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How to tell the difference between a good and bad Double Eyelid Procedure

Many of us want to attain double eyelids, where the eyelids perfectly frame our eyes and complement our overall facial structure. However, with all the various methods and surgical techniques available, how do we know what a good double eyelid procedure is?

Of course, it’s important to note that positioning and one’s idea of “good-looking” are subject to one’s personal tastes and preferences. That aside, we’ve asked Plastic Surgeon, Dr Samuel Ho, to share some tips on what you should look out for when evaluating a double eyelid procedure’s success. Read on to find out more!

How does a Double Eyelid Procedure work?

In general, most clinics offer two kinds of double eyelid procedures.

Non-incisional blepharoplasty

No cuts are made during this procedure. The eyelid crease is marked and stitched in place with sutures inserted through tiny holes. When the eyes are closed, no crease or scarring should be seen. When the eyes are open, the newly created double eyelids should make the eyes seem bigger and brighter.

To achieve this result, a variety of suture techniques can be used: Single, Double or Triple sutures.

  1. Single Suture
    1 suture used to create the crease. Tends to be tighter and less natural. Also a higher risk of failure.
  2. Double Sutures
    Two sutures are used to create a new fold or deepen the previous one.
  3. Triple Sutures
    A triple-looped suture is used as opposed to a double-looped one. This technique has a lower chance of loosening or breaking with this technique, resulting in more permanent creases.

Incisional blepharoplasty

After the double eyelid crease design is confirmed, a layer of excess fat, muscle and tissue is removed from the eyelid. Then, two sides of the incision (lengthwise) are stitched together to cover the exposed tissue and form a crease.

This technique is typically used on those who have droopier or puffier eyelids.

What makes a Double Eyelid Procedure Good or Bad?

Scar appearance

If you did an incisional blepharoplasty, you walk away with a scar which usually fades away within 2 months of the surgery.

For a non-incisional blepharoplasty, no scars should be seen on your eyelids.

If your healing trajectory wildly deviates from this one, your procedure might just be a flop.

Symmetry of the eyelid creases

Another objective way to determine if the procedure was done well, is to evaluate the symmetry of your eyelid creases after your wounds heal.

  • Do the creases differ significantly between the left and right eyes?
  • When you close your eyes, is the crease still present?
  • Is there more than one crease on each eyelid?

Unfortunately, if your response was “yes” to all questions, you likely have a poorly done
procedure on your hands.

Height, shape, and depth of the eyelid creases

Ultimately, these details are subject to your tastes and facial structure. Someone with more heavy-set eyes or thicker eyebrows might look better with deeper and highly-positioned creases. In comparison, someone with smaller eyes and thinner eyebrows might benefit from a lighter and lower crease.

Essentially, your new double eyelids have to look like they fit in with the rest of your face. If they look comical or exaggerated, you might just have had a bad procedure done.


Finally, the rarest and most prominent indicator of a badly done procedure — medical complications. Although rare, a badly done procedure might lead to complications such as:

  • Ptosis — droopy eyelids that obscure your vision or cause headaches and fatigue.
  • Difficulty opening and closing the eyelids — your eyelids might open and close jerkily. Or, they might remain shut when you want them to open, even after the swelling has gone away.
  • Vision problems — blurred or painful vision persisting for more than usual after the surgery should warrant immediate medical attention.

What can I do if I am unsatisfied with my double eyelid procedure?

If you are unhappy with the results of your double eyelid procedure, you may be eligible for corrective surgery. Whether it is unnatural-looking, asymmetric or excess skin and fat, there are ways to correct these issues. This procedure can be done with your current plastic surgeon or a new one whom you trust.

Revision policies regarding fee waivers and validity duration vary from clinic to clinic. Hence, it would be advisable to enquire about them before booking an appointment.


Finally, it’s important to note that when double eyelid procedures go wrong, there are many factors that contribute to this result. Sometimes, resultant scar tissue left behind from previous surgeries and undiagnosed ptosis that was not corrected could contribute to unsatisfactory new creases. These are factors that are usually difficult for your surgeon to pinpoint and correct as well. Thankfully, there are several ways to fix these issues as well.

There are plenty of things a patient can do before going under the knife. Prior research is crucial, and it would be good to identify what kind of results you want and to find a reputable doctor well-versed in double eyelid surgery. During your first consultation, you may even ask for photos of past procedures done.

Making this decision can be daunting. If in doubt, please book a consultation with your Plastic Surgeon. He/she will work with you in understanding what look would suit you best based on your facial features and desired results.