Are there different types of Asian Eyelid Surgery?
I've been contemplating of getting Asian eyelid surgery done.
My grandma recommends that I get the inner corner cut to make my eyes look larger.
But I also think I have hooded eyelids.
So what procedures would be the best if I want my eyes to become larger and attractive
looking?
Thank you for your question!
You submitted 3 photos and you’re interested in options for hooded eyes and you mentioned
some interesting advice from a family member as to what to do to make the eyes look larger.
So you’re asking a question: are there different types of Asian eyelid surgery?
Well, certainly, there are.
If you look in the plastic surgery literature, you’d be impressed by the number of articles
that have been written especially for the past 40-50 years about different methods of
Asian eyelid surgery.
I will discuss with you my approach and it certainly does reflect my personal aesthetic
ad philosophy and of course a basis as to why I do the things I do.
I’m a cosmetic oculofacial plastic surgeon specializing in eyelid surgery and Asian eyelid
surgery has been an area of focus in my practice for over 20 years.
Now when I think about Asian eyelid surgery, from the beginning, I follow a basic concept
and this concept is that 50% of people of Asian descent be it Chinese, Korean, Japanese,
the 50% of people have a defined eyelid crease of fold and 50% do not.
Now in the media of these different countries, there’s a lot of emphasis on having big
eyes and this is not necessarily to look Caucasian or non-Asian but to look as if you naturally
have an eyelid crease.
It creates an illusion of the eyes looking more open.
Even when the eyes are not very hooded, when there’s a subtle crease, it just looks more
open.
Now that of course is a personal aesthetic.
So when I set out to do eyelid surgery, I always try to perform the procedure in a way
as if the person was born with that natural crease.
Now unfortunately, there are a lot of people who don’t want that and want a more exaggerated
appearance.
Either they want a very high and deep crease or they want to the eyelids to look wider
and look as if they were born in a different way.
So in my practice, when I look at a patient who has interest in Asian eyelid surgery,
I try to establish with them by doing something simple by using a Q-tip to create a little
bit of a fold.
And I look at how the eyelid crease forms naturally.
If they have a very strong epicanthal fold, it tends to fold naturally in the epicanthal
fold.
If it’s a softer epicanthal fold, then the crease actually goes above it or parallel.
And in terms of the outer aspect of the eyelid, it tends to kind of taper outward in a parallel
manner and that seems to consistently to what has been successful for me in my practice.
Now in making the decision, you asked about the different types of Asian eyelid surgery.
I’ll break it down in to two basic categories: one is incisional, incisional meaning making
an incision to enter the skin and to create a connection.
Now when you do the incisional or the non-incisional, the idea is to create a connection between
the skin and a muscle called the levator muscle.
The levator muscle is the muscle lifts the eyelid.
It’s like word elevator except the letter “e”.
So, with the excisional procedure, we are removing skin, we’re removing a little bit
of fat to create a connection between the eyelid skin and the levator muscle.
In the non-incisional procedure, we are actually making little openings and technically it
still an incision but not a one long incision but several dots that are strategically placed
on the eyelid and those little openings are used to pass a suture to then engage the eyelid
skin to the levator muscle and without any stitches on the outside and creating a crease.
So how do we make the differentiation of whose a candidate for the procedure?
Well basically, I look at whether or not there’s extra skin, how cooperative the skin with
making the fold and whether or not the presence of absence of extra fat that might need to
be addressed in order to establish a fold.
Now both procedures have both their pros and cons and each procedure has its risks and
benefits.
I generally find that younger people with thinner skin which fold easily, I will opt
for the non-incisional procedure.
Someone who’s a little bit older tend to have a little bit of extra skin.
If someone has much thicker skin and fat behind and it doesn’t fold very easily, then I
recommend the incisional procedure.
Now as far as other procedures that are related such as extension of the lateral canthus or
the outer part or addressing the epicanthal fold with the procedure called epicanthoplasty.
I generally don’t recommend those procedures except in cases where the epicanthal fold
is so wide and prominent that it actually make the person look like they’re cross-eyed.
And those are more, in my practice, the exception than the rule.
Generally, what we try to do is to create a natural crease that either tapers into the
epicanthal fold and most of the time, that is the case in our practice or a little bit
deeper and higher to create a wider eyelid platform and deeper crease.
So I think that you certainly have the opportunity to meet with different doctors who specialize
in Asian eyelid surgery and learn more about the options and figure out what you’re comfortable
with.
Certainly, one of things that I found interesting that a lot of people have done before they
came to me is they used they little tapes and these tapes can be applied from right
above the eyelashes and it creates a fold when the skin is easy to fold in and these
patients have brought these tapes in and show me exactly where they want their crease.
And most of the time, I’m actually able to use the tape to mark off where I’m going
to place my stitches in order to create the crease that they desire.
Once you’ve met with qualified experienced surgeons who specialize in Asian eyelid surgery,
make the decision with the doctor that you’re comfortable with and move forward.
So I hope that was helpful, I wish you the best of luck and thank you for your question!