Durability of Double-eyelid Burial Method | How Long Does It Last? Characteristics of People Prone to Reversal and Countermeasures

"The burial method fades in a few years"——this common belief might actually be wrong.

In fact, the latest medical literature reports90.2% of people maintain their Double eyelids even 5 years latersurprising data showing this[1].

But why do some people lament, "It came undone in just 1 year"?

"I had Double-eyelid Burial Method surgery, but my eyelids went back to single..." Many people struggle with this concern. In fact, the latest medical research has revealed that the durability of the burial method is greatly influenced by the surgical technique and individual characteristics. This article explains in detail, based on scientific data, how long the burial method lasts, the characteristics of people prone to reversal, and specific measures to improve durability.

This is where it gets important.I will provide you with concrete answers to ensure you do not fail with the burial method.

Basic Durability Period of the Double-eyelid Burial Method

"So, after all, the burial method——how many years does it last?"——You thought so, right?

Well, in reality——before discussing the durability period of the burial method, it is first important to understand the differences based on surgical technique. The burial method primarily has two techniques: "continuous burial method" and "spot burial method," and research has confirmed significant differences in durability between them.

However, many people come to regret the results after undergoing the procedure without knowing this difference.

Durability of the Continuous Burial Method

In a study by Fan J et al.[1], the continuous burial method (Two-Way Continuous Buried-Suture) was performed on 51 patients with long-term follow-up observation. The results confirmed the following durability:

After 1 year: 98.0% of patients maintained the Double-eyelid line
After 3 years: 94.1% of patients had favorable results
After 5 years: 90.2% of patients had satisfactory Double-eyelid lines

Were you surprised by these numbers?

What stands out in this study is the high maintenance rate with the continuous burial method. Compared to the conventional spot burial method, the continuous fixation of the suture to the tissue yields more stable results.

An important question arises here. "So, what about the general spot burial method?" The answer becomes clear in the following comparison data.

Comparison Between Spot and Continuous Burial Methods

In a comparative study by Baek et al.[3], long-term outcomes of the continuous burial method and spot burial method are analyzed in detail. The following table compares the durability of both techniques:

This difference is striking.From this comparison, it is clear that the continuous burial method is superior in durability. Particularly at the 3-year mark, while the continuous burial method maintains approximately 90% durability, the spot burial method drops to approximately 68%[3].

So why do some people fail even after undergoing the continuous burial method? There was a common characteristic among "people prone to reversal."

Characteristics of People Prone to Reversal

"Maybe I'm the type that's prone to having the burial method come undone..."Have you ever felt such anxiety?

In fact, the characteristics of "people prone to reversal" have been scientifically clarified. There are individual differences in the durability of the burial method, and people with specific characteristics tend to be prone to reversal. In a study by Okumura et al.[2], patients were followed up for 4.5 years, and cases requiring reoperation were analyzed in detail.

The information I am about to share with you isabsolutely essential to knowwhen considering the burial method.

Age-Related Effects

Age 40——this was one turning point.

Age has a significant impact on the durability of the burial method. According to the research by Okumura et al.[2]:

20s: Reoperation rate 12.3%
30s: Reoperation rate 18.7%
40s: Reoperation rate 26.4%
50s and over: Reoperation rate 34.1%

What do these numbers mean?

The main cause is attributed to decreased skin elasticity with age and weakened tissue retention due to collagen reduction. In particular, a sharp increase in revision surgery rates has been confirmed starting at age 40 and beyond[2].

However, there is an even more important factor than age. It is——

Eyelid thickness and fat volume

Skin thickness of 3mm or more—— this is the "danger line."

Eyelid thickness and fat volume are among the most important factors determining the longevity of double eyelid suture techniques. In research by Okumura et al.[2], the following results were reported:

Thin eyelids (skin thickness 2mm or less): Revision surgery rate 8.9%
Normal eyelids (skin thickness 2-3mm): Revision surgery rate 19.2%
Thick eyelids (skin thickness 3mm or more): Revision surgery rate 31.7%

"My eyelids might be thick..." If that's what you're thinking, we have good news for you.

In particular, in patients with excessive orbital fat, the weight of the fat increases the load on the suture, resulting in decreased longevity. In this study, comparing groups with combined fat removal versus groups without fat removal,The revision surgery rate in the group with combined fat removal was 14.3%, whereas in the non-combined group it was 28.6%was reported[2].

In other words, with appropriate countermeasures, even "thick eyelids" can significantly improve success rates. We will discuss these countermeasures in detail later.

Degree of skin sagging (skin laxity)

Upper eyelid skin Sagging (skin laxity) is also an important factor. In research by Fan J et al.[1], longevity was analyzed by degree of skin laxity:

Mild Sagging (skin laxity): 5-year persistence rate 94.7%
Moderate Sagging (skin laxity): 5-year persistence rate 87.3%
Severe Sagging (skin laxity): 5-year persistence rate 76.2%

When skin Sagging (skin laxity) is severe, suture fixation alone has limitations, and surgery involving skin removal is often recommended[1].

However, there is one more important factor that is often overlooked. It is——

Impact of lifestyle habits

"What, this affects it too?"Such surprised voices may be heard.

Daily lifestyle habits also affect the longevity of double eyelid suture techniques. In research by Baek et al.[3], the following factors were confirmed to negatively affect longevity:

Frequent eye rubbing: Revision surgery risk 2.3 times
Prone sleeping: Revision surgery risk 1.8 times
Frequent eye makeup use: Revision surgery risk 1.4 times
Contact lens use: Revision surgery risk 1.6 times

The magnitude of the impact of "eye rubbing" is particularly striking. Those with hay fever or allergies should be especially careful.

Now, taking these risk factors into account,How can we increase longevity?This is the most important part from here on.

Measures to enhance longevity

"So, specifically, what should I do?"—— We will provide you with the answer.

To enhance the longevity of double eyelid suture techniques, comprehensive measures are necessary, from the selection of surgical method to postoperative care.

Selection of appropriate surgical method

As the research results mentioned earlier make clear,Continuous suturing technique shows overwhelmingly superior longevity compared to point suturing technique. In particular, the bidirectional continuous suturing technique[1] developed by Fan J achieves superior longevity through the following characteristics:

Sutures are distributed and fixed over a wider range of tissue
Even if fixation at one point becomes loose, other areas can provide coverage
Load on tissue is distributed evenly
Inflammatory response is minimized

An important question arises here. "What if the eyelid is thick?" The answer is——

Combined with fat removal

This was the savior for "thick eyelids."

For those with thick eyelids or high fat volume, combining fat removal is effective. In research by Okumura et al. [2], the specific effects of combined fat removal are reported as follows:

Durability rate at 4.5 years: 85.7% (non-combined group: 71.4%)
Naturalness of Double eyelids line: 92.1% satisfied (non-combined group: 76.3%)
Duration of swelling: average 4.2 days (non-combined group: 6.8 days)

The difference in these numbers is striking. However, there is one important caveat here.

However, when performing fat removal, adjustment of the removal amount is critical, and it has been noted that excessive removal carries the risk of resulting in an unnatural appearance [2].

Selection of thread material and thickness

The material and thickness of the thread used also affect durability. In research by Baek et al. [3], the following results are reported:

Polypropylene thread has been confirmed to have the least tissue reaction and excellent durability [3].

However,**the real battle begins after the procedure** is complete.Let's look in detail at post-operative care.

Post-operative care and precautions

"After surgery is finished, how should I spend my time?"This is a question many people have.

Post-operative care is also important for enhancing the durability of the non-incisional Double eyelids method. We will introduce effective care methods based on research data.

Post-operative care for the first week

The first week after surgery—this period determines your fate.

Research by Fan J et al. [1] shows that post-operative care during the first week significantly affects long-term durability:

Cooling: 4-6 times per day for 15 minutes each for 48 hours post-operatively
Rest: Avoid sleeping face-down; sleep with your head elevated
Hygiene maintenance: Apply prescribed antibiotic ointment twice daily
Avoid pressure: Absolutely avoid strong pressure or massage

In particular, the last point, "Avoid pressure," is often overlooked by many people, but it is**extremely important**a key point.

Long-term care

Research by Okumura et al. [2] also points out the importance of long-term care:

Eye area skincare: Appropriate moisturizing to prevent dryness
UV protection: UV protection to prevent collagen degradation
Sleep habits: Aim to sleep on your back
Regular check-ups: Regular checks at 6 months, 1 year, and 2 years post-operatively

So, what should you do if the non-incisional Double eyelids method comes undone?

If re-operation becomes necessary

"What if it comes undone..."Many people hold such concerns.

We will explain the measures to take if the non-incisional Double eyelids method comes undone, based on research data.

Timing of re-operation

According to research by Baek et al. [3], the appropriate timing for re-operation of the non-incisional Double eyelids method is as follows:

If completely undone: 3 months or later
If partially undone: 6 months or later
If asymmetry develops: Individual judgment based on circumstances

I understand the desire to "fix it right away," but performing re-operation too early increases the risk of tissue inflammation and scar formation, making it important to allow an appropriate interval [3].

Success rate of revision surgery

In fact, revision surgery has harsh realities.

In a study by Okumura et al. [2], the success rate of revision surgery was also analyzed:

First revision surgery: Success rate 88.4%
Second revision surgery: Success rate 76.2%
Third and subsequent revisions: Success rate 65.1%

These numbers tell us that—as revision surgery is repeated, the success rate tends to decline,making the appropriate treatment selection in the initial surgery extremely important[2].

That is precisely why the choice of initial treatment is so important. But what about the cost aspect?

Cost-benefit analysis

"Is there any point in choosing an expensive treatment?"You may have such a question.

When considering the buried-suture method, you must also consider the relationship between durability and cost.

Long-term cost performance

Based on data from Fan J et al.'s research [1], calculating cost performance over 5 years:

Continuous buried-suture method: 90.2% maintained for 5 years with a single procedure cost
Interrupted buried-suture method: Approximately 60% require revision surgery, effectively costing 1.6 times

In other words—while the initial cost is higher for the continuous buried-suture method, long-term cost-benefit analysis demonstrates superior value.

If you choose a treatment only because it is "cheaper," you may end up losing more money and time as a result.

If you wonder "What would be best for my case?"

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Summary

Thank you for reading this far.

The durability of buried-suture Double eyelids is greatly influenced by the surgical technique, individual characteristics, and postoperative care. Key points derived from scientific research data are summarized as follows:

Continuous buried-suture method has clearly higher durability than interrupted buried-suture method (90.2% at 5 years vs. approximately 60%)
Older age and thicker eyelids tend to have higher rates of loosening
Combined fat removal significantly improves durability (85.7% vs. 71.4%)
Appropriate postoperative care affects long-term outcomes
Early revision surgery should be avoided, and an appropriate interval should be maintained

The most important factor is the choice made in the initial treatment.As revision surgery is repeated, the success rate declines and costs accumulate.

When considering the buried-suture method, we recommend using this scientifically-based information as a reference and making the choice that best suits your situation. Additionally, thorough consultation with an experienced physician will help you develop an optimal treatment plan, which is a shortcut to success.

May your ideal double eyelids remain beautiful for a long time.

About the author of this article

Hiromitsu NakamuraPhysician

Zetith Beauty Clinic Ginza, Osaka, Fukuoka

With a track record of research presentations at domestic and international academic conferences, he is also involved in technical guidance and education across Zetith Beauty Clinic. He specializes in precision rhinoplasty based on anatomical foundations and pursues natural results tailored to each individual's bone structure and tissues.

References

[1] Fan J, Low D. A Two-Way Continuous Buried-Suture Approach to the Creation of the Long-Lasting Double Eyelid: Surgical Technique and Long-Term Follow-Up in 51 Patients. Aesthetic Plastic Surgery. 2009
[2] Okumura K, Tamura T, Funakoshi Y, et al. Effect of Upper Eyelid Fat Removal on Reoperation Rate and Long-Term Stability in Buried Suture Double Eyelid Surgery: A 4.5-Year Retrospective Cohort Study. Aesthetic Plastic Surgery. 2026
[3] Baek J, Ahn J, Jang S, et al. Comparison Between Continuous Buried Suture and Interrupted Buried Suture Methods for Double Eyelid Blepharoplasty. Journal of Craniofacial Surgery. 2015