A double eyelid is an eyelid that forms a fold when the eye is opened. Patients may undergo an upper blepharoplasty to create a double eyelid. This may be done by suture methods or open incisional methods.

In suture blepharoplasty, a few tiny incisions are made along the proposed crease, and a fine suture is introduced through these tiny incisions to catch the deeper layers of the eyelid. The suture is tied and buried. The incisions are so tiny they heal practically without a scar. The suture loop causes an internal scar which creates adhesions between the skin and the deep tissues, creating the double eyelid fold when the eye is opened. 

In open blepharoplasty, an incision is made at the proposed crease. Excess tissues are removed. The double eyelid fold is created by suturing the deep tissues to the upper eyelid skin. This creates a distinct upper eyelid crease.

If you have a single eyelid or you have a double eyelid but would like it more prominent, you are a good candidate to consider double eyelid creation. 

Comparing between the two, suture blepharoplasty is a quicker operation and causes less swelling but is more suited in patients in whom the upper eyelid is relatively thin. In patients with thicker upper eyelids, a suture may cut through the tissues resulting in a loss of fold and a recurrence of the single eyelid over time.

In an open blepharoplasty, the skin is directly sutured to the deeper tissues, and excess muscle, fat and tissues may be removed, hence the fold that is created tends to be deeper and more permanent with less risk of loss of the fold. The incision is well concealed in the eyelid crease and is invisible when the eye is open. However, it takes slightly longer and the swelling takes a little longer to recover.

You will need to be assessed by a plastic surgeon. Your desired outcome will be discussed with you and an appropriate treatment plan can be made.

There is a small risk of infection and bleeding with any surgical procedure. There is a risk that the fold may be lost over time, the risk is higher with suture techniques but can happen with any technique. Every attempt is made to make the folds symmetrical, but there is a risk that they are not symmetrical.

If you’ve had suture blepharoplasty before, you may choose to try suture blepharoplasty again if you do not want an incisional blepharoplasty. Incisional blepharoplasty would be recommended, but it’s really up to you.

Incisional blepharoplasty would be recommended so that the excess skin could be removed at the same time.

Differences in the sizes of eyes are commonly due to ptosis (drooping) of one or both of the eyes. This can be corrected during your procedure.

The procedure will be done while you are awake, under local anaesthesia. This way we will be able to assess your eyelids during opening and closing.

You will experience some swelling, but you will be able to open your eyes.

You shouldn’t apply eye makeup for 2 weeks after the procedure.

Any cut in the skin will leave a mark, but for these procedures they will be very fine and hidden in the eyelid fold.