A simple and durable way to create a supratarsal fold (double eyelid) in Asian patients.

BACKGROUND Although non-incisional surgery to create a supratarsal fold (double eyelid) is preferred by Japanese patients, current procedures are either technically complex or do not produce lasting results. OBJECTIVE We describe a new, non-incisional technique that makes use of double-armed sutures and twists to create double eyelids in Asian patients. METHODS After everting the upper eyelid, a double-armed suture needle is passed from the conjunctival surface through the tarsal plate and then to the skin surface. The other end of the suture is advanced about 3 to 5 mm and also brought out through the tarsal plate. A second suture is used to create another U-stitch adjacent to the first suture. The upper eyelid is returned to its original position, and the sutures from the central hole are twisted around each other 4 or 5 times. They are then passed under the skin, one medially and one laterally, and the lateral and medial sutures are tied. RESULTS The authors have performed 1108 procedures during the past 10 years with no loss of double-eyelid line in a mean follow-up time of 32 months. CONCLUSIONS The double suture and twist technique for creating double eyelids in Asian patients is simple, reproducible, durable, and safe. (Aesthetic Surg J 2001;21:227-232.).