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A new non-incisional "thread" method for correction of eyelid ptosis

Writing in the U.K.'s Journal of Plastic, Reconstructive & Aesthetic Surgery, three Japanese plastic surgeons at the Keio University School of Medicine in Tokyo have described an entirely new approach for the correction of ptosis, or droopy upper eyelids.

Compared to patients of European descent, mild ptosis seems to occur at a significantly higher rate in young adults of Asian descent. Since ptosis is not corrected by double eyelid surgery undertaken to create a crease, it is, when overlooked on one side, a common cause for postoperative dissatisfaction due to asymmetry.

asian eyelid ptosis

Incisional methods of double eyelid surgery are emphasized in the West, South Korea, and China, while more "petite" techniques such as non-incisional "suture methods" are favored in Japan.

Not surprisingly, three Japanese surgeons have adapted features of the non-incisional suture method to correct mild ptosis.


While existing techniques require a wide incision be made either on the skin of the upper eyelid or along the lid's inside layer (conjunctiva), the new technique does not.

Basically, the upper eyelid is turned inside out to expose its back surface. Threads (sutures) are introduced through the conjunctiva and into both the levator muscle (the muscle most responsible for opening the lid) and tarsus (a strip of cartilage-like material at lid's margin near the eyelashes). After connecting these two structures at two to four locations, the threads can be tightened and the drooping upper lid can be elevated to a better position. No dissection of eyelid tissues is required.

The technique is reported to yield a 97.5% rate of success in patients with mild ptosis. In moderate cases, the success rate dropped slightly to between 75-89%.

According to Drs. Shimizu, Nagasao, and Asou, their new minimally-invasive method offers the advantages of simplicity, no scarring, and quick recovery. As with all new surgical techniques, it will take wider adoption and years of follow-up to determine the usefulness of this fundamentally different approach.

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