Natural Adhesion vs. Incisional Double Eyelid Surgery: Which One Is Right for Me? | Complete Guide to the Differences Between Non-Incisional Double Eyelid Surgery

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Non-incisional double eyelid surgery and incisional double eyelid surgery— which procedure is right for me?

This is the question people ask most often during double eyelid surgery consultations.

Even if you search online, there is so much information that many people end up confused about which option suits their eyes best.

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To get straight to the point, there is no single better method.

The best method is the one that fits your eye condition.

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Today, I’ll explain the differences between natural adhesion (non-incisional) and incisional double eyelid surgery,

and help you sort out which method is suitable for which type of eyes.

Double eyelid surgery is divided into two types: non-incisional and incisional

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Double eyelid surgery is broadly divided into non-incisional and incisional methods.

The non-incisional method includes the buried-suture method and the natural adhesion method.

Broadly speaking, they are all non-incisional double eyelid methods,

but there are slight differences in the details, so they are referred to separately.

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What is natural adhesion double eyelid surgery (non-incisional)?

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Natural adhesion is a non-incisional double eyelid surgery method that creates a double eyelid line by making small holes in the eyelid and passing sutures through them.

The principle of natural adhesion is that the sutures passed through the upper eyelid connect the skin and muscle to the tarsal plate, creating the double eyelid line.

At first, it is held in place only by the tension of the sutures, and over time, as the tissue adheres, the line becomes established.

Diagram of the natural adhesion surgery principle

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Advantages of natural adhesion double eyelid surgery

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• There is almost no scarring

Since no incision is made, there is no visible scar.

▸ Recovery is fast

Swelling goes down quickly, and returning to daily life is relatively fast.

This is one of the biggest advantages of non-incisional double eyelid surgery.

▸ It is advantageous for revision surgery

If you later want to change the line or need revision surgery, access is easier than with the incisional method.

Finding the existing sutures, loosening them, and removing the adhesions is relatively simple.

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Disadvantages of natural adhesion double eyelid surgery

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• It can come undone

If the suture tension weakens before tissue adhesion forms, the double eyelid may come undone.

The likelihood of this is higher, especially if the eyelid is thick or has a lot of fat.

• It is not suitable for all eyes

If the skin is significantly sagging, there is a lot of fat, or the eye-opening strength is weak, incisional double eyelid surgery is more suitable.

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The number of holes in natural adhesion surgery: more is not always better

Natural adhesion surgery is usually performed by making about 5 to 7 holes.

Some clinics make more than 10 holes, but more holes do not automatically mean better results.

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With more holes, the chance of the line coming undone is lower,

but the eyes may look artificial or noticeably surgical.

If there are too few holes (fewer than 5), the result may look more natural,

but the chance of coming undone increases, and it becomes difficult to make fine adjustments from the inner to the outer part of the eye.

That is why it is important to choose the appropriate number based on your eye condition and the style you want.

Before/after photos of natural adhesion double eyelid surgery

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What is incisional double eyelid surgery?

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Incisional double eyelid surgery is literally a procedure that makes an incision along the double eyelid line to fix the crease.

Because the surgery is performed while directly viewing the inside of the skin, more delicate manipulation is possible.

If needed, excess skin removal, fat removal, and ptosis correction can also be performed at the same time.

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Types of eyes that need incisional double eyelid surgery

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Incisional surgery is more suitable for eyes like these.

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• When there is a lot of fat in the upper eyelid

• When the eyelid skin is thick

• When the skin is sagging

• When the eye-opening strength is weak (ptosis correction needed)

• When asymmetry correction is needed

• For revision surgery

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Advantages of incisional double eyelid surgery

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• The double eyelid is less likely to come undone

It has better durability than non-incisional double eyelid surgery.

• There is a wider range of eye shapes to choose from

Because fat removal, skin removal, and ptosis correction can all be done at the same time, the desired shape can be created more precisely.

• It is advantageous for correcting asymmetry

For a certain level of asymmetry or more, approaching it with an incision is effective.

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Disadvantages of incisional double eyelid surgery

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• Recovery takes longer

Swelling lasts longer than with the non-incisional method, and it takes more time to look natural.

• Scarring may be relatively visible

A scar forms along the incision line, but it gradually fades over time.

However, this may vary depending on the individual’s constitution.

Before/after photos of incisional double eyelid surgery

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Natural adhesion (non-incisional) vs. incisional double eyelid surgery, at a glance

Item	Natural adhesion (non-incisional)	Incisional double eyelid surgery
Surgical method	Sutures passed through small holes	Incision along the double eyelid line
Recovery period	About 3–7 days	About 2–4 weeks
Scarring	Almost none	Present at first, but gradually fades
Durability	May come undone	Relatively long-lasting
Fat/skin removal	Limited	Can be done at the same time
Ptosis correction	Limited	Can be done at the same time
Suitable eyes	Thin eyelids, little fat	Thick eyelids, sagging, a lot of fat

How much do double eyelid surgery costs differ between natural adhesion and incisional methods?

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The price of double eyelid surgery varies depending on the surgical method, the clinic, and whether additional procedures (such as ptosis correction or fat removal) are included.

In general, incisional double eyelid surgery tends to cost more than non-incisional double eyelid surgery (natural adhesion).

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This is because incisional surgery takes longer,

and it may include additional steps such as removing skin or fat.

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However, the exact cost of double eyelid surgery depends on the condition of each person’s eyes,

so it is best to confirm it during a consultation.

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Non-incisional double eyelid surgery vs. incisional double eyelid surgery: Frequently asked questions (FAQ)

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Q. Is natural adhesion double eyelid surgery more natural than incisional surgery?

It depends more on the design and the surgeon’s skill than on the surgical method itself.

Incisional double eyelid surgery can also look natural if it is made thin and well-designed, and non-incisional double eyelid surgery can look unnatural if it is made too aggressively.

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Q. If natural adhesion comes undone, do I have to get revision surgery with the incisional method?

Not necessarily.

Depending on the condition, some cases can be treated again with non-incisional double eyelid surgery, while others may require an incision.

You can know for sure through an in-person consultation after visiting the clinic.

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Q. I’m worried about scarring from incisional double eyelid surgery. Will it be very noticeable?

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Since the incision line becomes the double eyelid line, it is not very visible when the eyes are open.

There may be some redness when the eyes are closed at first, but it gradually fades over time, so there is no need to worry.

However, this may vary depending on the individual’s constitution.

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Q. Is there a big difference in the cost of double eyelid surgery between non-incisional and incisional methods?

It depends on the surgical method and whether additional procedures are included.

In general, incisional surgery tends to cost more than non-incisional surgery,

but the exact amount is provided after visiting the clinic and carefully checking the eye condition.

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Q. Can the surgical method be changed during the consultation?

Yes, that happens often, so please do not worry and feel free to visit.

Some people come in thinking about non-incisional surgery at first, but after looking at their eye condition, they switch to incisional surgery.

That is why it is important to accurately confirm the method that suits your eyes during the consultation.

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To summarize

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Natural adhesion (non-incisional double eyelid surgery) and incisional double eyelid surgery each have their own advantages and disadvantages.

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Rather than asking which method is better, it is important to choose the one that fits your eye condition.

Rather than a place that says, “Non-incisional is always better” or “You have to do an incision to look pretty,”

we recommend choosing a clinic that carefully examines your eye condition and provides consultation on the most suitable method.

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