Double Eyelid Surgery

Clinical Overview & Guide

Double Eyelid Surgery (Upper Blepharoplasty for Crease Creation) is a specialized oculoplastic procedure designed to create a defined, natural-looking supratarsal crease by establishing a stable anatomical connection between the upper eyelid skin and the underlying levator aponeurosis or tarsal plate. At IBON Plastic Surgery, rather than applying a one-size-fits-all crease, Dr. Ju-Chan Kim (Board-Certified Plastic Surgeon) evaluates each patient's upper eyelid skin thickness, orbital fat volume, levator muscle function, and medial epicanthal fold anatomy to select the most appropriate surgical technique.

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Comparison of Surgical Techniques

IBON Plastic Surgery offers five tailored surgical methods based on individual anatomical findings:

Surgical Method	Core Mechanism	Ideal Candidates
Natural Adhesion Double Eyelid Surgery	Induces natural biological adhesion between the skin and levator muscle through micro-openings	Patients with thin to moderate eyelid skin seeking a natural crease without a visible incision scar
Non-Incisional (Buried Suture) Method	Creates a continuous subdermal suture loop without incising the skin	Patients with minimal excess skin or fat who prioritize rapid recovery and minimal swelling
Partial (Minimal-Incision) Method	Uses short micro-incisions to remove localized orbital fat while securing firm fixation	Patients concerned about suture loosening who want stronger fixation without a full incision
Incisional Double Eyelid Surgery	Makes a precise incision along the planned crease to address excess skin, muscle, and orbital fat	Patients with thicker eyelid skin, redundant tissue, or those requiring a permanent, well-defined crease
Revision Double Eyelid Surgery	Releases previous scar tissue adhesions and reconstructs anatomical layers to correct asymmetry or loosening	Patients experiencing crease loosening, asymmetry, high/"sausage" folds, or multiple creases after prior surgery

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Crease Design & Clinical Considerations

• In-Line / In-Out Line / Semi-Out Line / Out-Line: The height and starting point of the crease are customized according to medial epicanthal tension, brow-to-eye distance, and globe prominence so the eyes harmonize with overall facial proportions.
• Combined Functional & Contour Evaluation: If weakened eyelid elevation (blepharoptosis) is present, performing crease creation alone may result in a heavy-looking fold or early loosening. During consultation, we evaluate whether combining Droopy Eyelid Correction (Ptosis Surgery) or Eye Corner Surgery (Canthoplasty) is clinically indicated.
• Clinical Guides & References: For detailed procedure walkthroughs, explore our clinical guides on Natural Adhesion Double Eyelid Surgery, Partial-Incision Double Eyelid Candidacy, Revision Double Eyelid Surgery, and Double Eyelid Recovery Stages. Surgical safety and anatomical standards adhere to guidelines established by the Korean Society of Plastic and Reconstructive Surgeons (KSPRS) and the Archives of Craniofacial Surgery (ACFS).

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Surgical & Recovery Overview

• Procedure Time: Approximately 30 to 90 minutes (depending on technique and whether revision is performed)
• Anesthesia: Local anesthesia with short-acting intravenous sedation
• Suture Removal: None or days 3–4 for non-incisional/natural adhesion; days 5–7 post-op for partial or full incisional methods
• Recovery Timeline: Major swelling subsides within 1 to 2 weeks, while subtle tissue settling continues over 1 to 3 months. To receive a personalized anatomical evaluation, please book a 1:1 Online Consultation.

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Frequently Asked Questions (FAQ)

Q. How do I know whether I need the Natural Adhesion, Non-Incisional, or Incisional method?
A. The choice depends primarily on your upper eyelid skin thickness, fat volume, and skin laxity. Patients with thin skin and minimal sagging achieve reliable, natural results with Natural Adhesion or Non-Incisional techniques. When excess orbital fat or redundant skin is present, Partial-Incision or Incisional Double Eyelid Surgery provides long-term stability by removing the excess tissue that could otherwise cause a suture crease to loosen.

Q. When can I wash my face and return to daily activities after double eyelid surgery?
A. After non-incisional or natural adhesion surgery, gentle face washing is typically possible after 3 to 4 days. For incisional methods, face washing and light skin makeup can resume the day after suture removal (around day 5 to 7). Direct eye makeup and contact lens wear are generally recommended starting 2 to 3 weeks after surgery.