Also referred to as the non-incision technique, the suture method is suitable for patients that do not have redundant eyelid skin (excess eyelid skin) and have relatively thin or moderate eyelid thickness. Patients who suffer from ptosis are not good candidates for this method of double eyelid surgery unless the 3D Suture Technique (3D ST*) is applied.
HISTORY OF ADVANCEMENTS IN THE SUTURE TECHNIQUE
The traditional suture technique was simple in design and performed by placement of three fixations. Entry points were made through the skin and attached to the tarsus (or in some exceptional cases, to the eye elevating muscle complex) by use of multiple sutures. This older method resulted in frequent loosening of the sutures and weak, shallow folds.
TRADITIONAL 2D SUTURE TECHNIQUE
Advancements in double eyelid surgery using this method have predominantly come from South Korea since the late 1980s. Referred to as the traditional suture technique, one of the improvements has been the ability to decrease the early incidence of the loosening of sutures while still maintaining a natural looking fold. The 2D Suture Technique is performed by use of a double-looped, single continuous suture through the three entry points. Further advancements included adding additional fixation points (e.g., 4, 5, 6, etc.) to increase fold formation strength for patients with thicker skin or tissue. When performing this technique, the goal of the surgeon is to find a balance between creating a soft, natural looking fold and preventing suture loosening.
PROS AND CONS OF THE SUTURE TECHNIQUE
The estimated duration of the double eyelid surgery with the suture technique is 30 minutes to one hour, as the surgery is less invasive. The suture technique is less invasive and therefore results in less swelling and a shorter recovery time. Typically, after the suture technique double eyelid surgery, most swelling subsides within a few weeks and final results show in one to three months. There is relatively little bruising although it varies from patient to patient.
One of the biggest advantages of the suture method is that the results most closely resemble a natural eye fold. A disadvantage of this method is that the results are not permanent.
With this method, the fold will eventually get smaller, weaker, and can even disappear due to suture loosening. There are also rare occurrences of suture rupture (i.e., breakage) necessitating revision surgery.