Blepharoplasty – The Double Eyelid Surgery

Preparing For Blepharoplasty Double Eyelid SurgeryStatistics shows that approximately 50% of East Asians possess double eyelids, while the other half shows little or no sign of crease formation (single eyelid). Even when present, the Asian crease differ significantly from a typical Westerner crease. In general, the Asian upper eyelid crease forms closer to the eyelashes, is shaped differently, and is sometimes incomplete or broken into multiple folds.

Irrespective of ethnicity, double eyelids are typically considered more attractive by most people. The absence of a superior palpebral fold (the crease) makes the upper eyelid drapes like a single, unruffled curtain. With double eyelids, eyes appear bigger and thus give the impression of youth. The lack of excessive skin and fat also make eyes look more energetic. The platform of exposed skin between the crease and the eyelashes allow ladies to apply makeup more effectively too.

Single Eyelids vs Double Eyelids

Beauty, however, is in the eye of the beholder and is also culturally variable. While some people are comfortable with their single eyelid eyes, others do everything to achieve the ‘coveted’ look. Some use tapes while others use special glue and a small fork-like device to create the illusion of a crease. However, more and more people now opt for the more extreme end; going under the knife!

Double eyelid surgery (technically known as blepharoplasty) is now the most requested cosmetic surgery in Asia. The surgery involves creating the palpebral sulcus (the crease) that divides the eyelid into 2 well defined segments; pretarsal and preseptal, thus producing the double eyelids.

Generally, there are two groups of people requesting blepharoplasty. The first group is the single eyelid group whose aim is to create double eyelids; on the other hand, the other group already has double eyelids but it might be small with excess eyelid skin and fats, or drooping lids (due to aging) that cover their double eyelid. This group aims to enhance their existing double eyelids.

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Western vs Asian Surgery

Blepharoplasty performed on Westerners and Asian is significantly different. The most prominent differences between the two operations are the intended goals, surgical techniques, and the patients’ age. Asian blepharoplasty is actually a variation of the standard blepaharoplasty. Its advantage is it has more flexibility in sculpturing eyelid configuration.


  • Goal: To rejuvenate the aging upper lid.
  • Surgery: Help to remove the excess skin on the upper eyelid and the puffiness in the inner corner and middle of the upper eyelid caused by the underlying buildup of fat.
  • Focus: Minimal attention is devoted to reshaping the already-present crease.
  • Age: Middle age group.


  • Goal: Create new crease where no crease exist or enhance an inadequately defined crease.
  • Surgery: Minimal skin and fat removal.
  • Focus: Realignment of youthful internal eyelid structure.
  • Age: Young.

The Asian Blepharoplasty Technique

Although there are many techniques used in creating the double eyelids, the incisional (cut) method and the stitch method are considered the most common in Asian double eyelid surgery.

Before the surgery, patients must communicate well with the surgeon. It is important to tell your doctor about the shape, height and continuity of your desired crease. A good surgeon will explain everything and clear all doubts before proceeding with a surgery. Pre and postoperative photographs can be examined or a surgeon can manipulate the eyelid skin with a bent paper clip to let the patient get a taste of what they are getting themselves into.

Once things are determined, the surgeon will draw the line on the eyes and carry out the procedures.

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The Cut Method

Under local anesthesia, the skin is incised with a scalpel at a desired height. A small strip of skin above this initial incision is excised using scissors. The incision is carried deeper into the eyelid until the orbital fat is exposed. Small strips of muscle and fat are excised. The final crease height and shape are the result of both selective tissue removal and precise internal tissue rearrangement.

Patients will have to go back to surgeon in 5 to 7 days to remove the stitches. It will take approximately 3 weeks to 3 months to recover. The good thing is it will be permanent, it will not fade. The downside is that it requires longer recovery period, and if eyes are closed, you can still see a slight scar.

The Stitch Method

With technology advancement, various innovative techniques are being introduced. One such technique virtually ‘sews’ creases on. Under local anesthesia, the eyelid is averted and skin is stitched at a desired height. Small strips of muscle and fat are excised.

This method requires only 3 days to recover. Moreover, this technique is reversible. If patients are not happy with the results or have second thoughts, they can go back to the surgeon and ask for the ‘thread’ to be undone. There will be no scars and it is also cheaper. The downside of this technique is that it is not permanent, the double eyelids might fade away.

Risks And Complications

Although risks and complications are minimal, below are examples of what might go wrong:

  • Ptosis (asymmetrical eyes) – this is the most common of patient dissatisfaction. It can be corrected easily though.
  • Hollow eyes – too much fats were removed leading to incapability of closing fully. This can lead to dry eyes. This can be corrected with surgery too.
  • Bad scarring
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Note Of Caution

There are certain things that one should consider before undergoing the surgery.

  • A person must take into account his/her medical condition, finance and goal of surgery.
  • Expectation must be realistic as well. Keep in mind that cosmetic surgery is for improvement, not perfection.
  • As with all surgery, complications do occur. To avoid this, care and precaution must be taken and decisions should be communicated well in advance of surgery with the surgeon.

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3 Responses

  1. amin says:

    My wife is 20 years old and has eyelid(dropping skin or fat upper the eye) . is that healthly? or need surgery ?
    what is the other benifit moreover the look?

  2. To answer the previous poster, I htink cosmetic is the only benefit.

  3. rheaseo25 says:

    Many Asians complain of having a single eyelid fold in which the lids appear to be taut and heavy. This condition makes the person who has this kind of lids look sleepy and tired and only a surgical procedure can solve this dilemma.

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