Asian Eyelid Surgery
Buried Suture Method (non-incision)
“No artificialness, natural double eyelid”
It’s a method widely being used recently with minimal swelling and scar.Adequate for people with thin eyelids and not much of palpebral fat to get natural double eyelids. It’s a non-incisional method; making three small holes on the eyelid and connecting it with the muscle that opens an eye to make double eyelid fold.It’s a simple procedure with a short operating time and the revision operation of it isn’t very difficult. It accompanies minimal postoperative swelling and bruises compared to incisional double eyelid surgery.Although the facts that it has more cases of loosened double eyelid fold compared to the incisional method and creation of a bulge at the area of fixation sutures when the eye is closed may happen can be counted as its demerits, the actual chance of them happening is very rare.Cases of loosened double eyelid fold due to the gradual elasticity decrease of eyes and the aging process of eyelids sometimes happen but they are not caused from the unraveling of the sutures. For these cases, Buried Suture Method procedure on the upper part of the previous one or the incisional/partial incisional method can be done as the revision surgery so there won’t be much of problems.
Candidates for Buried Suture Method
The candidates for incisional and non-incisional methods are mainly divided regarding the severity of eyelid skin sagging, thickness of the eyelid tissue such as skin, muscle and etc, size of eyes and whether blepharoptosis(cause of sleepy eyes) is accompanied or not. Buried Suture Method is also called as ‘Embedding procedure’ since it embeds the sutures and doesn’t conduct much of manipulation on the eyelid skin itself. Therefore, the incisional method that removes sagging skin is more appropriate for the eyes with any amount of sagging skin. However, since double eyelid surgery itself gives elevation of slightly sagging skin as an additional achievement in the process of connecting the skin with the muscle that opens an eye, a light sagging of eyelid skin can be sufficiently taken care of by Buried Suture Method as well. Hence, the eyelid skin looking comparatively droopy doesn’t necessarily mean a candidate for the incisional method.
Advantages of Buried Suture Method
One of the biggest merits of Buried Suture Method is that it’s reversible.
This means that if one isn’t sure about double eyelid surgery or has hard time getting used to the postoperative self-appearance, removal of the sutures will bring back the original eyelids. Of course, having an operation expecting the other-wise situation isn’t very desirable and doesn’t happen often. However, you can say Buried Suture Method has high level of availability and use with its reversibility.Since Buried Suture Method is conducted through very small incision (average 1-2mm), no scar will be visible after a bit of postoperative time. Although the scar isn’t much of a problem in the incisional method since it will be hidden under the double eyelid fold, no scar will be detected whatsoever from Buried Suture Method even when one looks down without any make-up. Therefore, it is suitable for the people who want the utmost naturalness.Buried Suture Method also has merits of a short operating time (20-30 mins) and quick recovery with minimal postoperative swelling since not much of surgical manipulation is done on the eyelid tissues. Generally, it takes about 4~7 days for the acute swelling to be gone and additional off from work is unnecessary since being back to work on Monday after having the operation on previous Saturday is possible. Hence, it’s one of the double eyelid surgery methods suitable for busy contemporary people. There are various surgical methods for Buried Suture Method such as making a single loop, locating the knot on the conjuctiva area, making three short loops, continuous embedding of single knots and etc. Some may use new terms such as ‘quick double eyelid’, ‘Diamond procedure’ and etc. to promote them as if they are new surgical methods but they all fall under the category of Buried Suture Method with just slight changes of details from the original methods.All the methods mentioned above are within the category of Buried Suture Method using its principle with some surgical manipulation differences regarding the shape and maintenance of the postoperative double eyelid.
Misconception about Buried Suture Method
Many people think of it as a method with high rates of loosened double eyelids. It was true in the beginning stage of its introduction to Korea with its unsuitable application and inadequate surgical manipulations. This problem sure was troublesome for both patients and surgeons. Therefore, constant efforts to solve this problem have been made and allowed current Buried Suture Method that lowered the chance of loosening through improvements of the procedures and materials. That’s why the idea of ‘Buried Suture Method = easily loosening double eyelids’ is a misconception and even if the loosening happens by any possibility, a simple additional fixation of the sutures can revise it.
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Brian Lee
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