Surgery time
Non incisional about 30 minutes. Incisional about 40 minutes.
Guide
Incisional or Non Incisional Double Eyelid Surgery?
The honest answer is that it depends on your eyelid rather than on your preference. How thick the eyelid skin is, how much excess or sagging skin you carry, and whether the muscle that opens your eye is weak are what decide which method will give you a crease that holds. Those three things are read from the eyelid itself, which is why the choice is confirmed at your examination and not from a photograph.
Start here
The two methods in one minute
What actually happens during each operation, in plain language.
1
Non incisional, the buried suture method
The eyelid is not opened along its length. Dr. Lee Haksoo designs the line with you, tiny openings are made along that crease line, and double knots placed through them create the naturally adhered double eyelid.
Because nothing is cut open, there are no stitches to remove and no separate visit for stitch removal. Surgery takes about 30 minutes and the result is a soft, natural double eyelid line.
Non incisional double eyelid surgery2
Incisional, the open method
The crease line is planned with you first. The eyelid is then opened along that line so excess skin can be secured and unneeded fat or part of the orbicularis muscle removed. The skin is connected to the levator muscle and then sutured.
Because tissue is removed and the crease is anchored, this method carries little risk of the crease coming undone. Surgery takes about 40 minutes and stitches come out on day 4.
Incisional double eyelid surgeryResults vary from person to person. All surgery carries risk. This page is general information and not medical advice.
Side by side
Suture versus incision, compared
Every figure below comes from our own procedure pages.
Anesthesia
Both: IV sedation or local anesthesia, decided during your consultation.
Stitch removal
Non incisional none, so no separate visit. Incisional day 4.
Return to daily life
Both after 2 to 3 days. Eye makeup and contact lenses from two weeks.
Scar
Non incisional leaves no surgical traces, nothing to notice even with your eyes closed. Incisional once healed, a well placed incisional crease sits inside the natural fold and is not visible when the eyes are open, and any redness along the line usually fades over the following months.
Permanence
Incisional carries little risk of the crease coming undone. Non incisional varies by individual eyelid anatomy, worth asking candidly at your consultation
Reversibility
If a buried suture crease does not suit you, revision eyelid surgery is the route to adjust or redo it
Best suited to
Non incisional thin skin, little fat, little sagging. Incisional heavy fat, sagging skin, ptosis, or a defined line that will not loosen.
Aftercare, both
Cold compresses for four days. No baths, saunas, exercise or swimming for 3 weeks. No alcohol or smoking for 1 month.
Candidates
Who suits the non incisional method
These are the criteria we use on our own procedure page.
- Your eyelid skin is thin.
- Your eyelids are not very saggy and carry little fat.
- You already have a double eyelid line, but it loosens from time to time.
- Your crease splits into several faint lines instead of one clear one.
- A crease forms easily when you use double eyelid tape.
- You want the shortest possible interruption to daily life, with no stitch removal visit.
The tape test is more useful than it sounds. If a strip of tape lifts your lid into a clean crease with very little pressure, there is not much tissue in the way, and a lid like that tends to hold a buried suture well.
Candidates
Who suits the incisional method
When there is something on the eyelid that has to be removed or repaired, not just folded.
- Your eyelids carry heavy fat.
- Your eyelid skin is noticeably sagging, and excess skin needs to be dealt with.
- Fat, or part of the orbicularis muscle, needs to be adjusted or removed.
- Ptosis is preventing your eyes from opening fully.
- You want a clearly defined double eyelid line that will not loosen.
- You have had eyelid surgery before and the result needs correcting. This method is frequently used in revision cases.
The common thread is that something has to be taken away or repositioned. A buried suture can hold a fold, but it cannot remove excess skin or reduce fat. If loose upper lid skin from ageing is your real concern, see upper blepharoplasty; if a previous surgery elsewhere brought you here, see revision eyelid surgery.
The real question
The question people ask that matters more
Method choice is downstream of diagnosis. Ask what your eyelid needs before you ask which technique to book.
Almost everyone arrives with the question already framed as incisional versus non incisional. It is the wrong first question. Both methods answer the same narrow problem, how to create and hold a crease. Neither, on its own, answers a more common one: an eye that does not open far enough.
That problem is ptosis. Our ptosis pages describe it as the iris staying largely hidden under the eyelid when the eyes are open naturally, because the strength available to open the lid is weak. In everyday terms, an eye that looks sleepy or tired no matter how well rested you are.
Here is why it matters. If the lifting muscle is weak and you simply create a fold, you have moved the skin, not the opening. The crease may sit exactly where it was designed and the eye can still look half closed underneath it. That is a diagnosis problem, not a technique problem.
When ptosis is present, the operation that matters is ptosis correction, and it comes in the same two forms. Non incisional ptosis correction takes about 30 minutes: tiny openings are made along the planned line and the eyelid opening muscle is reinforced while the crease is anchored at the same time. Stitches come out 3 days after surgery. It suits thin eyelid skin that is not significantly saggy and carries little fat.
Incisional ptosis correction takes about 1 hour, with stitches out on day 4. It is recommended when the eyelids carry a lot of fat, when the skin is thick or sags heavily, and for eyes that look severely sleepy and tired. The eye opening muscle is strengthened while the crease is established, and the skin is connected to the levator muscle.
Notice that the incisional double eyelid page also describes connecting the skin to the levator muscle. The same anatomy is involved, which is why diagnosis comes first and the label second. If you are unsure which side of this line you fall on, read do I have ptosis before choosing a method. Where the crease, the eye opening and the inner corner are addressed together, that combination is our Beautiful Eyes Trio, which is double eyelid surgery plus ptosis correction plus epicanthoplasty.
Durability
Does the non incisional fold last?
The straight answer, without overselling it.
A crease held by buried knots can loosen over time in some patients. We would rather say that plainly than promise otherwise. The same reality shows up in our own candidate list: one of the people the non incisional method is aimed at is the patient who already has a double eyelid line but finds it loosens from time to time.
The risk is not evenly spread. The knots hold a fold by pulling a thin, light lid into a crease. The more tissue there is to hold, meaning thick skin or heavy fat, the harder that job is. That is why our procedure page limits the non incisional method to thin skin with little fat and little sagging.
The incisional method sits at the other end. Because excess skin, unneeded fat or part of the orbicularis muscle is removed and the skin is connected to the levator muscle before suturing, our page states that it carries little risk of the crease coming undone.
So the honest framing is a trade. The non incisional method offers a shorter operation, no stitch removal and no surgical traces. The incisional method offers a crease far less likely to come undone, at the cost of an open procedure and a stitch removal visit. Any figure for how many years a buried suture crease lasts is not published, since it depends heavily on individual anatomy. If a crease does loosen over time, revision eyelid surgery is available to restore or convert it.
Process
How the decision is actually made
A photograph can start the conversation. It cannot finish it.
1
Photo consultation on WhatsApp
You send photos of your eyes, open and closed, to KORA, our official medical travel partner. This gives us a first impression and a sense of the result you want.
2
Examination in person
At the clinic in Busan, Dr. Lee Haksoo examines what a photo cannot show: eyelid thickness, how much fat and excess skin the lid carries, its elasticity, and how strongly the muscle lifts the lid.
3
Dr. Lee Haksoo recommends a method
He explains what he found and which method fits it, including whether ptosis correction rather than a plain crease is the honest answer. He plans and performs every surgery himself.
4
You decide together
The crease line is designed with you, not for you. Height, shape and how defined you want the line are settled here, and only then is the method confirmed.
Treat any online answer, including this page, as preparation rather than a decision. Two people with identical looking photos can need different operations, because the difference between them is lid thickness and muscle strength, and neither is visible in a photograph. For travel planning, our guide on how long to stay in Korea for eyelid surgery shows how the stitch removal date shapes your trip.
Read next
The procedure pages in full
Each page lists surgery time, anesthesia, stitch removal, recovery and candidates.
Non incisional double eyelid
About 30 minutes, no stitches to remove. For thin skin with little fat.
Non incisional double eyelid surgeryIncisional double eyelid
About 40 minutes, stitches out on day 4. For heavy or sagging lids.
Incisional double eyelid surgeryNon incisional ptosis correction
About 30 minutes, stitches out 3 days after surgery.
Non incisional ptosis correctionIncisional ptosis correction
About 1 hour, stitches out on day 4. For thick or heavily sagging lids.
Incisional ptosis correctionBeautiful Eyes Trio
Double eyelid surgery, ptosis correction and epicanthoplasty as one plan.
Beautiful Eyes TrioDo I have ptosis?
The signs to check before choosing between a crease and a correction.
Do I have ptosisFAQ
Frequently asked questions
Can I change from non incisional to incisional later?
The incisional method is frequently used in revision cases at our clinic, so a patient whose non incisional crease has loosened can usually be treated with it afterwards. Dr. Lee Haksoo would examine the eyelid first to see what the earlier surgery left behind, since a revision is planned around the existing lid rather than from scratch.
Will the scar be visible?
Our procedure page describes the non incisional method as leaving no surgical traces, nothing to notice even when your eyes are closed, because the crease is set through tiny openings rather than an open cut. The incisional method places its line along the crease itself, so it sits inside the fold when your eyes are open. Once healed, a well placed incisional crease sits inside the natural fold and is not visible when the eyes are open, and any redness along the line usually fades over the following months.
Which one looks more natural?
Both are designed to look natural. Our non incisional page describes a soft, natural double eyelid line, and our incisional page describes a natural and clearly defined result. What makes a crease look natural is the height and shape chosen for your face and whether the method matches your eyelid, not the label on the technique.
Which one hurts more?
Both are carried out under IV sedation or local anesthesia, decided during your consultation, and both allow a return to daily life after 2 to 3 days with cold compresses for the first four days. The practical difference is the follow up: the incisional method needs a stitch removal visit on day 4, the non incisional method does not. The clinic does not publish a formal comparison. In general, patients describe both methods as more about pressure and tightness than sharp pain, with the incisional method being the longer, more involved procedure of the two and carrying a bit more initial swelling.
Can the non incisional method fix ptosis?
A plain non incisional double eyelid procedure creates a crease. It does not treat a weak eye opening muscle, so it will not make a sleepy looking eye open wider. If ptosis is the issue, the relevant operation is non incisional ptosis correction, where the eyelid opening muscle is reinforced through tiny openings while the crease is anchored. For thicker, fattier or heavily sagging lids, incisional ptosis correction is used instead.
Which is better if I have thick eyelids?
The incisional method is the one our procedure page recommends for eyelids that carry heavy fat, for noticeably sagging skin and for patients who want a clearly defined line that will not loosen, because excess skin and unneeded fat or part of the orbicularis muscle can be removed during the operation. Only an examination can tell you which group your eyelids belong to.
Results vary from person to person. All surgery carries risk. This page is general information and not medical advice.