Double eyelid surgery: buried suture vs incisional method
The two main double eyelid methods — buried suture and incisional: how each works, who each suits, and how recovery and longevity differ.
Double eyelid surgery is broadly done by the buried suture method or the incisional method. Rather than one being better, the right choice depends on the skin and fat in your eyelid, the crease you want and whether you have had surgery before.
The buried suture method
The crease is created with a suture through tiny openings, without a long skin incision. Because the procedure is small, recovery tends to be quicker, and if needed the suture can be removed to return close to the previous state.
It is usually considered when the eyelid skin is thin, there isn't much fat and there is little excess skin.
The incisional method
The skin is opened along the planned crease, excess skin or fat is trimmed if needed, and the crease is fixed. It is considered for thicker or fuller lids, sagging skin, or when a clearly defined, long-lasting crease is wanted.
The differences at a glance
- Incision — tiny openings with buried sutures; an incision along the crease with the incisional method
- Skin and fat — limited with buried sutures; can be trimmed at the same time with incision
- Recovery — relatively shorter with buried sutures; swelling can last longer after incision
- Longevity — a buried-suture crease can loosen; an incisional crease tends to be more stable
- Scar — barely visible with buried sutures; hidden in the crease after incision, but it needs time to heal
Recovery and longevity vary from person to person. At Cejong, the buried suture, partial incision or full incision method is chosen to suit the eye. Typically stitches come out at around 5–7 days and major swelling subsides over 1–2 weeks.
How is the right method chosen?
The consultation looks at lid thickness and fat, skin sagging, the strength of the lid-opening muscle (ptosis), epicanthal folds, and the height and shape of crease you want. If the lid opens weakly, ptosis correction may be considered at the same time.
Frequently asked questions
Can a buried-suture crease come undone? Over time the crease can become shallower or loosen. How well your eyelid suits the buried method affects how long it lasts.
Can I have incisional surgery after the buried method? Often, yes. It is decided after checking the previous method and your current condition. See also What to check before eyelid revision.
Related articles
Natural adhesion vs buried suture, Types of double eyelid crease