A well-formed, crisp and natural double eyelid fold can make the eyes appear larger. Quite often, an absent or low double eyelid fold can be associated with a droopy eyelid in general, leading to a condition known as eyelid ptosis.
If this happens, part of the procedure that needs to be done would be raising the eyelid as well as creating the double eyelid fold.
The suture (or stich) upper blepharoplasty is a minimally invasive (or ‘closed’) form of double eyelid creation. It avoids the needs for large incisions, and relies on a good knowledge of anatomy to precisely place sutures in the appropriate structures to create the double eyelid crease.
It can be done under local anaesthetic in the clinic, and has relatively little bruising or swelling. As there is no ability for skin or fat to be removed, it is not suitable for all upper eyelids, especially the ones with heavier skin.
Other complications, though seldom and mild, include asymmetries, recurrence of single eyelid, and eye irritative symptoms. However, in select patients, the suture upper blepharoplasty can yield great, lasting results with minimal downtime.
Incisional double eyelid surgery involves a longitudinal skin incision where the eventual double eyelid crease will be created. Utilizing this ‘open’ approach, the anatomy of the upper eyelid can be clearly seen, and precise sutures can be placed in the relevant upper eyelid structures to create a lasting, natural crease. In addition, an open approach enables better control of any skin that needs to be excised or any fat that needs to be removed.
The downside as compared to the ‘closed’ suture blepharoplasty is that the bruising, swelling and recovery time will be a few weeks longer. However, it is the most powerful way of creating a pleasing double eyelid fold.
A hidden double eyelid is an eyelid crease that is present but is not easily perceptible due to it either being too low, or there being too much skin/fat/muscle overhanging the crease such that it cannot be seen. This can be surgically corrected with the appropriate procedure, as discussed with your plastic surgeon.
Just as hidden double eyelids are caused by skin/fat/muscle overhanging the crease, a double eyelid that disappears is due to swelling of the tissue around the eyelid crease which causes the crease to be camouflaged. This can be caused by conditions which lead to water retention in the eyelids, such as lack of sleep, crying or post-procedural swelling, amongst others.
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