I often receive emails from patients I have never met before asking for double eyelid surgery using the suture technique because they read that this technique has minimal downtime. Unfortunately, no all patients are suitable for this procedure. I normally ask them to send me a picture of their upper face to find out if the technique is appropriate for their eyelids. Suitable eyelids are those which are thin or have existing indistinguished skin creases. Those with puffy eyelids are not suitable candidates because the fat (and hence the puffiness) will prevent proper attachment of the overlying skin with the underlying structures.
Below are some single eyelids and you can test yourself to find out which eyes are suitbale for suitable technique. Answers at the bottom.
As mentioned earlier patients with puffy lids are not suitable for suture technique; so the unsuitable candidates are c, d and e.