Hello, I’m Dr. Hyo wan Suh, the head surgeon at Lively Plastic Surgery.
When considering double eyelid surgery, most patients focus on two important factors: achieving a natural-looking crease and ensuring that the result remains stable over time without loosening.
In reality, these two goals can sometimes conflict with each other. Nevertheless, they are both priorities that I consider extremely important as well.
The traditional non-incisional blepharoplasty offers advantages such as faster recovery and minimal scarring because it does not require an incision. However, it is also the procedure most commonly associated with the question, “Won’t the crease eventually loosen?”
This concern is not unfounded. It stems from the structural limitations of the buried suture technique itself.
As medical technology and surgical techniques have continued to evolve, the Natural Adhesion Double Eyelid Technique has emerged as a more advanced alternative that addresses many of the shortcomings of the conventional buried suture method.
Furthermore, at Lively Plastic Surgery, we have developed and implemented our own proprietary technique called the “Run-proof Natural Adhesion Method,” designed to further minimize the possibility of loosening.
In this article, I will explain the differences between the conventional buried suture technique and the standard natural adhesion method, as well as how the Run-proof Natural Adhesion Method achieves a more secure and long-lasting result.
※ Important Notice
The Run-proof Natural Adhesion Method is not suitable for every eyelid type. The most appropriate surgical method should be determined after a board-certified plastic surgeon directly evaluates the condition of the eyelids.
[Run-proof Natural Adhesion, pre / postoperation 1 month ]
Three Techniques: What Makes Them Different?
To fully understand the Natural Adhesion Method, it is important to first understand the conventional buried suture technique.
The buried suture method creates approximately five to six small entry points along the planned double eyelid line. Sutures are then passed through these points to create a connection between the eyelid skin and the muscle responsible for opening the eyes.
As a result, double eyelids appear natural when open, and because there is no incision, visible scarring is minimal.
However, since the fixation relies solely on sutures, there has always been a relatively higher possibility of the crease loosening over time.
People blink more than ten thousand times a day, and repeated movement can gradually weaken the fixation.
To overcome this limitation, the Natural Adhesion Double Eyelid Technique was developed.
While this method also uses sutures for fixation, it additionally encourages adhesion between the skin tissue and the muscle that lifts the eyelid around the suture areas. This biological adhesion increases the stability of the crease.
In other words, the Natural Adhesion Method adds tissue adhesion as a secondary support mechanism in addition to the sutures themselves, thereby reducing the likelihood of loosening.
However, even among procedures referred to as “natural adhesion,” the actual surgical details can vary significantly.
At Lively Plastic Surgery, we found that creating adhesion only around the knot areas was insufficient in terms of long-term durability. For this reason, we perform the <Run-proof Natural Adhesion Method>, which promotes tissue adhesion throughout the entire double eyelid line.
What Is the Run-proof Natural Adhesion Method?
The Run-proof Natural Adhesion Method, developed exclusively at Lively Plastic Surgery, is a surgical technique designed to overcome the limitations of conventional natural adhesion procedures while maximizing the durability of the eyelid crease.
What differentiates this method from standard natural adhesion techniques is the expanded range of tissue adhesion along the entire double eyelid line.
As mentioned earlier, conventional natural adhesion methods typically create adhesion only around the suture knot areas. In contrast, the Run-proof Natural Adhesion Method partially removes the anterior tissue of the tarsal plate across the entire designed eyelid crease line, inducing a longer and more continuous linear adhesion.
Key Advantages of the Run-proof Natural Adhesion Method
1) Minimized Risk of Loosening
Because the area of tissue adhesion is significantly expanded, both the strength of the sutures and the biological bonding force between tissues are enhanced. This substantially reduces the risk of the double eyelid crease loosening compared to conventional methods.
2) Even Distribution of Tension
Since tissue adhesion occurs over a broader area, the tension placed on the sutures is distributed evenly across the crease line. This minimizes excessive pulling or bunching at specific knot points, resulting in a more comfortable and natural appearance, even when the eyes are closed.
Who Is the Best Candidate for the Run-proof Natural Adhesion Method?
Choosing the right double eyelid surgery technique begins with a careful evaluation of each individual’s eyelid structure.
The Run-proof Natural Adhesion Method tends to produce optimal results in patients who have:
- Thin eyelid skin with minimal excess fat
- Fair eyelid-opening strength
- Mild or no ptosis, with eyelid-opening function above a certain standard
- A desire for natural-looking results with minimal scarring
On the other hand, different surgical approaches may be more appropriate in the following cases:
- Thick eyelids or excessive fat
→ Partial incision with fat removal or a full incisional method may be recommended - Moderate to severe ptosis
→ Ptosis correction surgery may be more suitable
Understanding Non-Incisional Double Eyelid Surgery: More Than Just a Cosmetic Procedure
Natural adhesion double eyelid surgery is often perceived as a simple cosmetic procedure, but in reality, it requires a high level of precision and extensive clinical experience.
From designing a crease that harmonizes with the patient’s eye structure and facial proportions, to precisely controlling the depth and range of tissue dissection, and optimizing the fixation points and tension of the sutures — every step of the process directly influences the final result.
This procedure requires accurate placement and tension control of the sutures along the desired crease line while ensuring stable tissue adhesion in the intended position. For this reason, it is extremely important to carefully evaluate the experience and expertise of a board-certified plastic surgeon before undergoing surgery.
If you have any further questions regarding this procedure, please feel free to contact Lively Plastic Surgery at any time.
We will carefully assess your eyelid condition in person and guide you toward the most suitable treatment option to achieve the best possible result.
Thank you.