Non-Surgical Double Eyelid Suturing

Non-incisional double eyelid surgery (suture method) is a procedure that creates a double eyelid crease by passing sutures through tiny points to anchor the upper eyelid skin to the levator muscle, without removing any skin. The procedure takes approximately 30–45 minutes, with mild swelling lasting 3–5 days. It is ideal for younger individuals with thin eyelid skin, minimal fat, and no excess skin; it is not suitable for severe hidden double eyelids or sagging skin.

Compiled from BonBoz Clinic clinical documentation — currently in medical review

How It Works

A natural double eyelid crease is formed when fibers from the levator muscle attach to the overlying skin. Non-incisional double eyelid surgery (suture blepharoplasty) recreates this connection using specialized sutures: through 2–3 tiny micro-punctures along the pre-designed crease line, the surgeon threads sutures to secure the skin to the levator muscle or tarsal plate. When the eyes open, the muscle pulls the skin inward to form a clean crease. Because this technique removes neither skin nor fat, the outcome relies heavily on whether excess skin or fat weighs down and obscures the fold.

Non-Incisional vs. Incisional Blepharoplasty

Non-incisional (suture technique): No long incision, fast recovery, and fully reversible if unsatisfied. However, the crease may fade or loosen over time, and it cannot address excess skin or orbital fat. Incisional blepharoplasty: Uses an incision along the crease line to excise redundant skin and fat, delivering a longer-lasting fold; however, it requires a longer recovery period and leaves a fine scar hidden within the natural crease. The choice should be based on anatomical suitability rather than a mere preference for a "minimally invasive" procedure.

Indications

Young individuals with monolids or faint double eyelids who have thin eyelid skin, minimal orbital fat, and no skin laxity; patients with asymmetric eyelids where the targeted side meets the aforementioned criteria; or those who want to preview a double eyelid crease before committing to an incisional procedure. The surgeon thoroughly evaluates skin laxity, fat volume, levator muscle function, and facial symmetry prior to confirming eligibility.

Potential Risks

Fading or loosening of the crease (especially with thicker eyelid fat), asymmetry, visible or palpable suture knots, creases that sit higher or lower than planned, prolonged swelling and bruising, and suture point infection (rare). Early suture removal can generally restore the eyelid to its near-original state.

At BonBoz

You will receive an in-depth consultation directly from a plastic surgery specialist who evaluates your eyelid skin and fat volume and simulates the proposed crease using a specialized probe for a clear visual preview. If significant skin laxity or thick fat is present, the surgeon will recommend incisional blepharoplasty over the suture method to prevent crease loss. The examining doctor directly performs the procedure, utilizing specialized sutures and multi-point fixation techniques for long-lasting results. You will receive comprehensive aftercare instructions and scheduled follow-up visits on Day 7 and at Month 1.

Technique variants

1

Single-point/Few-point non-incisional double eyelid surgery

Fewer fixation points, quick procedure, ideal for trying out a crease; shorter longevity.

2

Multi-point non-incisional double eyelid surgery

Multiple fixation points along the crease line, creating a more defined and longer-lasting fold; takes slightly longer.

When should you see a doctor?

  • Excess eyelid skin or thick fat layer — suture technique struggles to maintain the fold, causing it to fade easily.
  • Asymmetrical eyelids caused by true ptosis.
  • Multiple previous suture techniques, with residual marks from old folds.
  • Desire for long-lasting eyelid folds — non-incisional suture techniques have a limited lifespan, requiring clear understanding before choosing.

How is it performed?

Local anesthesia is administered. The doctor marks the designated crease line, creates 2–3 tiny access points along this line, passes sutures through to connect the skin to the levator muscle or tarsal plate, and securely knots them to form the eyelid crease; eyelid symmetry is evaluated with the eyes open before concluding the procedure. The procedure takes approximately 30–45 minutes with no hospitalization required.

Before the procedure

Undergo an eyelid examination, measurement, and crease simulation with a testing probe; discontinue anticoagulants, alcohol, and tobacco several days prior as instructed; avoid applying eye makeup on the day of the procedure.

After the procedure

Apply cold compresses for the first 48 hours, keep the area clean, and avoid rubbing your eyes; swelling will subside after 3–5 days, and the eyelid crease will look natural after 2–4 weeks. Follow-up visits are scheduled on day 7 and at 1 month.

Possible risks — your doctor explains them before treatment

  • Crease fading or loosening over time, especially with thick eyelid fat
  • Asymmetry between both sides
  • Visible or palpable suture knots
  • Crease higher or lower than intended
  • Suture site infection (rare)

Who should NOT have this?

  • Excess, sagging eyelid skin due to aging
  • Thick eyelid fat, puffy eyelids
  • Ptosis caused by weak levator muscles
  • Active eye area infection
  • Expecting a wide, deep crease similar to incisional blepharoplasty

How BonBoz uses it

Lower Eyelid Skin Excision

Lower eyelid skin excision addresses loose, wrinkled under-eye skin caused by aging via an incision placed right along the lower lash line, which may be combined with orbital fat management. Recommended for individuals whose primary concern is excess skin, typically aged 45–70.

Learn about this method →

Full Incision Double Eyelid Surgery with Excess Skin and Fat Removal

Full incision double eyelid surgery utilizes an incision along the full length of the eyelid crease to excise excess skin, manage fat, and create a stable crease. It serves as the foundational technique for aging upper eyelids and puffy eyelids—not a 'large eye creation' procedure.

Learn about this method →

Mini Incision Double Eyelid Surgery (Mini Line)

Mini Line double eyelid surgery uses an incision approximately two-thirds the length of the eyelid to remove moderate skin laxity and secure the crease. Positioned between suture techniques and full incision surgery, it offers greater durability than suture methods while being less invasive than full incision surgery.

Learn about this method →

Eye Care Services: BonBoz Eyes Double Eyelid Creation

Services page: A specialist physician conducts an examination, recommends the most suitable option, and provides a clear cost estimate prior to your decision.

Want a cost range for your own case?

Estimate the cost →

Cost guidance

The cost depends on the specific suture technique, the number of fixation points, whether the procedure is performed on one or both eyes, and if previous crease correction is required.

The final price follows the doctor’s recommendation after an in-person exam. A confirmed quote has no hidden extras.

Inside the BonBoz clinic

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Frequently asked questions

How long does non-incisional double eyelid surgery last?

For thin eyelid skin with minimal fat, the crease can last for many years. With thicker fat or excess skin, the crease may gradually fade after 1–3 years due to tissue pressure; in such cases, incisional blepharoplasty is recommended.

Is non-incisional double eyelid surgery painful?

Local anesthesia is administered, so you will primarily feel a slight pressure or sting during the injection. Afterwards, there may be a mild tight sensation and swelling for 3–5 days, rarely requiring strong painkillers.

How long does it take for the eyelid crease to look natural?

The crease may appear slightly high and stiff for the first 1–2 weeks due to swelling, becoming progressively natural after 2–4 weeks.

Can non-incisional double eyelids be undone/reversed?

Yes, the doctor can remove the sutures through the original entry points. The crease usually disappears, and the eyelid almost entirely reverts to its original state if removed early.

Does non-incisional double eyelid surgery leave visible marks?

The suture entry points are extremely small, fade after a few weeks, and are concealed within the crease, making them barely noticeable.

Can individuals with monolids and thick eyelid fat undergo non-incisional double eyelid surgery?

It is not recommended. Excess fat presses down on the crease, causing it to look indistinct or loosen. Incisional blepharoplasty with fat removal provides a much more stable result.

Does non-incisional double eyelid surgery make the eyes bigger?

A double eyelid crease makes the eyes appear vertically larger and more defined, but the actual palpebral fissure size remains unchanged.

How long after non-incisional double eyelid surgery can I wear makeup?

After 7–10 days, once the puncture sites have healed. Remove makeup gently and avoid rubbing or pulling the eyelids during the first month.

Does having non-incisional double eyelid surgery affect future blepharoplasty?

Not significantly. The surgeon will remove the old sutures and redesign the crease during the incisional blepharoplasty procedure.
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