Dual-layer Non-incisional Double Eyelid Method: A Novel Approach for Dermatochalasis-induced Pseudoptosis

Dermatochalasis frequently causes pseudoptosis that complicates double eyelid formation in Asian patients.Conventional non-incisional buried suture techniques are often inadequate for managing redundant skin, while incisional methods entail permanent scarring and prolonged recovery.We report three cases of Asian patients with mild-tomoderate dermatochalasis-induced pseudoptosis treated with Dual-layer Non-incisional Double Eyelid Method (DND Method), a novel technique employing two vertically stacked buried sutures with levator aponeurosis fixation.All three patients achieved naturalappearing supratarsal folds with improved Margin Reflex Distance-1 (MRD-1), reduced compensatory eyebrow elevation, and high patient satisfaction.No significant complications were observed at 3-6 months follow-up.DND Method may extend non-incisional surgical options to patients with dermatochalasis who are unsuitable candidates for conventional buried suture techniques.