Undoing Natural Adhesion: Why Multi-Knot Double Eyelids Are Difficult to Remove

Occasionally, patients who have undergone natural adhesion surgery (buried suture method) visit us wanting to undo their results, only to discover they have multi-knot sutures.

Typically, most buried suture methods are performed using a single-knot technique.

In this case, when a single knot is formed at the end of the entry point, the entire thread can be pulled out smoothly once it is caught.

Usually, when the thread is extracted, this is the most common length, although lengths can vary.

It may be shorter or longer depending on the individual case.

However, in multi-knot methods, the threads are extremely small and deeply embedded. Sometimes patients do not remember the specific technique used, or the original clinic provided incorrect information, leading to the discovery of multiple knots during the suture removal surgery.

When reopening the area through an incision, the threads are found embedded like this, making removal very difficult.

They become incredibly hard to locate. With some luck, one or two might be found, but it is often impossible to know exactly how many threads were originally inserted.

Among those with multi-knot sutures, some patients occasionally opt to proceed directly with an incisional revision on the same day.

For those with thick double eyelid folds who wish to lower the line, it is possible to perform an incisional procedure on the same day.

In contrast, because single-knot methods involve a long, continuous thread, removal is almost always possible using our clinic’s specialized equipment and unique techniques.