How is an eyelid crease created? It’s generally  understood that about half of people of Asian

descent do not have an eyelid crease so  common question I hear during consultation

is about how they can get an eyelid crease or a  double eyelid fold not having a double eyelid foam

can make the eyes look smaller the eyelashes can  be barely visible as well as make it challenging

to apply eye shadow now these patients are  motivated to make their eyes appear bigger

and brighter and I’ll discuss how I help people  who want to have an eyelid crease in my practice

I’m Dr Amiya Prasad I’m a Board-certified cosmetic  surgeon and Fellowship-trained oculofacial plastic

and reconstructive surgeon I’ve been in practice  in new york city and long island for over 25 years

I’m well known for my work for both primary  and revision cosmetic eyelid surgeries such as

treating under eye bags and hooded eyes as well  as advanced oculoplastic procedures like eyelid

ptosis surgery I’m also known for eyelid surgery  performed for specific ethnicities such as keloid

prone darker skin types and Asian double eyelid  surgery an eyelid crease is formed through a

natural connection between the muscle that lifts  the upper eyelid called the levator muscle and the

overlying eyelid skin the point where the this  connection is made is where the eyelid folds

when the eyes are open thereby forming the  eyelid crease people without this skin to muscle

connection don’t have a defined crease they may  have a weak skin to muscle connection resulting in

shallower crease or multiple shallow creases a  weak connection can also be seen as a crease that

only forms some of the time but it’s typically  not very deep if someone doesn’t have a natural

eyelid crease it can be created with surgery known  as Asian eyelid surgery Asian blepharoplasty or

double eyelid surgery when I perform double eyelid  surgery I create skin to muscle connection using

sutures during consultation i show my patients  how their creases would look like by pushing

the upper eyelid skin back using a Q-tip or an  instrument this reveals what a natural crease

would have looked like if someone were born with  it and serves as an approximation of how they will

look after surgery an individual’s facial anatomy  determines the shape of the crease whether it runs

parallel or tapers towards the inner corner of  the eye while non-surgical methods like taping

or gluing the eyelids can temporarily create the  appearance of an eyelid fold surgery is really the

only way to create a stable defined long-lasting  eyelid crease the adhesive used to do and double

eyelid temporarily can irritate the skin and the  constant removal of tape or glue can even stretch

the eyelid skin and even go so far as the muscle  that lifts the eyelid which may require more

extensive and expensive surgery than the usual  double eyelid surgery which I routinely perform

there are two main categories for double  eyelid surgery non-incisional and incisional

generally speaking the anatomy and the age  of the patient determines which technique

is most appropriate for that individual  excessive skin as well as prolapsed fat can

interfere with the formation of a defined crease  that would reveal the natural shape of the eye

by performing incisional asian eyelid  surgery i can precisely address these issues

and create the connection between the skin and  levator muscle to form the desired eyelid crease

if you don’t need to have excess skin or fat  removed I select the non-incisional technique

to create an eyelid crease when I  perform a so-called non-incisional

Asian blepharoplasty I’m actually creating some  small openings through which I can place sutures

to make a connection between  the skin and the levator muscle

generally the non-incisional technique is  indicated for younger patients as well as

older patients who have had previous eyelid  surgery and no longer have any excess skin

I routinely perform these procedures under local  anesthesia and LITE IV sedation in my office

operating facilities my patients appreciate not  having to be under general anesthesia and thereby

avoiding the associated risks and complications  of general anesthesia our patients typically

return to work in one week or less with minimal  swelling depending on the type of procedure they

have aftercare consists of the application of cold  compresses and antibiotic ointment for a few days

so with a better understanding of how  eyelid crease surgery is performed

you can now learn more through a proper  consultation with an experienced surgeon

with expertise in Asian double eyelid surgery  a natural double eyelid can reveal the

true shape of the eyes while maintaining the  characteristics specific to your ethnic background

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

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