Tissue thread grafting: nonincisional double-eyelid operation.

Most double-eyelid operations emphasize the levator insertion into the upper eyelid skin using suture material. For supratarsal fixation, we used autogenous tissue threads from the patients' own temporal fascia, periumbilical tissues, capsulopalpebral fascia, and allogeneic human dermis. We engaged tissue threads using a newly designed Yeop's needle (AILEE Inc., BuSan, South Korea) or modified 5-0 Vicryl suture (Ethicon Inc., Somerville, NJ) material. The suture passed through the whole upper lid in the same pattern used with the conventional nonincisional technique. A total of 78 double-eyelid operations were performed. There were 53 primary cases, 22 secondary cases, and 3 tertiary cases. Tissue threads were maintained for 9.3 days on average. There were no complications regarding tissue threads, including infection or granuloma formation in the upper eyelid or at the donor site. Tissue thread grafts not only offer safe fixation of the palpebral crease, but they also incorporate safely into the eyelid tissues for scarless, natural-looking double-eyelids.