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