All About Asian Eyelid Surgery

Upper eyelid surgery is usually performed to address excess skin which causes a tired or narrow eye appearance.  This condition is usually a result of the aging process.  But this is not the only reason a patient may seek out consultation for upper eyelid surgery.

The anatomy of the Asian upper lid differs from that of the Caucasian eyelid giving it a distinctive appearance.  Approximately half of the Asian population  (typically descendants of the Han race) have eyelid creases which are similar to the Caucasian eyelid crease.  However, the remaining people of Asian race may have little to no crease in the upper lid.  This difference has been variably described as a ‘single eyelid’ or lack of an upper eyelid crease vs the more Western ‘double’ eyelid which has a crease. Several procedures have been developed to address this difference for Asians who wish to add a crease to their upper lids.

The procedure is similar to a blepharoplasty (eyelid lift) where the skin around the eye is reshaped. In fact, the scar position is nearly identical to a typical upper lid lift.  The difference between the two procedures is that in order to create a crease above the eyelid (i.e. double eyelid), tissue between the skin and the supportive structure of the eyelid is removed.  The skin is then fastened to the underlying structures, which can give the appearance of a crease.   Many Asians desire to have this performed as it gives the overall impression of larger eyes.

The procedure itself is a relatively quick surgery and virtually scarless.  The individual patient’s eyelid anatomy (amount of fat, exact size of the underlying support structures, and skin to be removed, if any) and the symmetry or asymmetry between the eyelids determine the length of the procedure.  Recovery occurs on an outpatient basis with the final results appearing after one to two months.

There has been some controversy with this procedure.  Critics of the Asian Eyelid Blepharoplasty have proposed that the single eyelid in those of Asian decent who have it are changing a beautiful feature of their heritage and should not change it to fit into the “Western standards of beauty.”

When asked about this controversy, Dr. Franckle responded, “This is certainly a compelling argument and is likely the basis for many arguments against cosmetic surgeries which alter our natural appearance.  Happily, we live in a world where anyone has the right to decide for him or herself what is best for them.”  Dr. Franckle believes that anyone considering this type of surgery think it through as it is difficult to reverse.  “The small, imperceptible scar which usually results from this surgery is not easily undone and will likely result in a permanent and irreversible change to the eyelid.”


The In’s and Out’s of Eyelid Surgery

Eyelid surgery, professionally known as a blepharoplasty, addresses several areas around the eye to help reduce a tired, “heavy-lid” appearance.  An eyelid procedure can include either the upper or lower eyelids or both.  Complaints from candidates for this procedure include puffiness, bags under the eyes, excess skin or wrinkles of the lower eyelid.  Eyelid surgery alone cannot correct crow’s feet, sagging eyebrows or dark circles under the eyes. In that case, other procedures or treatments combined with eyelid surgery is the best option.

As we age the layers of muscle above our eyes weaken, the skin loses elasticity, begins to sag and fat deposits shift to less desirable areas (creating bags under the eyes).  For an upper eyelid procedure, an incision is made in the natural crease to remove excess skin.  In some cases a layer of underlying muscle and fat deposits (to reduce puffiness) may also be removed.

The American Society of Plastic Surgeons website offers a very helpful 3D animation to more thoroughly explain the procedure step-by-step:

Recovery time is dependent on the extent of your procedure. Some people require only minimal skin excision to achieve a great result.  Others may need more extensive procedures including fat removal or an eyelid support procedure to achieve the desired result.  Here are some general guidelines so you know what to expect:

  • 24 hours after your procedure you will notice redness and swelling.  You will be experiencing some discomfort but that can easily be handled with pain medication we provide to you.
  • Plan to be out of work for 5-7 days.  During that time be sure to ice the area, keep your head elevated and avoid any exercise or strenuous activity.
  • 4-6 days after the procedure I will remove the sutures.  There will still be some swelling and redness, but once the sutures are removed makeup can be worn to cover those issues.
  • 2 weeks after the procedure, most noticeable swelling has reduced and most patients feel “normal” again.

Eyelid surgery is a popular procedure among patients, especially combined with other less invasive treatments; Botox, chemical peels or injectable fillers. It is a relatively small procedure, with manageable recovery time.