Which is better: non-incisional double eyelid surgery or incisional double eyelid surgery?

In daily life, many women admire double eyelids, as they make the eyes appear more attractive. Consequently, numerous women with single eyelids opt for double-eyelid surgery. However, there are different surgical techniques available—namely, suture (non-incisional) and incisional methods—and many women are uncertain which approach is best suited for them. So, which is better: suture or incisional double-eyelid surgery? Below, we address this question.

Which Is Better: Suture or Incisional Double-Eyelid Surgery?

Generally speaking, before deciding on double-eyelid surgery, it’s essential to understand your individual eye anatomy to realistically anticipate postoperative outcomes. Therefore, results vary significantly among individuals, and neither technique is universally superior—each has distinct advantages and limitations. In suture double-eyelid surgery, specialized Korean-style sutures are placed within the eyelid to create adhesions between the upper eyelid skin and the tarsal plate—or levator aponeurosis—producing a natural, subtle double-eyelid fold. This method is ideal for individuals with relatively wide palpebral fissures, thin eyelid skin, no upper eyelid laxity, and no prominent epicanthal folds. In contrast, incisional double-eyelid surgery involves making an incision along the lid margin through the skin, subcutaneous tissue, and orbicularis oculi muscle. Excess skin or fat may be removed if necessary, followed by suturing the dermis at the lower edge of the skin incision to the tarsal plate—or levator aponeurosis—to form stable adhesions and achieve a well-defined, deep-set double-eyelid crease. This technique has broader applicability, especially for individuals with puffy eyelids, eyelid ptosis, or other structural concerns.

Additional Information: Key Considerations for Incisional Double-Eyelid Surgery

1. Preoperative Evaluation

Prior to undergoing incisional double-eyelid surgery, patients should undergo routine preoperative assessments, including complete blood count (CBC) and coagulation function tests. Aspirin, vitamin E, corticosteroids, and other anticoagulant medications should be discontinued 7–10 days before surgery. Patients should bathe the day before surgery and avoid wearing makeup on the day of the procedure. Additionally, anti-inflammatory eye drops should be administered as prescribed, beginning two days prior to surgery.

2. Postoperative Care

On the day of surgery, patients should avoid reading, using computers or watching television to prevent visual fatigue. Spicy and stimulating foods should be avoided for one week postoperatively. Patients must monitor for signs of severe bleeding or hematoma formation; if either occurs, prompt medical attention is required. Furthermore, surgery should be scheduled outside of menstruation, and postponed during the first and last three months of pregnancy. Patients should also minimize intake of greasy foods and follow dietary restrictions as advised prior to surgery.

The above outlines the comparative considerations between suture and incisional double-eyelid surgery. We hope this information proves helpful to you.