Hi Cali,
The condition you are describing is upper eyelid ptosis where the lid margin, the end of the eyelid with the lashes, rides too low on the eye. In some cases, the eyelid can block the field of vision however many of these are deemed cosmetic depending on your insurance carrier (never hurts to ask though). While you have a double fold already, the exact surgical principles needed to enter your upper eyelid for double fold surgery need to be respected for fixing a ptotic Asian or a Caucasian eyelids.
The biggest error that non-oculoplastic surgeons (and some oculoplastic sugeons) make is placing the incision to fix the eyelid too high. I don't fault the surgeons, the problem is that many plastic surgery textbook describe the placement of the incision at the wrong place. The effect is an extremely long eyelid platform (the portion of the upper eyelid between the eye lashes and the upper eyelid crease which lives under the upper eyelid fold. Commonly this is marked at 10 mm intraoperatively or at what is perceived as the existing upper eyelid crease. Generally, it is much better to make this incision lower at 6 to 8 mm. As the eyelid heals, this incision tends to migrate up about 1-2 mm. Next the surgeon needs to identify the levator tendon and shorten it based on effect. Consequently, these surgeries need be be performed under light IV sedation so that you can open and close the eye during the surgery.
These are specialized surgeries and require a fellowship eye plastic surgeon who is also a board certified general plastic surgeon and not a facial plastic or general plastic surgeon who does eyelid surgery as a sideline business. The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a website at ASOPRS.org with a geographically listing of members to assist you in finding a highly qualified surgeon in your area.
