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Designing natural beauty with trust.

I am Masataka Fujihashi, a board-certified plastic surgeon.

 

 

Double eyelids are visible when the eyelids are opened. The skin is drawn into the levator aponeurosis—the tendon connecting to the levator palpebrae muscle (the muscle that lifts the eyelid)—causing the skin to fold back.It appears.

During counseling sessions,Sometimes clients bring in photos of their double eyelids created with eyelid tape and say, "I want double eyelids shaped like this."

Here, we'll briefly outline the differences between double eyelids created with eyelid tape and natural double eyelids.

 

• eyelid tape

　→ Adheres to the skin's surface to "make it appear broken"

　→ There is no synchronization with movement. / Prone to sagging over extended periods / Continued use may cause skin to stretch easily

 

• Natural double eyelids

　→ The skin and the levator palpebrae muscle work togetherand,The natural crease formed as the eyelid opensStructure

　→ appears to move in sync with blinks and facial expressions

 

 

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1. How Double Eyelids Form (Mechanism)

connected to the muscle that lifts the eyelid (levator palpebrae superioris)Connective tissue extending from the levator aponeurosis to the skinWhen you open your eyelids,The skin is pulled inward.。

This creates a double crease. It is also called a double indentation.

Source: 'Facial Plastic Surgery, 1st Edition' (Nihon Iji Shinposha, 2021), p.3, Figure 2, reproduced with modifications

 

With a single layer, this bond is absent, preventing interlocking.

Source: 'Facial Plastic Surgery, 1st Edition' (Nihon Iji Shinposha, 2021), p.3, Figure 2, reproduced with modifications

 

Double eyelids,The skin and the levator palpebrae muscle work togetherThis creates a crease, forming a structure where the skin naturally folds along with the movement of opening the eyelid.

The buried suture method does not alter the eyelid structure itself, but rather uses sutures to recreate the coordination between the skin and the levator muscle.

When the eyelid conditions are right, buried suture double eyelid surgery can create a sufficiently natural and stable double eyelid.

 

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2. What Full Incision Can Do

Compared to the buried method,Full incision directly reshapes the eyelid tissue.by doing so,Surgery to create the double eyelid structure itselfis.

While internally forming the articulation between the skin and the levator aponeurosis,The thickness of the eyelid and the amount of skin can be adjusted as needed.。

・You can directly create "linked" double lines
　→ High reproducibility of line depth and width

・Thickness adjustmentcan be performed (orbicularis oculi muscle, fat, skin volume)
　→ Also suitable for those with thick eyelids or prone to shallow creases

・For pronounced epicanthal folds, combining with epicanthoplasty can
　→ You can adjust the width of the inner double line.
　→ Freedom of form, such as parallel/mixedspreads

・When eyelid opening strength is weak
　Performing ptosis surgery simultaneously can improve the eye opening itself.

 

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3. Comparison of the Buried Method and Full Incision

・Buried suture method → A surgical procedure that creates a fold by using sutures to recreate the connection between the skin and the levator muscle.

・Full incision method → Surgery that directly reshapes eyelid tissue to create the double eyelid structure itself

It's not a matter of which is better; the appropriate surgery varies depending on the condition of the eyelids and the desired shape.

 

Buried suture is a natural and low-impact method when conditions such as thin eyelids, minimal fat, weak epicanthal folds, and little sagging are present.

 

Full incision surgery is most effective for individuals with thick eyelids, those seeking specific width or shape, those wanting improved eye opening, or those desiring long-term stability.

 

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Summary

By thoroughly understanding the principle behind double eyelids, you can choose the surgery that best suits you.

Full incision surgery directly reshapes the eyelid tissue to create the double eyelid structure itself, offering high design flexibility.

Let's aim for beautiful, long-lasting double eyelids that are natural and comfortable, using the appropriate surgical technique while comparing your current eyelid condition with your ideal outcome.

 

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【Profile】

Masataka Fujihashi, MD, Plastic Surgeon

Leveraging expertise as a board-certified plastic surgeon, I offer comprehensive facial cosmetic procedures including eyelid and nose surgery, facial liposuction, thread lifts, and hyaluronic acid injections. From incisional surgeries and revision procedures requiring delicate design to minimally invasive injections and lifts with minimal downtime, I strive to provide treatments tailored to each patient's ideal outcome.

We are dedicated to achieving natural results and minimizing downtime, pursuing medical care that leaves you feeling confident in your choice through sincere consultations.

Designing natural beauty with trust.

We cherish that sentiment and apply it to our daily practice.

 

Read other blog posts ▼

https://biancaclinic.jp/author_cat/fujihashi/

 

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【Career】

March 2015: Graduated from the School of Medicine, Showa University

April 2015 Showa University Yokohama Northern Hospital Initial Clinical Training

April 2017 Showa University Hospital Department of Plastic Surgery

October 2017 Maebashi Red Cross Hospital Plastic Surgery / Cosmetic Surgery

April 2019 Nishio Municipal Hospital Plastic Surgery Department

April 2020 Showa University Fujigaoka Hospital Plastic Surgery Department

November 2020 Ota Nishinouchi Hospital Plastic Surgery / Cosmetic Surgery

July 2022 Tokyo Rosai Hospital Plastic Surgery / Cosmetic Surgery  Department Head

July 2022: R.O.clinic (Part-time), Kusano Taro Clinic (Part-time)

April 2024 Deputy Director, Ginza TA Clinic

November 2025 BIANCA CLINIC

 

【Professional Affiliations and Qualifications】

Japanese Society of Plastic and Reconstructive Surgery Board-Certified Plastic Surgeon

Member of the Japanese Society of Aesthetic Plastic Surgery (JSAPS)

Member of the Japanese Society of Aesthetic Surgery (JSAS)