Boston Plastic Surgery, Cosmetic Plastic Surgery, Dr Seckel, Boston Massachusetts, Concord Massachusetts

Double Eyelid–Asian Eyelid Blepharoplasty Surgery


Asian eyes are exotic and beautiful. In today’s fashion photography Asian eyes are often featured. For years many Asian women have had blepharoplasty surgery to create a double eyelid fold or crease. This can create a beautiful effect if the Asian blepharoplasty is done correctly and the eye is not westernized too much. The key is to make a very small low double fold and to not remove too much fat. A small low double fold is natural for many Asian women and the eyelid shape is maintained. If a Western or Caucasian blepharoplasty is done however the natural Asian look is lost and a wide eyed or round eyed appearance is created. If you look at photographs of the Asian movie stars who are considered beautiful, you will see a very small natural fold above the eyelashes, but the normal fold near the nose (the Epicanthal Fold) and the normal beautiful slant of the eye is present and undisturbed.

Asian eyes are beautiful eyes and as we age, the eyes are the first facial feature to show aging changes and loose skin and puffiness can hide a beautiful fresh exotic look. Asian modern blepharoplasty can restore the Asian eyelid to a beautiful young appearance, however expert technique is essential. Many of today’s plastic surgeons assume, incorrectly that Asian women seeking blepharoplasty are looking for a wide eyed, round eyed Caucasian or Western look, and do the wrong type of Asian Blepharoplasty which ruins the lovely Asian eyelid look.

The best Asian Blepharoplasty preserves the fold near the nose and the normal slanted shape of the Asian eyelid. Also it is very important to leave a small fold of skin which falls over the incision and hides the incision so that you cannot see the scar. It is also very important not to remove too much fat from the Asian eyelid or the eye will look hollow.

What Is Different About the Asian Eyelid?

The main difference between the Asian and Occidental upper eyelid is the attachment of a small muscle called the Levator Palpebrae Superioris. This muscle lifts the eyelid upward to open the eye. In the Occidental this muscle is attached to the skin about 8 to 12 millimeters above the eyelashes so that when the muscle pulls on the skin to open the eye, a fold or line is created. This line is called the Supratarsal (above the tarsus or lower edge of the eyelid) Fold. This fold is visible about 10 millimeters above the eyelashes when the eye is open in most women, and is called the double eyelid fold or double eyelid crease.

In the Asian eyelid this muscle attaches very weakly or not at all to the skin but does attach to the tarsus which allows the eye to be pulled up and opened. Because the muscle is not attached to the eyelid skin when the muscle pulls up, the Supratarsal Fold or crease does not appear. In many peope a small double fold is present, but it is very low, only 3-5 millimeters from the lashes. Thus the Supratarsal Fold or double eyelid fold or crease is low, about 3-5 millimeters above the lashes or not present at all if there is no muscle attachment to the skin.

The fat distribution in the upper Asian eyelid is also different in that the fat is present across the entire upper eyelid and not limited to two deep pockets as it is in the occidental eyelid. This makes the Asian eyelid look fuller.

What is the Asian Blepharoplasty Technique?

The modern eyelid rejuvenation blepharoplasty operation starts with an incision placed in the eyelid skin along the exact position of the desired post operative Supra tarsal fold or upper eyelid fold. In Occidentals this line is placed from 10-12 millimeters above the eyelashes. This results in a normal visible fold 10-12 millimeters above the eyelashes when the eye is open. Loose skin is removed. Also any protruding or bulging fat that is causing eye bags or puffy eyes is also removed during the Caucasian or Occidental blepharoplasty.

See before and after modern caucasian blepharoplasty pictures below:

Before and after Modern Eyelid Surgery to correct Dark Circles

Before and after Modern Blepharoplasty to correct dark circles and puffiness

Before and after modern Caucasian laser blepharoplasty to remove eye hoods, puffy eyes and dark circles in 38 year old patient.

Before and after Upper and Lower Eyelid Surgery Blepharoplasty

Before and after Upper and Lower Eyelid Surgery Blepharoplasty

Before and after Caucasian blepharoplasty to remove eye hoods and eye bags in 48 year old.

In the Asian blepharoplasty this incision is placed lower on the eyelid usually about 3 millimeters above the eyelashes-this creates a more natural Asian look to the fold after surgery. The incision is made much shorter than in the Occidental to avoid scarring the fold near the nose.

In addition, the Levator Palpebrae Superioris muscle is attached to the tarsus and skin to create the normal attachment which is missing in the Asian eyelid. This assures that the normal fold will appear after surgery. This is a very important and technically refined component of the Asian blepharoplasty.

A deep suture is also placed beneath the skin to pull the upper skin down so that a small fold of skin falls down to hide the incision. In Occidentals the fold is left open so the fold shows. The ideal Asian eye has a small fold of skin over the deep fold to hide the depths of the fold. This prevents the wide eyed or round eyed Western look.

Notice in the before and after picture of the Asian blepharoplasty below the fold is lower and smaller and skin is left behind to cover the incision. The Epicanthal Fold near the nose is left intact to maintain the normal eyelid shape.

Before and after Asian Eyelid Surgery to create a double fold

Before and after Asian Eyelid Surgery to create a double fold

Above: Before and after Asian Blepharoplasty to create a low double fold and preserve a natural Asian eyelid look in 43 year old. More skin can be removed but would create a wide eyed Western look. Patient is only a few weeks post op and still swollen.

It is also very important to be conservative with fat removal. If the same amount of fat is removed as is done in Caucasian blepharoplasty, the Asian eye will look unnaturally hollow.

Finally, the low fold of the skin near the nose, the Epicanthal Fold is normal in the Asian eye. It should not be violated and a short incision should be used that avoids this fold. This will help hide the incision and leave the natural shape of the eyelid.

What Are the Essential Elements For A proper Asian Blepharoplasty?

The main important elements of the Asian Blepharoplasty which must be done are:

• Proper location of incision 3-5 millimeters above the eyelashes
• Insertion of the muscle to create the Supratarsal Fold
• Minimal fat removal
• Do not violate the Epicanthal Fold near the nose
• Create a very small fold of skin over the incision hiding the depths of the Supratarsal Fold.

Where Do I Find An Experienced Asian Blepharoplasty Surgeon?

You will have to do your homework to find an experienced board certified plastic surgeon who is experienced at the Asian Blepharoplasty. Consult board certified plastic surgeons and ask specifically if they have experience with this technique. Search the internet, as most surgeons who do this procedure will express their interest in their internet writing.

Ask friends who have had this procedure if they are happy with their results and if they are happy with the doctor who performed their surgery.

Ask the doctor how he/she plans to do the procedure and be certain he includes a discussion of the essential elements discussed above.

Bring a photograph of a model in a magazine who has the shape and look of the eyelid you desire and ask the doctor if he/she can achieve the look you want.

For more information on Asian eyelid surgery call 9780-369-4499 or email us. Read our free newsletter to learn more about plastic surgery and non-surgical laser face and body rejuvenation. Read Save Your Face to learn how to prevent facial aging.

Dr. Seckel
Concord, Massachusetts
Boston, Massachusetts

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