Double eyelid surgery is one of the most popular cosmetic surgical procedures in Asia, and in 2015 alone there were more than 1.3 million double eyelid surgeries performed. Also known as East Asian Blepharoplasty, double eyelid surgery first gained popularity in South Korea and Japan and many of the techniques that local surgeons in Singapore use are inspired by the pioneering plastic surgeons in those regions.
Types of double eyelid surgeries
There are three ways to attain double eyelids through cosmetic surgery:
The incision method involves cutting and is suitable for all types of eyelids. In addition to surgically removing and reshaping the tissues in the eyelid, excess fat and loose skin can also be eradicated. The recovery period for patients who undergo the incision method of double eyelid surgery is comparatively longer than those who have the sutured surgery, with the full recovery time being between 3 to 6 months. During this recovery period, the initial puffiness of the eyelids post-surgery will ease and the double eyelids will gradually look more natural. Incision double eyelid surgery is permanent and long-term.
The sutured method of attaining double eyelids is a non-invasive process that utilizes stitches to create creases on the eyelids. Commonly known as the ‘pinch method’, this is a popular option for those who are reluctant to go under the knife. However, the sutured method is only suitable for those with eyelids that are not droopy (Ptosis) or overly-thick. The recovery period for the suture method is short and patients can return to their normal daily activities within 2-3 days after surgery.
This method of double eyelid surgery combines both the use of sutures and the full-incision technique to minimise scarring and for a more natural look. An incision is made to remove excess fat in the eyelids before stitches are used to tighten the skin and to create creases in order to form the double eyelids. It will take up to 2 weeks for patients to completely recover from the partial-incision surgery.
The buried suture method – Variations
Many different variations of the suture method have been created to cater to the diverse types of eyelids in order to achieve the best results.
Here are some of the more commonly used types:
- Hata method with 3 sutures
Created in 1933, the Hata method is suitable for those with very thin eyelids and makes use of 3 knotted stitches at different points on the eyelid to form a double eyelid crease. While it may be an old method, it is still being used in modern cosmetic surgery.
- Multi-suture method with 5 sutures
This is a more secure way to create double eyelids with the use of more sutures and the thickness of the eyelids can be adjusted as well. The results are natural-looking double eyelids and there is a short recovery period.
- Double Suture and Twist (DST)
A technique invented in 2001 by Dr Akihiro Minami, a famous plastic surgeon in Japan, the Double Suture and Twist method is now commonly performed by surgeons in Japan, South Korea and in Singapore. It allows for minimal scarring and the recovery period post-surgery is short. The entire process takes about 30-40 minutes to complete and it is a fairly straightforward procedure.
How is it done?
Firstly, a local anaesthetic is applied to the eyelids. Next, the surgeon will make 3 tiny holes in the upper eyelids through which 2 stitches will be threaded. These two sutures will be twisted around each other 4 to 5 times before being tied together to fashion a fold on the eyelid. With the sutures in place, the skin on the lower part of the eyelid is drawn backwards to create a crease when the patient opens his/her eyes.
The Pros and Cons of Double Eyelid Stitching
- Pros – Besides the fact that it is obviously less invasive than the incision method with no cuts being required, the suture method of double eyelids surgery is also quick, with most procedures being completed in less than an hour. Another point to note about Double Eyelid Stitching is that it takes less time to recover from the procedure. While it takes up to 6 months to recover from a surgery involving incisions, the recovery time for the suture method is only 3 – 7 days. The suture method of double eyelid surgery is also reversible. Should the patient fail to adapt to their double eyelids or they feel uncomfortable with them, they can opt for a procedure to revert to the eyelids they had prior to the surgery.
- Cons – Double eyelids stitching ensure temporary but extended results (it can last up to 5 years) but ultimately it is still a procedure that will not offer a permanent result and further surgery is required once the creases that form the double eyelids disappear over time. Unlike the incision method which is able to address other issues in the eyelids such as being able to remove excess fats and loose skin, the suture method is effective only in the formation of creases in the eyelids that mimics double eyelids. Therefore, only those with thin eyelids (i.e. absence of loose skin, droopy eyelids) can undergo this procedure.
- Type of eyelids
If your eyes are heavy-lidded, meaning your upper eyelids have a more fatty tissue, you only have one option when it comes to double eyelid surgery and that is to go for the incisional method. This is because the incisional method allows for the extra skin or fats on the eyelid to be removed to create more aesthetically-pleasing double eyelids. The non-incisional method will not work on those with heavy eyelids as the stitches that are created will not be able to take the weight of the extra tissues and is very likely to come undone very easily.
- How much time do you have?
The post-surgery downtime for the incisional and non-incisional methods vary in terms of the duration of the actual procedure, healing period and the time it takes for the effects to look natural. The incisional method of double eyelid surgery lasts 45 to 60 minutes in the procedure room, has a downtime of 2 to 4 weeks post-surgery and will take up to 6 months for the effects of the surgery to look natural as the swelling gradually subsides. The non-incisional method will take less than 30 minutes in the procedure room, set you back 5 to 10 days as you rest and heal, and you will have natural-looking double eyelids within 2 months.
- Are you sure?
Some may regret their decision after they have had the surgery. Fortunately, for those who would like to reverse the effects of their double eyelid surgery, it is possible to do so, but only if they have opted for the non-incisional method. Conversely, if you are dead set on the surgery and are very sure that you will not want to undo the effects, then the incisional method is the way to go as the effects are permanent.
Which is more popular?
The non-incisional method of double eyelid surgery is the more popular type that many opt for. This is due to it being less invasive with no cutting required, as well as there being less scarring and swelling, shorter downtime post-surgery. Most importantly, it is reversible.
When it comes to the cost of non-incisional double eyelid surgery, it is less than the incisional method and it will set you back $3,200 to $3,500. The incisional method of double eyelid procedure is priced at $3,800 to $4,500.
Cosmetic surgeons in Singapore
One of the more prominent cosmetic surgeons specializing in double eyelids surgery in Singapore is Dr Shens of Shens Clinic. He trained in South Korea and has developed a special technique based on the DST method known as the Korean-style Double Eyelid Creation. His take on the DST guarantees a longer crease along the eyelids and one that is completely free of any scarring.
Dr Ng Siew Weng is another cosmetic surgeon who travelled to South Korea to train in plastic surgery. He was the first cosmetic surgeon from Singapore General Hospital to undergo a one-year fellowship program in South Korea which allowed him to work with famous plastic surgeons in the country. As a result, his technique is strongly influenced by the work of the South Korean surgeons and one of his specialities is Blepharoplasty.
The outcome of a double eyelid surgery, whether it is the incision or suture method, is largely dependent on the skills of the plastic surgeon performing the procedure. It is therefore important that before anyone makes the decision to undergo double eyelid surgery, there has been ample research done on the procedures involved in and the implications of the surgery, as well as on the experience and expertise of the cosmetic surgeon. It is important to take into consideration the factors mentioned above when deciding if you should undergo the incisional or non-incisional method for double eyelid surgery.