BACKGROUND: Although non-incisional surgery to create a supratarsal fold (double eyelid) is preferred by Japanese patients, current procedures are either technically complex or do not produce lasting results. OBJECTIVE: We describe a new, non-incisional technique that makes use of double-armed sutures and twists to create double eyelids in Asian patients. METHODS: After everting the upper eyelid, a double-armed suture needle is passed from the conjunctival surface through the tarsal plate and then to the skin surface. The other end of the suture is advanced about 3 to 5 mm and also brought out through the tarsal plate. A second suture is used to create another U-stitch adjacent to the first suture. The upper eyelid is returned to its original position, and the sutures from the central hole are twisted around each other 4 or 5 times. They are then passed under the skin, one medially and one laterally, and the lateral and medial sutures are tied. RESULTS: The authors have performed 1108 procedures during the past 10 years with no loss of double-eyelid line in a mean follow-up time of 32 months. CONCLUSIONS: The double suture and twist technique for creating double eyelids in Asian patients is simple, reproducible, durable, and safe. (Aesthetic Surg J 2001;21:227-232.).
BACKGROUND: Although non-incisional surgery to create a supratarsal fold (double eyelid) is preferred by Japanese patients, current procedures are either technically complex or do not produce lasting results. OBJECTIVE: We describe a new, non-incisional technique that makes use of double-armed sutures and twists to create double eyelids in Asian patients. METHODS: After everting the upper eyelid, a double-armed suture needle is passed from the conjunctival surface through the tarsal plate and then to the skin surface. The other end of the suture is advanced about 3 to 5 mm and also brought out through the tarsal plate. A second suture is used to create another U-stitch adjacent to the first suture. The upper eyelid is returned to its original position, and the sutures from the central hole are twisted around each other 4 or 5 times. They are then passed under the skin, one medially and one laterally, and the lateral and medial sutures are tied. RESULTS: The authors have performed 1108 procedures during the past 10 years with no loss of double-eyelid line in a mean follow-up time of 32 months. CONCLUSIONS: The double suture and twist technique for creating double eyelids in Asian patients is simple, reproducible, durable, and safe. (Aesthetic Surg J 2001;21:227-232.).