If Your Buried-Suture Double Eyelid Has Come Undone, When and How Should It Be Redone?

Because the buried-suture method connects the skin and the eye-opening muscle with sutures and no skin incision, the crease can loosen over time or the sutures can come undone from external impact or eye rubbing. Eyes with thick skin or a thick fat layer may lack durability, and studies found more crease loss in puffy eyelids and with interrupted suture fixation.

The timing of revision is decided after swelling has gone down and it is confirmed that the crease has actually come undone. According to the clinic's blog guidance, most swelling and bruising subside about 2 weeks after surgery, but recovery is not yet complete, and the American Society of Plastic Surgeons (ASPS) notes that final healing after eyelid surgery may take a few months.

A crease that looks high or faint within a few weeks after surgery may be affected by swelling, so revision is not decided based on its appearance at that point. Conversely, if the crease has disappeared or does not fold when opening the eyes even after swelling has subsided, the eyelid conditions are examined again to decide the method.

A buried-suture revision is considered for eyes with thin skin and little sagging or fat, where the buried-suture method was suitable from the start. Because repeating the buried-suture method can cause fibrosis inside the eyelid, the number of repetitions and the eyelid condition are reviewed together, and for complex conditions with significant sagging or fat, thick skin, or ptosis, switching to the incisional method is considered.

The incisional method cuts the skin to adjust soft tissue such as skin, fat, and muscle and fixes the crease, so it holds relatively well, but recovery is longer and pain or a scar may remain. In studies, among buried-suture techniques, continuous fixation retained the crease better than interrupted fixation, and the difference was larger the puffier the eyelid.

Myongji Best Plastic Surgery Clinic in Myeongji-dong, Gangseo-gu, Busan checks skin thickness and degree of sagging, the amount of eyelid fat, ptosis or levator muscle function, and eyelid asymmetry to choose between the buried-suture and incisional methods. In the buried-suture method, the crease is designed and sutures are passed through small openings using a continuous single-knot buried technique; in the incisional method, fat is removed after the incision and the levator muscle and dermis are sutured to fix the crease.

The published non-covered fee list shows buried suture at KRW 1.1 million and ptosis correction as an additional KRW 400,000 (confirmed October 22, 2026). No single fee for revision or for the incisional method is published, so the total cost is confirmed during consultation after the eyelid condition is examined, and non-covered fees are subject to change.

Myongji Best Plastic Surgery Clinic has no published statistics on crease loss rates or revision outcomes. In multi-clinic cosmetic surgery data from Japan, 22.3% of 600 two-point buried-suture cases had reoperation because of suture loosening, with the highest rate of 41% in patients under 20 and the lowest of 12% in those in their 30s.

The American Society of Plastic Surgeons (ASPS) lists bleeding, infection, difficulty closing the eyes, dryness, unfavorable scarring, and the possible need for revision surgery among the risks of eyelid surgery. Because revision is performed on tissue changed by previous surgery, the eyelid condition must be checked more carefully than before the first surgery.