Comparing Incisional to Suture Techniques

Comparing Incisional to Suture Techniques

Video transcript: The main advantage of the suture technique is that the recovery period is relatively quick. Most people don't get significant swelling, the creases look very natural and most people would not have evidence that they have had surgery within a short period of time, sometimes in little as a week.The main advantage of the incisional technique is that it allows removal of extra skin, it allows removal of extra fat, and it allows for more specific control of the crease height and shape.

Which Double Eyelid Surgery Is Best for You? Incisional or Suture?

The technique that is most appropriate for each patient is best determined through a consultation with Facial Plastic Surgeon and double eyelid surgery expert Dr. Thomas Buonassisi. This page may help patients considering the surgery understand the pros and cons of each technique.In short, patients with thin skin who do not have extra skin and fat to be removed may be candidates for the double eyelid suture technique. Those who have thick skin, extra skin and fat or who desire a permanent crease may be candidates for the double eyelid surgery incisional technique.

The Incisional Technique

How it is performed:1. Optional Oral Sedation – many patients find it more relaxing to have surgery with the aid of an oral sedative. The medication is provided prior to the surgery. It is important to have a responsible adult to drive you home from the surgery.2. Local Anesthetic – Dr. Buonassisi injects local anesthetic into the eyelids.3. Some patients have extra skin and fat in the upper eyelids that they wish to have removed during the double eyelid procedure. If this is the case, Dr. Buonassisi carefully reshapes these eyelid features. By removing the extra skin and fat, the patient experiences reduced puffiness and more eyelid definition.4. Creating The New Crease – Dr. Buonassisi carefully measures and marks the eyelid with a pen. A series of small punctures are made in the skin, and sutures are places through the punctures and tightened to create the crease. The sutures are hidden underneath the skin.5. Recovery and Transport Home – Cool compresses are placed on the eyes and the patient rests in recovery after the surgery. The patient's responsible adult drives them home and most patients return home to rest.Pros of The Incisional Technique- The new crease is permanent- The surgeon has greater control over the crease shape and height- The surgeon can address excess skin and fat on the eyelidsCons of The Incisional Technique- The results are irreversible- There is a longer healing period- 1-2% of patients experience crease breakage – meaning the crease does not hold in one or both eyesRisks of The Incisional Technique- Rare risk of bleeding and infection- Crease asymmetry- Breakage

The Suture Technique

How it is performed:1. Optional Oral Sedation – many patients find it more relaxing to have surgery with the aid of an oral sedative. The medication is provided prior to the surgery. It is important to have a responsible adult to drive you home from the surgery.2. Local Anesthetic – Dr. Buonassisi injects local anesthetic into the eyelids.3. Creating The New Crease – Dr. Buonassisi carefully measures and marks the eyelid with a pen. A series of small punctures are made in the skin, and sutures are places through the punctures and tightened to create the crease. The sutures are hidden underneath the skin.4. Recovery and Transport Home – Cool compresses are placed on the eyes and the patient rests in recovery after the surgery. The patient's responsible adult drives them home and most patients return home to rest.Pros of The Suture Technique- Reversible- A shorter healing periodCons of The Suture Technique- Sometimes punctures where sutures are placed may be faintly visible when the eyes are closed- 5-10% of new creases may “break” or “fall out” in one or both eyes- The surgeon is unable to address excess fat and skin- Although uncommon, sutures can cause irritationRisks of The Suture Technique- Rare risk of bleeding and infection- Crease asymmetry- Breakage