The desire for a natural eyelid crease or “double eyelid” is very popular in Asian cultures, as an estimated that 50% of the Asian population don’t naturally have the double eyelid fold. The double eyelid gives the upper eyelid a visible crease or fold when the eye is open, and makes the eyes look brighter and less tried. For women, it is easier for them to apply eye makeup on eyelids with the sought after crease.
Since, the mid 1990s, Oculoplastic surgeon Dr. Amiya Prasad, M.D. has been a highly sought after specialist for Asian eyelid surgery. In fact, Dr. Prasad was featured in World Journal (a major Chinese language publication) and Chinese World TV for his work on performing revision surgery on patients who had unsuccessful double eyelid surgery done elsewhere.
What is Different About Asian Eyelid Surgery?
As an Oculofacial plastic surgeon, Dr. Amiya Prasad highlights the importance of understanding that Asian eyes are anatomically different from Western eyes. Double eyelid or Asian Eyelid Surgery requires the performing surgeon to have a thorough understanding of the anatomy of the eyes which make Korean, Chinese, Japanese and other Asians different from people of European, Asian Indian or African lineage. In fact, eyelid surgery is considerably more complex than most people appreciate. Ethnicity, age, gender and skin quality as well as general health need to be well integrated into developing a proper strategy.
The delicate epicanthal fold that lies in front of the eye must be treated with finesse so that proper rejuvenation does not mar the natural beauty of this type of eye. A common mistake many plastic surgeons make in performing this surgery is “Americanizing” or “Europeanizing” the eyelids, resulting in a very unnatural appearance, and the loss of the characteristics that are unique to the Asian eye.
Types of Asian Eyelids
Although Asian eyelids are seemingly lumped together, it must be said that Asian do not have only one type of eyelid. There are 4 types of Asian eyelids: (1) eyelid with no crease, (2) eyelid with partial crease, (3) eyelid with multiple creases, and (4) eyelid with double crease.
These folds or creases are positioned differently with every patient, thus, the procedure always varies greatly. Other times, the symmetry and definition of their eye creases also vary from day to day. Because of this, many Asian patients desire to have a stable and single crease to enhance the appearance of their eyes, and this is where Asian Eyelid surgery can help.
Blepharoplasty vs. Epicanthoplasty
Blepharoplasty refers to eyelid surgery of both the upper and lower eyelids. In Asian patients, the aim of the upper eyelid blepharoplasty is to create a crease in the upper eyelid using different techniques.
Located in the inner corner of the eye, the epicanthal fold is a prevalent feature among the Asian population. An epicanthoplasty is a procedure to change the epicanthal fold so the inner corners of the eyes (inner canthus) is revealed. The eyelid crease can look longer and the eye can appear wider.
Asian Eyelid Surgery Procedure
During your consultation with Dr. Prasad, various factors will be evaluated including:
- Your age
- Your gender
- Your skin thickness and quality
- Your fat volume under the skin
- Your healing from past procedures
- Your unique anatomy around your eyes
Based on this evaluation, Dr. Prasad will be able to gauge whether you are a suitable candidate for Asian Eyelid surgery, and customize the procedure to create the fold.
Depending on the amount of extra skin and fat under the upper eyelid, Dr. Prasad will choose to perform a non-incisional or an incisional procedure.
For the non-incisional approach, instead of making an incision and removing skin from the upper eyelid, small openings are made in the skin. A stitch is passed through to attach the upper eyelid skin to the underlying levator muscle muscle, which is responsible for lifting the eyelid. This will result in the eyelid skin folding in when the eyes are opened.
This incisional approach is used to create the fold, if there is extra skin and fat on the upper eyelid. After Dr. Prasad draws the appropriate pattern, an incision will be made in the upper eyelid area. Typically, a small volume of fat will be removed in order for the crease to be defined with the intention of avoiding creating a “hollow” area.
Dr. Prasad performs double eyelid surgery in approximately 1 hour. However, preparation time and immediate post-operative recovery means you’ll be at the clinic for approximately 3 hours. The time of the surgery can be longer when performed with other procedures.