Everything you need to know about double eyelid surgery

Photo of woman with double eyelid

Many individuals aspire to have double eyelids that enhance the beauty of their eyes and face. With varying ideals of beauty, it can be challenging to determine what constitutes a successful double eyelid procedure. In this article, we will explore key factors to consider when evaluating the success of a double eyelid procedure.

Double Eyelid Surgery

There are different types of double eyelid procedures commonly offered:

1. Non-Incisional Blepharoplasty

Illustration of non-incisional double eyelid surgery

This procedure is often advertised as not involving any cuts (but there are actually small puncture holes). The eyelid crease is marked and stitched in place using sutures inserted through tiny holes. When the eyes are closed, there should be no visible crease or scarring. When the eyes are open, the newly created double eyelids should make the eyes appear larger and more attractive. To achieve the desired outcome, various suture techniques can be used, such as Single, Double, or Triple sutures.

Single Suture

This technique uses a single suture to create the crease. However, it may result in a tighter and less natural appearance, with a higher risk of failure.

Double Sutures

Two sutures are used to create a new fold or enhance the existing one.

Triple Sutures

This technique employs a triple-looped suture instead of a double-looped one. It reduces the chances of loosening or breakage, resulting in more permanent creases.

The methods vary from surgeon to surgeon and this procedure is not suitable for just anyone. It is also the favourite double eyelid operation of non-surgeons offering aesthetic procedures.

2. Incisional Blepharoplasty

Illustration of incisional double eyelid surgery

This procedure involves the removal of excess fat, muscle, and tissue from the eyelid; but the most important step is suturing the skin to the eyelid muscle. After confirming the design of the double eyelid crease, both edges of the incisions are stitched to the muscle that pulls the skin into a fold when the eyes open.

This technique is typically recommended for young individuals who are not suitable for the suture blepharoplasty and those with droopy eyelids that need loose skin removed. This method is more reliable than the suture method.

The suture method “sells” well. People fall for advertisements that promise results without surgery; but there is always a price to pay, even if you’re not the one who will pay the price.

Criteria for evaluating a Double Eyelid procedure

Scar Appearance

Photo of scar after eyelid surgery

If you underwent an incisional blepharoplasty, a scar will be present, but it should fade within approximately two months after the surgery.

Symmetry of the eyelid creases:

An objective way to determine the success of the procedure is to evaluate the symmetry of the eyelid creases after the wounds have healed. However, perfect symmetry is NEVER achieved. Of course, there cannot be glaring differences between the left and right eyes. There is also the possibility that a created double eyelid not persisting.

Most people do not look at their eyelids so closely until they have eyelid surgery. They will stare at themselves in the mirror and notice every tiny irregularity that has actually always been there, and blame the surgery for causing it.

Height, shape and depth of the eyelid creases

Photo of Asian child with double eyelid

These factors are subjective, and depend on individual preferences and ideals of beauty. The ideal eyelid creases should “look natural”. Eyelids that appear comical, exaggerated, or do not blend naturally with the rest of the face, may indicate an unsatisfactory outcome.

Everyone will say that they want to “look natural”, only to complain that the final result “was not obvious enough”.
There are also people who want to “look done”, otherwise “who is going to notice that I have had surgery!”

Westerners usually do not like to look like they have had surgery. It is the Oriental races that seem to like that exaggerated K-Pop type of look. There are also some who seek cosmetic surgery to modify their appearance; and there are others who seek surgery to correct ageing.

There is a difference.


Although rare, complications can occur as a result of a poorly executed procedure. These may include difficulty in closing the eyes and having dry eyes.

It is crucial to consider multiple factors when evaluating the success of a double eyelid procedure. Prior research, including reviewing the surgeon’s past procedures and reputation, is helpful.

During the initial consultation, discuss your desired results and facial features with the ENT surgeon to ensure the best possible outcome. Curious on why you should engaged an ENT Surgeon certified in facial plastic surgery? Check out our latest article covering the reasons why! If you have any doubts or concerns, we invite you to schedule a consultation with us today, and let us help you achieved your aesthetic goals.