"A double eyelid plasty is performed by an incision technique or a nonincision technique, the latter comprising a stitch method and a buried suture method. With this surgery, an appropriate design and operative technique must be selected into careful consideration of patients desire and eyelid condition. Patients were classified into four groups according to age and upper eyelid condition and got double eyelid plasty, modified techniques based on the Shirakabe’s bead stitch method by each group. From above mentioned techniques, authors obtained a relatively successful result, so authors would like to report the outcome of the modified surgery methods. In this study, bead stitch method was performed in 405 patients(402 females, 3 males, average 31.2 years) from January to December of 2001. The follow up period ranged from one month to four years. Preoperatively, considering the patients age, skin laxity of the upper eyelid and quantity of periorbital fat, patients was divided into four groups. For the bead stitch method, the eyelid is everted by raising the eyelash, and No. 2 braided white silk suture 16 cm in length is thrust from the two third of upper tarsal rim on the conjunctival side to the anticipated point on the skin side by using No. 5 round needle. The other end of the suture is guided out at a 4 to 5 mm distance from that point in a similar manner, such a procedure is usually carried out six to seven times for each eye. Simultaneously, if necessary, defattimg, skin undermining and upper blepharoplasty was also performed.Most of our patients were satisfied except thirteen cases with minor complications(mild asymmetry: 7 cases, sunken eye: 3 cases and high fold: 3 cases). But, the post operative palpabral swelling is comparatively strong.In conclusion, Some of the positive aspects were the followings: Lowering the chance getting an infection from stitches, the prevention of loosening by the scars forming double eyelids, and the development of natural double eyelids coming from the even pressure on the upper eyelids by the glass beads. Moreover, the new method improves, by combining the bead stitch method with the blepharoplasty, the prior incision method, which was difficult to apply to eyelids with excessive skin, therefore being able to expect more successful results from all age groups."