Creating natural double eyelids with continuous buried suture and mini-incision technique using subcutaneous absorbable suture for patients with puffy eyelids.

IMPORTANCE Incision and buried suture are 2 primary techniques for creating double eyelids. The incision method is suitable for all kinds of eyelids, but operational trauma and prolonged recovery time limit its application. The nonincision approach can shape a natural and vivid crease with a relatively short recovery time. However, it is not suitable for patients with puffy eyelids, and in those patients the duration of the supratarsal crease is not long. We propose a method of combining the techniques of continuous buried suture and mini-incision. OBJECTIVE To explore a new kind of double eyelid plasty, a corrective surgical procedure for patients with puffy eyelids. DESIGN, SETTING, AND PARTICIPANTS Observational study of 221 patients with puffy single eyelids who underwent this new blepharoplasty from May 2007 to and March 2012. INTERVENTIONS Combined continuous buried-suture and mini-incision surgery using subcutaneous absorbable suture to create natural double eyelids under local anesthesia. All procedures were performed by the same surgeon. MAIN OUTCOMES AND MEASURES All patients were observed after surgery for a period ranging from 1 to 28 months (mean follow-up, 16 months). Data collection included operative time, postoperative recovery and complications. RESULTS All double eyelids appeared natural after short operative time and rapid postoperative recovery, leaving an invisible scar and long-lasting supratarsal crease. No corneal damage or infection occurred. CONCLUSIONS AND RELEVANCE Combined continuous buried-suture and mini-incision surgery using subcutaneous absorbable suture to create natural double eyelids is a reliable, durable, and less-invasive technique for patients with puffy eyelids.