One variation known as DST (double sutures with twisting, double stranded twist, or durable suture technique, all of which indicate the same operation) employs two sutures that are tied in three places and twisted around each other four or five times at the central tie.
While promoted as yielding a more stable or even permanent result, we have seen many patients who have undergone this operation elsewhere only to have their creases fade as early as one to eight months following surgery.
Essentially a "stock" operation, individual customization is limited. Typically, no tissue is removed, which imposes a major limitation in patients showing signs of skin aging. Even in the young, there is little ability to vary the crease shape and height.
The final crease is not dynamic (that is, it is not dependent upon eyelid opening) and is thus visible even when the eyes are closed.
One major objection is that since the suture technique does not allow for an orderly removal and realignment of internal eyelid tissues, the major anatomical impediments to true crease formation are not addressed.
The technique is non-physiologic with no ability to replicate the natural crease formation mechanism found in people born with a crease.
Despite statements to the contrary, unpredictable duration presents a major flaw . . . |
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