I’m a 28y old Chinese female and dislike my eyelids. My eyelids have always had a flap of skin that hangs down to my lashes. I would like to have the extra skin removed from my lids but am afraid of not looking Chinese to my family.
Can you do eyelid surgery and still have a patient look Asian?
P.L. Irvine, CA
You ask some very good questions about Asian eyelids. First of all, Asian patients do have different eyelid anatomy than most Caucasian patients. In the typical Asian type of eyelid patient, the superior palpebral fold (the upper lid fold between the lashes and brow) is absent. This occurs in approximately 50% of Asian patients and is a genetic feature that is passed on from parents to their children with a dominant gene.
The Asian eyelid without a palpebral fold is often referred to as a “single eyelid”, while an eyelid with a fold is called a “double eyelid”. Operations designed to construct a superior palpebral fold are becoming more popular in Asian patients around the globe. This surgery has become commonplace in large cities in the Orient as well as in the United States areas, especially in areas like Orange County containing large Asian populations.
The “single eyelid” occurs because a muscle called the levator palpebrae ends within the substance of the lid, instead of attaching to the top of the cartilage plate in the lid, and is not caused by a skin excess! In such procedures, every attempt is made to create the desired fold but not to alter the general shape of the eye or to destroy the web that many Asian patients have medially, near the nose. Destroying this epicanthal fold would make a lid look more Caucasian and destroy this important Asian feature of an eyelid and give the patients and eyelid version of Michael Jackson’s nose – this is to be avoided!
As mentioned, 50% of Asians lack the palpebral fold, but the other 50% do have such a fold – the Asian eyelid procedure is designed to create such a fold and still leave the patient looking Asian. A surgeon doing such surgery should be familiar with the differences between Asian and Caucasian anatomy.