4 Double Eyelid Surgery Methods — How Do Buried Suture and Incisional Techniques Differ?

Double eyelid surgery isn't a single technique. It's broadly divided into four methods — buried suture (non-incisional), partial incision, partial incision with muscle reinforcement (ptosis correction), and full incision — and the right choice depends on the degree of skin laxity, fat volume, and the strength of the muscle that opens the eye. Even with the same method, results and recovery vary by individual.

What Is the Buried Suture Method?

The buried suture method is a relatively simple technique that creates three small openings and passes thread back and forth through them to form the crease. The single-knot continuous buried suture technique uses one long thread, designed so the thread's tension is distributed evenly, aiming to reduce the risk of the crease coming undone; because there's only one knot, it also tends to be less noticeable. The buried method can be designed to look natural even with the eyes closed, and a combined buried suture technique can also remove fat at the same time. According to the original material, buried suture surgery is generally possible up to one's 40s, though a different method may be more suitable depending on skin condition.

When Is the Partial Incision Method Used?

The partial incision method makes one longer incision within an otherwise buried-suture approach, combining the advantages of both the buried and full incision techniques. It's used when there's some degree of skin laxity, excess fat, or when muscle reinforcement is needed. For older patients, roughly half of the outer portion is incised, while the inner corner — where laxity is less of a concern — is treated with buried sutures. If dissolvable sutures are used after surgery, there's no need to return for suture removal, so let us know beforehand if you'd prefer this option.

Why Is Ptosis Correction Surgery Needed?

When the muscle that opens the eye is weak (a condition called ptosis), the eyebrows and forehead muscles compensate for the deficiency, which can cause the eyebrows to rise and forehead wrinkles to deepen when opening the eyes. Prolonged strain on the eyebrow muscles is described as a possible cause of headaches and reduced concentration. In such cases, the central portion of the eye-opening muscle is reinforced using a partial incision rather than a full incision, with the goal of reducing the need to strain the forehead when opening the eyes after surgery. Scarring tends to be minimal, and since most cases of ptosis are mild, the partial incision method is often sufficient.

How Does the Full Incision Method Work?

The full incision method fully opens the skin and removes the excess, sagging tissue. If we assume the skin stretches by roughly 1mm per year, removing that amount of excess skin is expected to reverse an equivalent degree of laxity — the same basic principle behind lifting surgery. When weak eye-opening muscles are combined with skin laxity, the full incision method can be used to remove skin while correcting the muscle at the same time. If you're interested in correcting sagging skin more broadly, we also encourage you to review our Facelift Guide.

How Do I Determine the Right Method for Me?

The choice of surgical method should be based on three factors — skin laxity, fat volume, and the strength of the eye-opening muscle — rather than trends. Eyelid condition varies from person to person even at the same age, so please confirm the appropriate method through a consultation with a specialist. You can find more about the surgeon's background on our About the Director page.

Consultation Information

Kim Jongseo Plastic Surgery (Apgujeong, Seoul) · 2F Apgujeong Building, 842 Nonhyeon-ro, Gangnam-gu, Seoul · 02-3416-0070 (after hours 070-4027-0070) · Book a consultation

This article is provided for informational purposes only. Surgical and treatment results and recovery time may vary by individual. All medical procedures carry potential side effects, so please consult thoroughly with a specialist.

Treatment Reference Materials

Below are treatment information materials from our previous website (surgery.co.kr). Before-and-after results may vary by individual, and all medical procedures carry the possibility of side effects.