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2026.02.27

Which is better, natural fixation or implantation? Senhime Akashi answers frequently asked questions about bifid surgery!

明石 仙姫
Supervising Physician
Board Certification in Internal Medicine, Japanese Society of Internal Medicine Senhime Akashi

With deep medical insight cultivated as an internal medicine specialist, I bridge aesthetic surgery, dermatology, and internal medicine. Having spent my childhood in China, I communicate fluently in Japanese, Chinese, English, and Korean. Possessing an international perspective—evidenced by invitations to present at overseas conferences—I actively promote techniques as a Key Opinion Leader (KOL) for GOURI and REJURAN®. My specialty procedures include double eyelid surgery, skin-nurturing boosters, and body hyaluronic acid treatments. My approach leverages the holistic understanding of the body cultivated through internal medicine to guide patients toward natural, healthy beauty.

自然癒着法と埋没はどっちがいい?二重整形でよくある質問を明石 仙姫がお答え! 銀座・表参道にあるBIANCA CLINIC ビアンカクリニック|美容外科・美容皮膚科・再生医療・美容婦人科・美容内科

 

Hello, I am Senhime Akashi from Bianca Clinic.
One of the most common questions I get these days from people who want to have double-exposed eyes is, “Which is better, natural fixation or implantation?” One of the most common questions we receive from people who want to have double-exposed eyelids is, "Which is better? These two methods are often compared on social networking sites, and even among friends, "Which is better? It is a topic of conversation among friends. However, as a doctor, I can tell you that which is better depends on your eyelids. First, let's talk about the difference between the two surgeries.

Natural adhesion method is one of the implantation methods

I am very often asked, “Which is better, natural fixation or implantation?” In fact, the natural fixation method is a type of implantation method. Both are so-called "petit surgery" that uses thin medical threads to create a double-edged eyelid without making a large incision as in the incision method. The main difference is in the approach used to create the double fold line.

“Resorptive implantation to create a double line using a ”line"|Natural fixation method

自然癒着法 銀座・表参道にあるBIANCA CLINIC ビアンカクリニック|美容外科・美容皮膚科・再生医療・美容婦人科・美容内科

[Procedure Name] Double Implantation Natural Adhesion Method [Description of Pictures] Top: before the procedure Bottom: 1 month after the procedure [Cost] 239,580 yen [Risks and Side Effects] Internal bleeding, swelling, swelling, heat and lethargy around the eyes, and in rare cases, loosening or removal of the threads.

 

The natural adhesion method is the same as the implantation method in that it uses threads, but the lines themselves are not fixed firmly in place with a knot of thread. A small incision is made through a small hole in the eyelid through which the thread is threaded, and a mild inflammatory reaction that occurs during the incision causes the skin and fascia to naturally adhere to each other, thereby stabilizing the line. The image is that of a double-exposed eyelid, with the threads supporting the shape and the body's own natural healing powers finishing the job.

<Benefits of spontaneous adhesion

    • No need for a large incision
    • Lines are “easy to blend.”
    • Lines are easily stabilized even for those with slightly thicker eyelids.
    • Easy to create a long-lasting double line

The most popular choice for those who are anxious about incisions but want to have a more stable double-exposed line than with implantation.

 

▶ Double implantation method: The natural adhesion method isHere

Creating a double-layered line with threads

二重埋没 裏留め 銀座・表参道にあるBIANCA CLINIC ビアンカクリニック|美容外科・美容皮膚科・再生医療・美容婦人科・美容内科

On the other hand, the implantation method involves passing a thin medical thread between the skin of the eyelid and the levator muscle and securing the line with a knot. There are many variations in the number of threads and the way they are fastened. The appeal of this method is that it offers a high degree of freedom in design, such as "natural-looking double eyelids," "clear double eyelids," and "wide eyelids.

<Merits of the implantation method

  • without an incision
  • Short downtime
  • Relatively short treatment time
  • The line can be readjusted by removing the thread

For this reason, it is often chosen as the first double-layered surgery. Incidentally, there are several different implantation techniques, depending on the method of threading and clamping, which can be selected in detail according to the characteristics of the eyelid and the ideal line.

 

▼ Double-layered implantation is here.
Double implantation: 2-point and 4-point fixation

Double Implantation (back clamping) B TWICE

Which is better, natural fixation or implantation? ───The right choice is based on the type of eye area for which you are suited.

明石先生施術 銀座・表参道にあるBIANCA CLINIC ビアンカクリニック|美容外科・美容皮膚科・再生医療・美容婦人科・美容内科 Which is better in the end, natural adhesion or implantation? The answer depends on the "personality" of your eyelids.

Cases in which the natural adhesion method is suitable|If you seek long-lasting and stable adhesion, this is the method for you.

The strength of the natural adhesion method is its ability to fixate by promoting adhesion. Therefore, the line tends to be more stable even for those with slightly thicker eyelids.

<To whom the spontaneous adhesion method is suited.

  • having thick eyelids
  • Past experience with immediate removal of the implantation.
  • I want to stabilize the wide line.
  • I want to avoid incisions, but I want to make them last as long as possible.
  • Sagging is strong there, but I prefer a natural double layer.

For these individuals, the natural adhesion method is a strong ally.At Bianca Clinic, we have also seen many cases where people who thought they had no choice but to have an incision because of the strong sagging have obtained a beautiful double fold using the natural adhesion method.

The best choice for those who “want to try it first”.

The implantation method is easy to adjust and has a short downtime. For those who are not sure which double-exposed eyelid width is right for them, or who are not comfortable with the idea of having an incision, the ease of trying it out is a major attraction.

<Persons who are suitable for the implantation method

  • having thin eyelids
  • I have a mild double quirk.
  • Minimize downtime
  • I want to try a double first.
  • Possible future design changes.
  • I would prefer the security of being able to remove the threads.

Many people are resistant to incisions. However, there is no need to go overboard. By having a "try-before-you-buy" procedure like the implantation method, you can search for your ideal and suitable line step by step.The implantation method is a safe option to start with for those who want to take the first natural step.

Important perspectives on how to choose, which you should know before comparing surgical techniques.

In cosmetic medicine, we are often asked the question, “Which is the best?” However, to be honest, there is no "best technique" for everyone.

The important question is, "How many years do you want to spend in that duplex?"

When considering a bifocal surgery, we tend to focus on "which procedure is best," but there is actually a more important point. That is, "how many years do you want to spend with that double-exposed eyelid?For example, the procedure to choose will differ depending on whether the idea is that "keeping it for a few years is enough" or "I want to have the same double-layered line for as long as possible.

 

If you want a stable line that lasts as long as possible, the natural fixation method is suitable in many cases. On the other hand, if you are at the stage of "first wanting to find a line that suits you," the implantation method is easier to adjust and less burdensome, making it an easier choice.

 

That is why it is important for you to openly tell us “how you want to spend your time” during the counseling session.If you tell us about your lifestyle, such as "I may want to change the width of my face in the future," or "I want to shorten the downtime due to my work schedule," the doctor can more accurately recommend a suitable surgical technique.Once you are clear on your values, the best choice of duplexes will naturally be established.

Eyelid “habits” differ from person to person.

When I examine patients, I always feel that eyelids are truly ten different people. Therefore, even if the same design is desired, it is not always possible to achieve the same result. That is why there is always a part of you that “cannot be understood without examining you. In fact, sometimes the examination will reveal that the eye opening is stronger than expected, while other times it may be weak and difficult to draw a line. It may sound straightforward, but the eyelids really do have strong habits.

  • Skin thickness
  • Amount of orbital fat
  • Ease of skin and fascia adhesion
  • Eye opening (whether there is ptosis)

By comprehensively evaluating these factors, we can make a decision that "the natural adhesion method is best for this person" or "the implantation method is more stable for this person.So I don't recommend choosing based solely on information from friends or social networking sites. Because your eyelids have features that are unique to you.Although they may look the same, the nature of each person's eyelids is unique. The “right” solution for you will only be known after a consultation.

To find out which one is right for you, visit Bianca Clinic first.

Both natural fixation and implantation are attractive techniques. Which is best, however, depends entirely on “your eyelid.The thickness of your eyelids, the amount of fat, the way your eyes open, your lifestyle, and your ideal design. Choosing a surgical technique based on all of these factors is the true shortcut to enjoying a natural and beautiful double-exposed eye for a long time.The ideal line is not determined by the procedure itself, but by working backwards from your eyelids. Which is right for me? The best moment to consult with us is when you feel that way.At Bianca Clinic, we will examine your eyelid characteristics in detail and carefully suggest the best way to create a double fold. Please feel free to consult with us anytime if you want to know “the best double-lid for you”.

 

▶ Bianca Clinic's double eyelid related procedures areHere

▶Counseling appointments are available atHere

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