Double Fold (Non-Incision)

Last updated date: 01-May-2023

Originally Written in English

Double Fold (Non-Incision)

Since not everyone enjoys invasive operations and long recovery times, non-incisional double eyelid surgery is a great alternative to its incisional counterpart. For someone who has always hated their droopy eyelids, this quick and simple treatment can change their life. Many concerns with the look, expression, and even eyesight can result from abnormalities with the upper eyelids. Some ladies may find it difficult to get a flawless cosmetic look as a result. Here is provided information that you may need to help you learn more about non-incisional double eyelid surgery and determine whether it is worthwhile for you to get the treatment.


What is Non-Incisional Double Eyelid Surgery?

Non-Incisional Double Eyelid Surgery

Non-incisional double eyelid surgery is a type of eyelid procedure in which the upper eyelid is not punctured. Instead of doing it for functionality, most people get this operation done for cosmetic reasons. To create a double eyelid, this technique uses sutures to tighten the skin and muscles. In addition, it is less invasive than making incisions, resulting in a quicker recovery period without sacrificing natural-looking results.

Since this approach cannot get rid of extra skin, non-incisional double eyelid surgery is mostly intended for people who have moderate upper eyelid drooping as well as people who have thin eyelids. The non-incisional procedure has advantages as well, such as the following:

  • Almost no scarring
  • Easy reversible
  • Speedier recovery
  • Minor swelling
  • Rapid procedure


Non-Incisional Double Eyelid Benefits

Double Eyelid Benefits

One type of surgery that can improve droopy eyelids and clear the field of vision is eyelid surgery. This is a practical method for avoiding aging around the eyes. This technique can give the face a more youthful appearance. The technique tries to get rid of extra skin, fat, and muscle around the eyes. Both the upper and lower eyelids may be treated in this way. Women frequently use this to avoid having eyes that appear tired and old. Following are a few advantages of non-incisional double eyelid surgery:

  • Improve the scope of vision. Not all advantages of eyelid surgery are indeed aesthetic. Some persons who only have one upper eyelid have extremely narrow eyesight. It will open the eyelids even further with a second fold in the upper lid. As a result, one's field of vision may be enhanced. Yes, driving can benefit greatly from this. This also applies to carrying out other jobs that need to be aware of your surroundings.
  • Make you look less tired. The amount of extra skin that causes bags and puffiness under the eyes can be reduced with blepharoplasty. This frequently results in you appearing anxious or exhausted even when you are not. The patients will observe that they appear more relaxed and awake after the operation. A brow lift and eyelid surgery are popular elective procedures. This is because it might promote a youthful and renewed look. The forehead's creases, lines, and wrinkles will be reduced while the brows will be elevated. To lessen the patient's post-operative recovery period, these procedures are carried out simultaneously.
  • Improve facial harmony. The eyes are regarded as the most attractive features of the face in the vast majority of cultures around the world. This is the rationale behind the widespread use of eye-catching cosmetics by women. The harmony of the face will be enhanced through double eyelid surgery. It can give the eyes a modest enlargement and improve harmony with other features.
  • Provide a youthful appearance. Patients will look younger after the treatment because eyelid surgery aims to minimize the skin around the eye. Additionally, blepharoplasty can eliminate bags and dark circles under the eyes. 
  • Create a new upper eyelid fold. To give the upper eyelid a fold, double eyelid surgery is performed. Many want to get this procedure because over 50% of Asians naturally have an upper eyelid fold. A second fold is both a functional and cosmetic enhancement. Many Asians claim that having a second eyelid makes makeup application simpler.


Non-Incisional Double Eyelid Preparation

The general approach in the operating room is the same whether executing an incisional or non-incisional blepharoplasty. The first step in pre-operative preparation is eyelid marking, which is done while standing up so that the eyelid's final gravitational position can be seen. This is then evaluated while also lying flat. The patient's ideal height is used to design the proposed supra-tarsal crease, which runs from the medial to the lateral canthus. Once the mark's bilateral symmetry has been accurately evaluated in both the upright and supine positions, a sterile preparation can be carried out. The upper eyelids are then given local anesthesia, and a corneal shield may be used. With or without IV sedation, the surgery can be performed. Few clinical or animal studies have been conducted to test the effectiveness of the various suture types in face procedures, therefore the choice of suture material for the treatment is mostly based on surgeon preference.


Non-Incisional Double Eyelid Surgery

Non-Incisional Double Eyelid Surgery

Non-Incisional double eyelid surgery takes only a few minutes to an hour to complete. Since there are no incisions made during the procedure, just a local anesthetic is required. It is still recommended that you have this procedure done by a board-certified plastic surgeon with proven experience conducting eyelid surgeries, despite the simplicity of the procedure. This is to ensure that your procedure will be successful and safe and that you will have the results you seek. The following steps are carried out after the surgeon injects local anesthetic onto the upper eyelid:

  • Locate and mark the upper eyelid's center (6 to 8mm above the lid margin is appropriate for most eyelids).
  • To divide the difference between the center mark produced, make two markings, one on the medial third of the eyelid and one on the lateral third. To produce a curve on the lateral aspect, the lateral third mark can be marked 1 mm wider than the central mark.
  • Apply local anesthesia to numb the area
  • two incisions should be made. At each of the three marks, 1 to 2 mm horizontally through the skin.
  • Pass the Prolene suture through all of the tissue layers where the incision was made. Enter through the palpebral conjunctiva
  • The same suture should be reinserted through the palpebral conjunctiva in a different path, through to the sub-dermis.
  • Subcutaneously bury the knot by tying the suture.
  • At each incision point, repeat steps 6 through 8.
  • The doctor leaves the three little incisions open so they can heal.


Other Non-Incisional Techniques

Techniques for partial thickness sutures are also frequently used. A transcutaneous or transconjunctival bite is used for the initial bite. The suture, however, only penetrates a piece of the eyelid before returning to the plane of the initial bite rather than cutting through all planes of tissue. In a transconjunctival approach, the layer through which the suture commonly goes is either the subcutaneous or orbicularis oculi planes, or the tarsus in a transcutaneous technique. Similar procedures to those previously mentioned can be used for both continuous and discontinuous approaches.

Additionally, patients who receive debulking of pre-tarsal tissues through tiny stab incisions on the lid before the installation of sutures have reported better results, according to modern techniques. But at the moment, this is not a typical practice. The sutures are normally removed within 4-7 days in all non-incisional approaches.


Non-Incisional Double Eyelid Recovery

Non-Incisional Double Eyelid Recovery

Non-incisional double eyelid surgery requires ten to two weeks for the whole recovery process. Swelling and bruising could happen, just as with any surgery. After the treatment, your eyes may also be wet, sensitive to light, and blurry. If required, your doctor will give you prescription drugs to reduce your discomfort while you heal. To prevent complications and hasten the healing process, it is essential to adhere to your doctor's post-operative care instructions. Following surgery, you should take certain precautions, including:

  • Stay away from alcohol and smoking.
  • Do not rub or touch the area around your eyes.
  • For many days or as long as there is residual swelling, apply cold compresses to the treated areas.
  • Never wear contact lenses
  • During the recovery process, avoid using skincare or cosmetics around the eyes.
  • For the planned checkup, come to your doctor's office.


Non-Incisional Double Eyelid Complications

Non-Incisional Double Eyelid Complications

  • Very high and asymmetrical folds. The most frequent consequence, with occurrence rates as high as 34%, is eyelids with irregular height or shape. Asymmetric eyelid folds can be caused by a variety of factors, including differences in preoperative marking, differences in the quantity of skin removed, unequal skin tension during supratarsal fixation, and uneven amounts of fat removed. Following surgery, about 6% of patients have excessively high folds. If the folds extend past the tarsal plate's superior border, they are regarded as being too far superior. As previously mentioned, the eyelid crease should be 6 to 8 mm above the lid edge. Adhesions between the orbicularis and the skin above the level of surgical fixation may be the source of this abnormal appearance. Preaponeurotic fat pads that have been removed too aggressively may also result in high folds.
  • Blepharoptosis. Iatrogenic injury to the levator palpebrae superioris muscle and its aponeurosis may result in the appearance of a drooping eyelid after non-incisional blepharoplasty. Levator function is disrupted by unintentional separation from the tarsal plate and scarring from extremely high aponeurosis fixation to muscle.
  • Bleeding. As with any procedure, there is a chance of bleeding, which can vary from a prolonged ecchymosis to a significant hematoma. All ethnicities experience bleeding rates that are similar to those for blepharoplasty.
  • Suture weakening. Some patients may develop skin laxity again over time and lose the surgically induced upper eyelid fold. The suture ligation method and the use of absorbable sutures both increase the likelihood of this occurring, however, it only occurs in less than 4% of cases. This results from a failure of adhesion between the levator and muscle or dermis and a weakening of the fixing suture. Debulking of orbital fat or deliberate suturing to strengthen the levator-dermal junction and the tarso-dermal junction during supratarsal crease formation can prevent this problem.
  • Upturned cilia. Trichiasis is more common in Asian people due to the stimulation of downturned eyelashes caused by the presence of an epicanthal fold. The development of a second eyelid can ease the condition and aid in cilia eversion. The upper lid eyelashes, however, have the potential to evert and expose the palpebral conjunctiva if sufficient preoperative preparation and care are not performed.
  • Ocular surface disease. The formation of a double eyelid may cause or aggravate minor symptoms of dry eye. The ptosis that occasionally accompanies people who don't have an eyelid crease may help prevent the onset of dry eye. Therefore, it's important to evaluate the patient for the emergence of these issues in the lead-up to surgery.
  • Ectropion. During surgery, damage to the facial nerve's zygomatic or recurrent buccal branches could prevent the orbicularis oculi muscle from working properly. This may result in issues like ectropion in addition to changing the position of the lower lid edge. Ectropion will also develop if the eyelid levator is under tension beyond what healthy skin can tolerate. This is a result of the inferior incision or skin flap on the levator being positioned incorrectly.


Non-Incisional Double Eyelid Before and After

Non-Incisional Double Eyelid Before and After

Patients are happy with the results of the treatment even though the non-incisional double eyelid surgery does not produce permanent results. The outcomes will be identical to those of the incisional approach. Only the outcomes' longevity and the time needed for recovery will vary. The upper eyelid has transformed, as can be noted in the pictures of the patients before and after procedures.

Despite the procedure's absence of incisions, it was still able to create a double eyelid and give the patients' eyes a younger, bigger, and brighter appearance. Additionally, the outcomes appear natural, as if the patients have always had double eyelids.

A less invasive option to the widely used incisional form of double eyelid surgery is non-incisional double eyelid surgery. Sutures are used to tighten the skin and muscles and create a double eyelid without making any incisions. A board-certified plastic surgeon may complete the entire surgery quickly and easily in just 30 minutes.

You can heal from the operation in as little as two weeks during the recovery time. To avoid complications and have a quick recovery, you must strictly adhere to the doctor's post-operative care instructions, just like with any other eyelid procedure. The bigger, brighter, younger-looking eyes produced by this non-incisional procedure are identical to those of the incisional method. It simply varies in terms of how long-lasting the effects are and how quickly the body recovers.

It is strongly advised that you get this treatment in South Korea because the country's plastic surgeons are the foremost experts on all matters involving eyelid surgery. You may be sure that the doctors will get the results you want because they perform thousands of eyelid operations each year. Knowing about non-incisional double eyelid surgery has made it easier for you to schedule an appointment at your favorite center. Get ready for brighter-looking eyelids.



Eyelids with two distinct creases are said to have double eyelids. To add a crease to the eyelids, double eyelid surgery is typically done for aesthetic reasons.

To discuss the benefits and drawbacks of this operation and determine whether you are a good candidate, speak with your eye doctor and a licensed plastic surgeon.

Additionally, there are nonsurgical ways to develop double eyelids. Remember that neither having double eyelids nor having only one is abnormal from a medical standpoint.