Aesthetic Plastic Surgery

, Volume 33, Issue 3, pp 421–425

A Two-Way Continuous Buried-Suture Approach to the Creation of the Long-Lasting Double Eyelid: Surgical Technique and Long-Term Follow-Up in 51 Patients

Original Article

DOI: 10.1007/s00266-009-9344-x

Cite this article as:
Fan, J. & Low, D.W. Aesth Plast Surg (2009) 33: 421. doi:10.1007/s00266-009-9344-x



Although it is seldom reported in the Western literature, the buried-suture operation to create a double eyelid is very popular in Asia. However, the buried-suture methods are traditionally associated with a high recurrence rate. Corneal damage and exposed conjunctiva suture are also possible.


The two-way continuous buried-suture approach was applied in double-eyelid operations. With seven to nine stab skin wounds on the upper eyelids, a continuous single-armed suture is passed through the dermis as well as the superficial part of the tarsus. Then the needle is inserted in the opposite way. Both ends of the suture are tied within the far lateral incision. The operation takes no longer than 20 min. The scars of the stab incision were no longer visible after several months postoperation.


From August 2003 to January 2008, 51 patients underwent this technique. All patients have been satisfied with their appearance after their initial surgery except two patients who had minimal associated morbidity. No disappearance of the formed double eyelids or corneal damage occurred.


The two-way continuous buried-suture approach is a simple method for establishing a long-lasting double eyelid. The results are durable and the potential for corneal injury is reduced.


Two-wayContinuousBuried sutureDouble eyelid

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2009

Authors and Affiliations

  1. 1.Plastic Surgery Department, Beijing Chao-yang HospitalCapital Medical UniversityBeijingChina
  2. 2.Center for Human AppearanceHospital of the University of PennsylvaniaPhiladelphiaUSA