• In most cases, the new crease weakens or disappears within a matter of years (or even months).
• The new crease is not created by a true anatomical rearrangement but rather by crushing the internal tissues into place.
Once the sutures weaken (which is almost inevitable), the crease will fade.
• There is little room for adjustability. Most often, the new crease is subtle.
• The technique is not truly "non-incisional." Two or even three smaller incisions are made across the eyelid.
In many cases, the resulting external scar is just as visible as with a full incisional technique.
• In the slightly older patient who may also benefit from trimming of excess skin or fat, he or she is simply out of luck.
• The new crease does not come and go with blinking. For the part, it's always there, even when the eyes are closed.
• Most significantly, the operation is not as kind to the internal tissues as many patients assume.
Once multiple entry points are made into the lid, sutures are woven this way and that and then looped and tied, scar tissue is created that makes future double eyelid surgery (incisional or non-incisional) more difficult, less predictable, and more expensive.