The eyes are often called the windows to the soul, and they are usually the first feature people notice when meeting someone. In Taiwan, double eyelid surgery is the most common form of cosmetic surgery. Oculoplastic procedures encompass a wide range of treatments, including suture and incision methods for double eyelid creation, eye bag removal, correction of drooping eyelids (ptosis), and more.

Double Eyelid Surgery—Suture Method

This technique creates a double eyelid fold using sutures without making large incisions. It is best suited for individuals with thin eyelids, no eyelid drooping (ptosis), and minimal orbital fat. The main advantages of this method include a shorter surgical time, quicker recovery with reduced swelling, and minimal visible scarring. However, in some cases, the double eyelid fold may fade or become less defined within a year, potentially requiring a revision procedure. Using a small-incision suture technique can enhance the stability of the fold, making it less likely to disappear. This method also causes less discomfort, as it avoids the need to flip the eyelid for suturing.

Double Eyelid Surgery—Incisional Method

For individuals with “puffy eyes,” thick eyelids, sagging skin that creates multiple eyelid folds, or age-related drooping, an incision-based double eyelid surgery is often necessary. This procedure involves removing excess skin and fat, and reshaping the eyelid contour based on the distance between the eyebrows and eyelashes. It allows for precise correction of these concerns and offers a more defined and long-lasting double eyelid effect. However, this method does come with some trade-offs — a longer recovery period, visible swelling that typically subsides within one to two weeks, and full natural results that may take one to two months to appear. A faint scar may also remain, though it usually fades over time.

Lower Eyelid Surgery—Internal (Transconjunctival) Approach

Excess fat can be removed through a transconjunctival approach, which involves making an incision on the inner side of the lower eyelid. This technique offers the advantage of a faster recovery and leaves no visible external scar. It is especially suitable for younger patients who have mild to moderate eye bags and good skin elasticity.

Lower Eyelid Surgery—Outer (Transcutaneous) Approach

This procedure is suitable for patients with loose or sagging lower eyelid skin. It addresses multiple concerns simultaneously, including eyelid laxity, eye bag fat, and weakened fascia. Depending on the patient’s condition and the surgical approach chosen by the physician, the treatment may involve removing or repositioning protruding fat to fill the tear trough, tightening or suturing the fascia to improve eyelid support, and excising excess skin for a smoother, more youthful appearance.