Suture Reaction from Double Eyelid Surgery

Q: Dr. Eppley, I went to my birth country to get double eyelid surgery. I underwent a procedure called non-incisional double eyelid surgery or suture double eyelid surgery, of which I hope you are familiar. It’s currently holiday period in Korea so I have been unable to contact my surgeon. It’s been over 4 weeks since my double eyelid procedure, and my right eye has healed very well. 

However, on my left eyelid. There is a tiny but clear bump from one of the suture puncture holes. The skin is a darker brown color, which is not the case with every other suture hole, and the feel of the bump is more noticeable. My left eyelid has also started twitching very regularly, and I’m not sure if it’s because of the suture bump or if something has gone wrong with the surgery. 

I don’t mind the feel of the bump from the suture or puncture hole, but the twitching is driving me mad. Every hour or so, my left eyelid will twitch or throb for a couple of seconds. I know there’s botox to stop this twitching but I’ve also read it needs to keep being repeated every couple of months.

1) From your medical knowledge and experience with surgery on east asians, is it normal for the eyelid to be reacting like this so long after the surgery? This was not happening the first couple weeks post surgery, and has started becoming more frequent in the last week.

2) If the twitching will eventually subside, how long should I wait for it to subside as it is actually driving me insane!

3) Is the twitching an effect of the thread lump? When I feel the other puncture holes, they do not hurt when I touch it. But this particular one on my left eye is still a bit sore when I touch it even though it’s almost been a full month. 

As I am an international patient, would you advise me to fly all the way back to have this revised?

A: I am very familiar with the suture or non-incisional method of double eyelid surgery even though this is is not my preferred method for double eyelild surgery.

The bump to which you refer is undoubtably the knot from the underlying suture. It is apparently right under the skin and is more prominent than the others. This accounts for the bump that you feel and the skin discoloration. It is likely this is the source of your blepharospasm as well. Such events when they occur often do not occur for 4 to 6 weeks after surgery when the initial swelling has subsided and the tissues try and return to normal.

If this issue has no resolved in the next few weeks you will need to have that suture removed/replaced for a resolution of your symptoms.

Dr. Barry Eppley

Indianapolis, Indiana