Double eyelid surgery — the suture and incision methods are different operations

This creates a crease that folds when the upper eyelid opens. The principle is simple: link the muscle that opens the eye to the eyelid skin, and the skin folds at that point when the muscle pulls.

The suture method makes that link with stitches, without cutting. Swelling settles faster, and if you dislike the result the stitches can be released. In exchange, the crease can fade or come undone over time.

The incision method opens the eyelid, trims loose skin and fat, then forms the crease. It lasts, but recovery is longer and undoing the crease is much harder.

Thick eyelids or loose skin often do not hold a suture-method crease. Which one fits is decided by looking at the thickness and condition of the lid.

Swelling lasts longer than people expect. It takes about two weeks to look presentable, but three to six months for the height of the crease to settle. Judged before then, it almost always looks too high.

The two sides will not match exactly. Eyes are not symmetrical to begin with. Lid thickness and the strength of the opening muscle differ side to side, and surgery narrows that gap rather than closing it.

Revision is not rare. And an eyelid that has already been cut leaves less to work with next time.

If the eye does not close fully, or it keeps feeling heavy when you open it, that may not be swelling. Tell the surgeon who operated.

Check first whether you also need ptosis correction. If the eye looks small because the opening muscle is weak rather than because of skin, a crease alone will not make it look bigger. These are two different operations.

A lower crease is the safer choice. Raising a low crease is easier than lowering a high one.

Smoking slows healing. Less blood flow means worse swelling and worse scars.

Say in advance if you take aspirin or a blood thinner. It bears directly on bleeding and bruising.

Rather than what you want the eye to look like, start with what bothers you about it now. Bringing a photo helps, but the eye in that photo has someone else's lid thickness and someone else's muscle.

How much can be undone depends on the method. For a first operation, the suture method leaves more options open.

You do not have to decide now. Eyelids change with age, and this is an operation you can decide on after seeing that change.