Buried Suture Removal with Early Revision: Can They Be Done Together?

Introduction

It’s one of the most common questions we hear from patients who visit our clinic after surgery elsewhere:

“My eyelids feel tight — I think the buried sutures are causing discomfort. But I also want to fix the asymmetry. Can both be done at the same time?”

This is a deeply personal situation. Some patients feel small lumps under the skin after double eyelid surgery. Others notice an unnatural crease, stiffness, or swelling that just doesn’t fade with time. These symptoms often come from buried sutures — the dissolvable or non-dissolvable threads used to create or support the eyelid fold.

But when those threads cause irritation or visible irregularities, suture removal becomes necessary. The question is — should it be done together with early revision surgery, or is it safer to wait?

At Gangnam Seoyon Plastic Surgery, we approach this question with both surgical precision and patient empathy, because every eyelid tells a different story.

Understanding Buried Sutures — and Why They Sometimes Cause Problems

Buried sutures are designed to be invisible and stable under the skin. In most cases, they serve their purpose quietly, helping the new fold settle naturally. But sometimes, things don’t go as planned.

There are a few common reasons why buried sutures may need to be removed:

• Excessive tension or improper depth during surgery, causing tightness or unnatural movement

• Allergic or inflammatory response to the suture material

• Asymmetrical anchoring of the crease, leading to uneven eyelids

• Prolonged swelling or palpable thread knots under the skin

It’s important to remember: these issues don’t necessarily mean your surgeon did something wrong. The human eyelid is delicate — thin skin, complex muscles, and multiple healing layers. Even small differences in tissue reaction can change how sutures behave over time.

The Concept of Early Revision — and When It’s Appropriate

“Early revision” refers to corrective surgery performed within a few weeks to a few months after the initial procedure — before all scar tissue has fully matured.

Traditionally, many surgeons recommend waiting 6 months or longer for revision surgery. This allows swelling and scar tissue to stabilize, giving a clearer view of the final result. However, in some cases, waiting too long can actually make revision more difficult.

At Gangnam Seoyon, Dr. Dong-il Choi often considers early revision when:

• The eyelid crease is abnormally high or low right from the start

• The fold disappears or is too faint on one side

• The buried suture causes visible irregularity or chronic discomfort

• The asymmetry is structural — not just from swelling

Early revision can help minimize scar formation and restore natural movement before tissues harden. But it requires extremely careful judgment and a deep understanding of eyelid anatomy in its healing phase.

Can Buried Suture Removal and Early Revision Be Done Together?

The short answer: sometimes, yes — but only if your eyelid is ready for it.

This is not a one-size-fits-all decision. Whether these two procedures can be combined depends on several key factors:

1. Degree of Inflammation or Scarring

If your eyelid still shows redness, swelling, or thickened scar tissue, it’s usually best to remove the sutures first, then allow a short healing period before any revision. Operating through inflamed tissue can increase the risk of uneven folds, poor healing, or new scar tissue.

2. Type of Previous Surgery

For non-incisional (buried suture) double eyelid surgery, early revision can sometimes be performed immediately after suture removal if tissue damage is minimal.
For incisional surgeries, however, combining removal and revision is riskier — the healing environment is more delicate and unpredictable.

3. The Patient’s Healing Response

Some patients heal quickly and show soft, flexible tissue just weeks after surgery. Others experience prolonged stiffness. At Seoyon, we often perform ultrasound-based tissue assessments to understand each patient’s healing status before deciding.

4. Surgical Goal

If the goal is simply to relieve discomfort from a buried thread, removal alone may suffice. But if the patient also wants improved crease height or symmetry, a limited early revision can be considered — provided the tissue allows for it.

The Seoyon Approach: Safety Before Speed

To be honest, most patients don’t realize how much timing affects surgical safety. Early revision might sound convenient, but pushing it too soon can sometimes worsen the very problems it’s meant to solve.

At Gangnam Seoyon Plastic Surgery, we follow a staged approach:

1. Precise Diagnosis: We use magnified eyelid analysis and digital imaging to evaluate fold height, suture placement, and tissue condition.

2. Selective Removal: If necessary, Dr. Choi removes problematic sutures under local anesthesia — a short, delicate procedure that restores comfort and improves movement.

3. Observation Period: We allow the eyelid to settle for a few weeks, carefully monitoring healing patterns.

4. Customized Early Revision (if appropriate): Once inflammation subsides and tissue flexibility returns, a fine-tuned revision can be performed to restore natural harmony.

This method respects both the biology of healing and the emotional recovery patients go through after unsatisfying surgery.

Why Patients Seek Combined Procedures

Many patients come to us from abroad or other clinics with one goal: to resolve everything in one trip. We understand that completely.

However, while combining suture removal and revision may seem efficient, it’s only safe when tissue conditions truly allow it. A rushed revision can lead to new asymmetry, scarring, or unnatural folds — issues far more complicated to correct later.

That’s why at Seoyon, we prioritize long-term naturalness over short-term convenience. A few weeks of patience can often mean the difference between a temporary fix and a truly beautiful, lasting result.

Emotional Healing Matters, Too

For many patients, the discomfort from buried sutures isn’t just physical. It’s also emotional — a daily reminder that something feels “off” about their appearance.

We’ve met patients who spent months hiding their eyes behind glasses or makeup, unsure whether it was “too soon” to seek help. If this sounds familiar, know that you’re not alone — and it’s absolutely okay to ask for a second opinion.

Revision isn’t just about fixing what went wrong; it’s about restoring comfort, expression, and confidence. That’s why every consultation at Seoyon begins not with a surgical plan, but with a genuine conversation about how you feel about your results.

What to Expect from Suture Removal and Revision at Gangnam Seoyon

• One-Doctor Policy: Dr. Dong-il Choi personally performs every consultation and surgery — no substitute surgeons.

• Microscopic Precision: Specialized magnification tools ensure even removal of deep sutures without damaging surrounding tissue.

• Holistic Care: Our integrated team includes anesthesiology and family medicine specialists, ensuring safety even in early revision cases.

• Natural Design Philosophy: Every revision is guided by balance, softness, and anatomical respect — not simply “making the crease higher.”

When to Seek a Professional Evaluation

If you experience any of the following after eyelid surgery, it may be time to consult a specialist:

• Persistent stiffness or tightness lasting beyond 3–4 weeks

• Visible suture knots or foreign body sensation under the skin

• Uneven or disappearing creases

• Pain, inflammation, or redness near the incision line

Even if your surgery was recent, an early professional evaluation can clarify whether immediate removal, conservative treatment, or early revision is best.

A Thoughtful Path Forward

Every eyelid heals in its own rhythm. The best surgeons are not those who promise instant fixes, but those who listen carefully to what your tissue — and your emotions — are telling them.

If you’re uncertain whether buried suture removal and early revision can be done together, don’t rush into a decision. Get a precise assessment from a safety-first clinic where the lead surgeon stays with you from consultation to recovery.

At Gangnam Seoyon Plastic Surgery, our mission is to help you regain comfort, confidence, and the quiet joy of feeling like yourself again — naturally, safely, and at your own pace.

If you’re currently struggling with discomfort or uneven results after eyelid surgery, consider visiting our Gangnam clinic for a personalized assessment with Dr. Dong-il Choi. Early clarity often prevents long-term complications — and your peace of mind is always worth the conversation.