I want to walk through how we remove buried sutures — specifically clear sutures — to reverse a buried-suture double eyelid.
Removing buried sutures through a tiny puncture is genuinely difficult to begin with.
And when the sutures are clear (rather than dark), it is even harder. We make two small punctures and retrieve the sutures through them.
The puncture is roughly 2 mm — about the size of an entry point for a buried-suture procedure itself.
Two small entry points, one on each side. The center arrow above is just marking a previous suture trace; the actual punctures are the lateral two. Our entry points are smaller than the original ones the previous clinic used.
Can you see it? At the very tip there is a suture hanging — clear material can look almost white in the photo.
By eye, it is hard to tell whether you are looking at suture, muscle, or nerve.
I tried to photograph it on gauze, but clear suture barely registers, so this is the best I could do.
Here is the contralateral side, with the clear suture grasped before removal. I take them out completely.
Suturing the entry points is not strictly necessary, but to keep even a 2 mm puncture from leaving a mark, I close it with a single stitch.