurance claim.
Your surgeon will ask you about your cosmetic goals, and they might want to see photos of celebrities with the kind of double eyelids you would like to have. Depending on your facial proportions, your facial structure will also be evaluated to see if you would look better with a heavier or lighter crease.
During your consultation, you should disclose any medications and supplements you take, including vitamins, herbs, and over-the-counter medicines. Some of these drugs can thin your blood and make it more likely for you to bruise or bleed after your surgery.
The non-incision procedure relies on sutures to create a new fold and to deepen a pre-existing one. This technique has a lower success rate than the incision method, and it is not ideal for patients who need to excise excess fat or perform other concurrent procedures, such as epicanthoplasty. The incision method, however, has a higher success rate and can result in more reliable, beautiful, and long-lasting results than the suture method.
Recovery
Immediately after the procedure, your eyes will be covered with a bandage, and your vision may be blurry. Your doctor will instruct you to rest for a few days and avoid strenuous activity. You can use over-the-counter pain medication to ease any discomfort. During this time, it is essential to stay out of the sun as much as possible, as exposure can worsen swelling.
Your doctor will remove any stitches four or five days after the operation. Incisional methods will typically produce more swelling than non-incisional methods. However, both methods require similar healing periods.
If you choose the incisional method, your surgeon will mark the area for the double eyelid crease and then make several small incisions. Your doctor will remove fat tissue and the orbicularis oculi muscle through these incisions. This method is also considered the most permanent. It can create an eyelid crease that is longer and deeper than those achieved with the suture-ligation method.
The non-incisional method uses several stitches that ligate the upper eyelid skin, levator aponeurosis, and Muller’s muscle to create a double eyelid crease. This technique is less invasive and produces less swelling than the incisional method. However, the success of this method can be limited by the reliance on a few stitches to hold multiple layers of tissue. Additionally, this method is inappropriate for patients needing additional procedures such as epicanthoplasty.
