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Asian Eyelid Surgery – Double Eyelid Surgery

What is double eyelid surgery?

Double eyelid surgery or Asian eyelid surgery is a popular procedure among Asian descendants around the world, including their countries of origin. Seeking the “double eyelid” gives the upper eyelid a visible crease or fold when the eye is open. It has been estimated that 50% of the Asian population don’t naturally have the double eyelid fold.

Considered to be a desirable aesthetic feature among many East Asian cultures, this procedure for the upper eyelid makes the eyes appear more open, less tired, and easier to apply eye shadow. Dr. Amiya Prasad, a highly respected Oculofacial plastic surgeon for over twenty years uses his expertise in eyelid surgery (Asian Blepharoplasty) to provide patients with natural looking results.

double eyelid surgery before and after results female patient
THIS ASIAN LADY IN HER MID-20S HAD NO EYELID CREASE, AND WANTED THEM FOR AS LONG AS SHE COULD REMEMBER. THE INCISIONAL TECHNIQUE FOR ASIAN DOUBLE EYELID SURGERY WAS NEEDED FOR A STRONGER CONNECTION AS SHE DID HAVE LITTLE EXTRA SKIN, BUT HER TAUT, YOUNG SKIN NEEDED A STRONG ANCHOR TO CREATE THE CREASE. SHE ALSO HAD SOME FAT ABOVE HER EYELID THAT WAS PREVENTING HER EYELID CREASE FROM FORMING, SO SOME FAT ALSO NEEDED TO BE EXCISED. AFTER SURGERY, SHE HAD THE OPTION FOR THE FIRST TIME IN HER LIFE TO USE EYESHADOW.
double eyelid surgery before and after results female patient
THIS ASIAN LADY IN HER MID-20S HAD NO EYELID CREASE, AND WANTED THEM FOR AS LONG AS SHE COULD REMEMBER. THE INCISIONAL TECHNIQUE FOR ASIAN DOUBLE EYELID SURGERY WAS NEEDED FOR A STRONGER CONNECTION AS SHE DID HAVE LITTLE EXTRA SKIN, BUT HER TAUT, YOUNG SKIN NEEDED A STRONG ANCHOR TO CREATE THE CREASE. SHE ALSO HAD SOME FAT ABOVE HER EYELID THAT WAS PREVENTING HER EYELID CREASE FROM FORMING, SO SOME FAT ALSO NEEDED TO BE EXCISED. AFTER SURGERY, SHE HAD THE OPTION FOR THE FIRST TIME IN HER LIFE TO USE EYESHADOW.

Asian eyes vary in terms of the epicanthal fold, amount of skin, excess fat and other important structural elements. One procedure does not fit all. Oculoplastic surgeon Dr. Prasad has extensive experience with Asian eyelid surgery and has performed double eyelid blepharoplasty for many of his Asian patients from all over the world.

How to get natural looking double eyelid surgery?

Creating a natural-looking double eyelid must take into account factors such as the age and gender of the patient. An important decision before Asian Blepharoplasty is determining whether you are a candidate for an incisional or a non-incisional procedure.

double eyelid surgery male patient before and after results
THIS GENTLEMAN IN HIS MID-40S HAD PARTIALLY FORMED EYELID CREASES, BUT WERE BARELY VISIBLE. SINCE NO FAT WAS PREVENTING HIS SUBTLE CREASE FROM FORMING, A NON-INCISIONAL APPROACH WAS APPROPRIATE, AND NO SKIN NEEDED TO BE REMOVED. HIS RESULTS WERE EYELIDS WITH A ROUND, NATURAL SHAPE, THAT BRIGHTENED UP HIS WHOLE FACE.
asian double eyelid surgery male before and after
THIS GENTLEMAN IN HIS MID-40S HAD PARTIALLY FORMED EYELID CREASES, BUT WERE BARELY VISIBLE. SINCE NO FAT WAS PREVENTING HIS SUBTLE CREASE FROM FORMING, A NON-INCISIONAL APPROACH WAS APPROPRIATE, AND NO SKIN NEEDED TO BE REMOVED. HIS RESULTS WERE EYELIDS WITH A ROUND, NATURAL SHAPE, THAT BRIGHTENED UP HIS WHOLE FACE.

If you’re a candidate for an incisional procedure, it’s critical to avoid removing too much skin or fat which is a common technical error made by surgeons less familiar with Asian eyes. Successful surgery begins with a design planned prior to the procedure. We have helped many Asians who have had eyelid surgery ended up dissatisfied with their appearance. Dr Prasad performs many Asian eyelid revision surgery procedures.

What can go wrong with double eyelid surgery? 

One of the most frequent errors made by plastic surgeons performing Asian eyelid surgery results in “Americanizing” or “Europeanizing” the eyelids, which results in a very unnatural appearance. The Asian eyelid is different from the “Western” or “Occidental” eyelid in many ways, which is why Asian eyelid surgery (blepharoplasty) is so unique. It is important to know that Asians do not only have one type of eyelid:

Asian female eyelid with no crease

Why is double eyelid surgery popular?

Among the 50% of Asians having an eyelid crease there can be variability as to the symmetry and definition of the eyelid creases. Some people report that the crease can change where one day they have a crease and the next day the crease is not as defined. Many Asian patients come to address their desire to have a stable and single crease to enhance the appearance of their eyes.

asian male eyelid with partial crease

The position of the fold to be created varies from patient to patient, Dr Prasad will show you where the fold can be placed to achieve a natural look. Depending on your anatomy, the fold can be positioned 2-3 mm above the lid (fine crease), 4-6 mm(medium crease) or 7-10 mm( deep crease).

This is a function of the amount of skin which overlaps the position of the actual crease which can vary from 6.5 to 10 mm. In contrast, blepharoplasty (eyelid lift) in Caucasians is generally performed to reveal more of the eyelid and can be 10 mm or higher.

Female Asian with multiple eyelid crease
asian female eyelid with double crease

Am I a candidate for double eyelid surgery?

If you’re someone who wants to have a more defined eyelid crease, you may be a candidate. It’s important to understand that age can be a factor in the type of crease and the method of surgery required. For example, a 60-year-old woman would likely need a different type of surgery when compared to a 30-year-old man.

before and after Asian double eyelid surgery using Incisional procedure technique
THIS GENTLEMAN IN HIS MID-20S HAD VERY SLIGHT EYELID CREASES WITH A WEAK FOLD, AND ONE OF THEM DIDN’T SPAN THE ENTIRE WIDTH OF HIS EYE. A LITTLE FAT THAT PREVENTED A MORE DEFINED CREASE FROM FORMING WAS REMOVED, AS WELL AS SOME EXTRA SKIN THROUGH THE INCISIONAL TECHNIQUE OF DOUBLE EYELID SURGERY. HE WAS ABLE TO ACHIEVE CLEARLY DEFINED EYELID CREASES THAT COVERED THE ENTIRE WIDTH OF HIS EYES, AND A MORE OPEN LOOK.
incisional asian double eyelid surgery before and after male
THIS GENTLEMAN IN HIS MID-20S HAD VERY SLIGHT EYELID CREASES WITH A WEAK FOLD, AND ONE OF THEM DIDN’T SPAN THE ENTIRE WIDTH OF HIS EYE. A LITTLE FAT THAT PREVENTED A MORE DEFINED CREASE FROM FORMING WAS REMOVED, AS WELL AS SOME EXTRA SKIN THROUGH THE INCISIONAL TECHNIQUE OF DOUBLE EYELID SURGERY. HE WAS ABLE TO ACHIEVE CLEARLY DEFINED EYELID CREASES THAT COVERED THE ENTIRE WIDTH OF HIS EYES, AND A MORE OPEN LOOK.

How to Prepare for Surgery

As with most cosmetic surgeries, its important that you be in good health. Management of conditions such as blood pressure and diabetes are also important. Prior to surgery, we routinely review current medications and make sure our patients avoid any medication or supplement that is a blood thinner. During your consultation, Dr. Prasad will guide you in preparing for your procedure.

How is the Asian eyelid surgery performed?

The Asian eyelid surgery consists of reshaping the upper eyelid. During your consultation with Dr. Prasad, various factors will be evaluated including:

  • Your skin thickness and quality
  • Your fat volume under the skin
  • Your healing from past procedures
  • Your unique anatomy around your eyes
  • Your age
  • Your gender

Dr. Amiya Prasad will 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.

Technically, the non-incisional technique is still surgery, but instead of making an incision and removing skin from the upper eyelid, small openings are made in the skin. A stitch is passed through in a way 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.

before and after non-incisional double eyelid surgery performed on female patient
THIS LADY IN HER EARLY 30S WANTED HER EYELID CREASES TO BE MORE DEFINED AND SYMMETRICAL. SHE HAD A PARTICULAR ISSUE WITH HER EYELID CREASES NOT REACHING THE INNER CORNERS OF HER EYES. BEING YOUNG AND WITH EXISTING BUT NOT FULLY FORMED EYELID CREASES NOT HIDDEN BY FAT, DR. PRASAD CHOSE THE NON-INCISIONAL APPROACH TO ASIAN EYELID SURGERY TO DEEPEN HER CREASES, AND EXTEND THE VISIBLE FOLD TO THE INNER CORNERS. HE ALSO EXTENDED AND RAISED THE EYELID CREASES SLIGHTLY IN THE MIDDLE PART OF THE EYELID AND OUTER CORNERS FOR MORE SYMMETRY BETWEEN TWO EYES, GIVING HER SUBTLY MORE ALLURING LOOK.
before and after non-incisional double eyelid surgery performed on female patient
THIS LADY IN HER EARLY 30S WANTED HER EYELID CREASES TO BE MORE DEFINED AND SYMMETRICAL. SHE HAD A PARTICULAR ISSUE WITH HER EYELID CREASES NOT REACHING THE INNER CORNERS OF HER EYES. BEING YOUNG AND WITH EXISTING BUT NOT FULLY FORMED EYELID CREASES NOT HIDDEN BY FAT, DR. PRASAD CHOSE THE NON-INCISIONAL APPROACH TO ASIAN EYELID SURGERY TO DEEPEN HER CREASES, AND EXTEND THE VISIBLE FOLD TO THE INNER CORNERS. HE ALSO EXTENDED AND RAISED THE EYELID CREASES SLIGHTLY IN THE MIDDLE PART OF THE EYELID AND OUTER CORNERS FOR MORE SYMMETRY BETWEEN TWO EYES, GIVING HER SUBTLY MORE ALLURING LOOK.

If there is extra skin and fat on the upper eyelid, an incisional approach is used to create the fold. 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.

 

Asian Eyelid Surgery Recovery & Follow Up

Following your double eyelid surgery, you will be seen in about 1 week for removal of sutures (for incisional surgery). Swelling after Asian eyelid surgery is common and can make the eyelid crease appear too high. You will see Dr. Prasad regularly after your procedure to make sure you are healing properly.

korean double eyelid surgery before and immediately after surgery photo
korean double eyelid surgery before and immediately after surgery photo
korean double eyelid surgery before and 2 weeks after recovery photo
korean double eyelid surgery before and 2 weeks after recovery photo

The healing process for an Asian eyelid surgery can appear to be longer than non Asian patient. Swelling between the eyelid crease and the eyelid margin can persist for months and even a year.

Factors which can affect the recovery process include allergies, sinus conditions as well as having sensitive skin. Dr. Prasad will see you throughout your recovery period to assist you during this time.

Swelling after Asian eyelid surgery can make a lot people worry about their results.

I’ll explain how I help my patients for whom I perform double eyelid surgery

I’m Dr Amiya Prasad.

I’m a Board Certified Cosmetic Surgeon and Fellowship Trained Oculoplastic Surgeon.

I’ve been in practice in Manhattan and Long Island for over 20 years.

Asian Eyelid Surgery often referred to as double eyelid surgery is a procedure I perform routinely in my practice.

The term “Double eyelid surgery” can be used to describe both the non incisional technique and the incisional techniques.

Before discussing these concerns, it’s important to understand why the procedure is performed, what are the principle objectives of the procedure, how the procedure is performed and what the healing process is like before you have a more stable appearance.

The goal of this procedure is to create a crease or double eyelid fold where one doesn’t exist or when a crease is partially present and the desire is to have a deeper and more well defined crease.

Asians who have a natural eyelid crease or double eyelid have a connection between a muscle called the Levator muscle and the skin.

The levator muscle is the muscle responsible for lifting your eyelids.

The procedure options include one called a non incisional technique and the other being an incisional technique.

The main goal is to create a connection between the skin and a muscle called the levator muscle.

The decision to choose the non incisional or the incisional method in my practice is based on the presence or absence of excess skin or fat.

When I perform the non incisional method, I make strategically placed entry points in the skin and place sutures to engage the levator muscle and create a connection which results in a crease.

When I perform incisional surgery, I close the skin with sutures and use different ways to attach the skin to the levator muscle for the same purpose of creating a crease.

Swelling between the crease and the eyelashes is something that concerns a lot of patients.

In addition the effect of swelling often makes the crease look higher than desired and can make amyn people feel anxious.

Swelling can also be different between the two eyes which can also make someone concerned about looking uneven or asymmetric.

During the consultation, I educate my patients about the healing process which includes swelling and the timing for return to work, social engagements and when to expect a stable appearance.

One area of significant concern, especially in the first few weeks after surgery is the perception that the height of the eyelid crease is too high.

I often get asked by patients who’ve had surgery elsewhere about how soon a revision surgery can be performed because they believe, the surgeon had made the crease incision too high.

It’s important to understand that swelling between the eyelash and crease is temporary and that it can make the eyelid crease look too high.

Typically my patients go back to work in about 1 week. For incisional surgery, this is when sutures are removed.

As far as social events or events where your appearance is important, allow for at least 2 weeks or more.

It’s important to understand that swelling can be present and continue to decrease over several months to up to 1 year after surgery.

Generally, I expect appearance to by close to the final appearance around 6 months. If a patient has a history of allergies, sinus problems, smoking or other circulation issues, swelling can persist longer than is typical.

If there isn’t significant swelling after 6 months, revision surgery, if needed may be considered.

In the first 2 days after the surgery, cold compresses help decrease the initial swelling after surgery.

After the first 2 days, the clearing of swelling depends on the amount of swelling and circulation.

I encourage my patients to be up and about walking, talking and smiling and if they’re planning to be more sedentary, warm compresses can help.

Swelling and asymmetry after Asian Eyelid Surgery can be concerning.

In my practice, I help my patients through this process by seeing them at closely spaced regular intervals so I can make observations and continue to educate them about the stage of healing they’re in.

I hope you found this information helpful…thank you for your question

If you are considering Asian/ double eyelid surgery, you can contact us at Prasad Cosmetic Surgery in New York, at Midtown Manhattan, near Grand Central Station at (212) 265-8877 or Garden City, Long Island at (516) 742-4636

Frequently Asked Questions (FAQs)

How much is double eyelid surgery?

Double eyelid surgery or Asian blepharoplasty is a procedure that is customized to the individual patient, and may be combined with other procedures. Cost for surgery includes surgeon’s fee, anesthesia fee, and facility fees.

Dr. Prasad is committed to performing surgery in the safest way at his state-of-the-art surgical facilities.

Does double eyelid surgery make your eyes bigger?

Yes, one of the objectives of double eyelid surgery is to make the eyes look bigger and more open, which adds a look of vibrancy and vitality to the whole face. Dr. Prasad makes the eyes look bigger by revealing the true shape of the eyes, and the intrinsic beauty of Asian eyes.

How long does double eyelid surgery last?

The results of double eyelid surgery can last 5-10 years, or even longer. There are factors that determine the longevity of results, such as age at the time of surgery. The results of a patient in their 30s will last longer than a patient who had their surgery in their 50s because aging factors, like eyelid skin stretching, and fat accumulation behind the eyelid, would be slower for a younger patient than an older one.

How long does double eyelid surgery take?

In most cases, double eyelid surgery takes 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.

How long does double eyelid surgery take to heal?

Depending on the extent of surgery and the type of double eyelid surgery done, the healing time will vary to form your double eyelid crease. In our case, our patients typically return to work after one week. Swelling or inflammation after Asian eyelid surgery is normal in the post-operative period.

You can review the factors that affect healing after double eyelid surgery in these YouTube video 1 and YouTube video 2 by Dr. Amiya Prasad.

Is double eyelid surgery painful?

There is no pain or discomfort during the procedure since it’s performed under local anesthesia with LITE™ IV sedation. Our patients tell us when they wake up from LITE™ IV sedation anesthesia that they feel wide awake and rested. During surgery, the patient will be asked to open their eyes to see how the eyelid crease has formed, usually sitting up under normal gravity, to ensure best results.

Do you get anesthesia for double eyelid surgery?

The procedure is performed under local anesthesia with intravenous or IV sedation (LITE IV sedation). Our patients are comfortable and appreciate being able to avoid general anesthesia.
When appropriate, Dr. Prasad will have select patients open their eyes during the surgery (there is no pain or discomfort) to see how the eyelid crease has formed. This allows Dr. Prasad to adjust the procedure for best results.

Patient Reviews on Asian Double Eyelid Surgery

Happy after my Asian eyelid surgery. Love my new creases! 3 months later, I am happy with the result, I look like I didn’t have anything done. Highly recommended. Reviewer: name withheld
I love the result of my Asian eyelid surgery. I don’t know why I waited so long I should have done it sooner. Reviewer: Giyg
asian eyelid surgery patient reviews "my new eyelid crease looks natural and I am happy with it"

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