DST Double Eyelid Surgery

Double Suture and Twist (DST) is a modern, non-incisional technique used to create and enhance double eyelids developed by a Japanese plastic surgeon. It is an improvement of the suture-double eyelid surgery. This differs from incision-based double eyelid surgeries (Incisional Upper Blepharoplasty) as no major incisions are made on the skin. there is hence minimal downtime and almost no visible scars after the procedure.

Compared to incisional upper blepharoplasty, where some skin and above the eyelids are cut and removed to create the double eyelids, DST achieves the same effect using surgical sutures. By strategically stitching parts of the upper eyelids, the signature crease of the double eyelid is created.

Surgery procedure

First, the surgeon will discuss with the patient which type of crease is preferred (height and orientation).

Once decided, anesthesia will be administered. 3 punctures will be made on strategic points on the patient’s upper eyelid. A pair of sutures is passed through these punctures and twisted using a specific technique. The 2 sutures are then tied together to crease the upper eyelid. The sutures pulls in the upper eyelids when the patient opens his/her eyes, giving the desired crease of the double eyelids.

The effects are immediately visible post-surgery. However, the eyes are expected to look unnatural for about a week after the surgery due to bruising and swelling. The scars and bruises will subside over time, and the best results can be seen from 4 to 6 weeks after the procedure, when the wounds have recovered and most or all of the scars have subsided.


What is the difference between incision and suture double eyelid surgery?

Type of Double Eyelid SurgeryIncision-basedSuture-based
Length of surgery45 - 60 mins15 - 40 mins
Dowtime2 - 4 weeks1 - 2 weeks
Swelling and bruisingMild to moderateMild
Best effects seen after2 - 3 months4 - 6 weeks
ScarsMore likely to be noticeableLess likely to be noticeable
Other benefitsCan correct other eyelid issues such as droopy, asymmetric eyelids etc.May not be able to correct other eyelid issues
Longevity of double eyelidsLong-lasting/Permanent, usually non-reversibleSutures may degrade over several years, causing the crease to deform/slowly fade away. Additional care is required to maintain the sutures.

Is the procedure painful?

Other than the mild sting felt when administering the anesthesia, you should not feel any pain or discomfort other than pushing/pulling sensations during the suturing.

Is there any downtime?

There will be some bruising and swelling around the eyes after the procedure. This is expected and will usually subside after a few days.

Are there any side effects/possible complications?

The wounds from the surgery may become infected/inflamed if it is unable to heal properly. The doctor will usually provide some medication to prevent this. Otherwise, there are minimal risks and side effects.

What should I take note of before the procedure?

Avoid wearing double eyelid glue/eyelid stickers for about 2 weeks before to ensure that your eyelids are in their natural state during the procedure. This will reduce the chances of future complications.

Avoid tobacco and smoking for about a month before the procedure.

What should I take note of after the procedure?

You should avoid putting make-up and other cosmetic products (eyeliner, eyeshadow) around your eyes for up to 2 weeks as advised by the doctor.

The doctor may request that you avoid wearing contact lenses for several days after the procedure, depending on the individual.

To ensure the longevity of the suture in the double eyelids, avoid putting excessive force on/around the eye area (general rubbing of your eyes, using makeup remover etc) to prevent the sutures from snapping. The double eyelids will last as long as the sutures are intact.

Am I suitable for DST double eyelid surgery?

You are suitable for DST double eyelid surgery if you:

  • Have no upper eyelid crease
  • Are in good general health

Suture double eyelid surgery like DST may not be suitable for certain individuals like those with fatty eyelids. The surgeon will observe your conditions during consultation before advising and recommending the best procedure for you.

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