I am Asian. I have the fold except my eyes are hooded. What procedure should I be looking into? I would like to do some research before I consider it except I don't know where to begin my research.
Asian Eyelid Surgery for Hooded Eyelids?
Doctor Answers 22
Asian Double Eyelid In Hiding
I operate exclusively on the Asian eyelid and most of my patients come with your particular issue and not a true "single eyelid" or "absent eyelid" crease. The crease is usually there but it simply needs to be exposed. So here we go. Question is, do you want something small (less down time) or something bigger (more down time but more permanent).
1. You likley need a coservative amound of skin removed and little to no fat. It is often taught to surgeons that fat should be removed in all Asian eyelids. Not true. A moderate to small amount is often in order but I can tell you that agressive removal of fat will give you a high and hollow crease. Very unnatrual. Skin +/- a little fat looks great, it's permanent, can be tailored from subtle to dramatic and take about 5 days healing time. Little to no bruising. If you're older you may need a bit more skin out.
2. Suture technique is commonly done. I do it often. Especially in younger patients you can have a great result that can last for many many years. The healing time is typically about 2 to 3 days and you can be in public the next day if you don't mind some mild puffyness of your upper eyelids. Tradeoff is if you place contacts in your eyes by lifting your upper lid every day you can loosen the sutures hold a bit. The sutures are placed deepto your skin and are never seen.
Do your research and let me again warn you. If the surgeon describes skin removal and removal of fat from your upper lid to help with "fullness" or "puffiness" ask exactly how much. Quiz him or her. Not taking enough fat (if any) is totally fine. Too much is not good.
Best of luck,
Dr. Chase Lay
Classic and Asian blepharoplasty
Roughly 50% of Asians are born with eyes that have "single eyelids" (as opposed to "double eyelids") in which case there is no crease that forms in the top lids when the eyes are open. Some of these patients also have extra skin and fat, which creates a hooded look. "Hooding" is sometimes used to describe an upper eyelid that is flat and slightly puffy.
I assume that you are refering to "hooded eyelids", and not to prominent folds that run into the corner of the eye - if this is the case, please let me know and I will respond with another comment - the epicanthal fold (if this is what you are refering to) needs special consideration for Asian (double) eyelid surgery.
When I perform double eyelid surgery, I am creating a natural crease in the eyelid that appears when the eyes are open, but not when they are closed. In some cases, I remove skin and fat to create a smoother and less puffy appearance.
As you already have a fold (crease), and if you are happy with its position and shape, you may be a candidate for a classic blepharoplasty. In this case, your fold (eyelid crease) will be left in place, however some of the extra skin and fat will be removed. Your surgeon will discuss with you which approach is best given your eyelid features and your objectives.
With a classic blepharoplasty, I make an incision inside the natural fold (crease) of the eyelid so that the scar is hidden when the eyes are open. My patients have high satisfaction from this surgery as the procedure can be done on an outpatient basis with local anesthetic and a sedative, and the recovery period is typically easy and without any discomfort.
I recommend you see a Facial Plastic Surgeon or Oculoplastic Surgeon in your area for a consultation. Choose a surgeon who has extensive experience with both classic blepharoplasty and double eyelid blepharoplasty as some consideration will need to be given to the existing fold that you have, and if it should be modified at all. The double eyelid surgery can be more complicated than a classic blepharoplasty and this is why choosing a surgeon with much experience with this procedure is highly recommended.
Asian Hooded Eyes - Surgery
The Asian double fold procedure is the most common aesthetic procedure performed on Asians. Some patients already have a crease but with extra skin and fat, this creates a hooded look. Other patients don't have this crease and need it to be created surgically, thus westernizing the eyelid. It is important to discuss with your facial plastic surgeon all concerns you may have as well as the type of eyelid you'd like to achieve. You may be a candidate for a classic blepharoplasty, this can be done as an outpatient procedure and with local anesthetic and a sedative. The recovery period for this is typically easy and without any discomfort.
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Asian Double Fold Procedure
The Asian double fold procedure is the most common aesthetic procedure performed on Asians. During this procedure I remove any excess skin that is "hooding" over the lashes. Then we form a crease about 9 mm above the lash line or strengthen the crease that may already be present. The procedure takes about 45 minutes to perform. I do it under a local anesthetic in the office. And, it is literally painless.
You may need a brow lift, volumizing or an Asian Double Eyelid Blepharoplasty.
You may need a brow lift, volumizing or an Asian Double Eyelid Blepharoplasty. This would all depend on how you looked in person or in a photograph. Your eyebrows should form an arch that is higher at the arch than either the lateral or medial end of the eyebrow. Also, the lateral eyebrow should be slightly higher than the medial eyebrow. The distance from eyelashes to the bottom of your eyebrow should be one iris width until you reach the arch where the distance from the lashes to the eyebrow should be around 1 1/2 iris widths. The highlight created by the arch should line up with the iris and nasal tip.
If your eyebrow is below this you could benefit from a brow lift or volumizing. A browlift would be good if you never had this ideal before and you want to change your anatomy. Volumizing would be good if you had this ideal before and want to restore it. Volumizing is also good if you want to improve the loss of tissue around your eyes as well. This loss of tissue often is the biggest culprit that causes aging around the eyes. Asian double eyelid blepharoplasty is useful if you would like to define the eyelid crease and to remove some extra skin.
One thing to realize is that removing extra skin can lead to thicker eyebrow skin being opposed to the thinner eyelid skin and this can look unnatural in the asian eyelid due to the thickenss of their skin.
Do your research
Asian eyelid surgery is probably the most frequent cosmetic operation performed in Asia. There are innumerable operations which have been designed and proposed to correct this deformity (which should be considered a deformity only based on desire). The procedures vary from one suture simple techniques performed under local anesthesia to more complicated ones performed with the patient asleep. The qualifications of individuals performing these different procedures vary as do the price and the results.
I suggest that you do your due diligence. Investigate the doctor and his practice, look at his results, talk to satisfied patients before deciding. Do not consider price only. Good luck.
Question about Asian Eyelid Surgery
The eyelid anatomy in those of asian descent is unique. So are the goals of surgery. Forming a low, natural crease, remove a small amount of skin, repositioning some of the eyelid fat, may all be options to help you reach your goal.
Upper Blepharoplasty is the solution for hooded eyes
Hooded eyelids on Asians
What surgery you will benefit the most depends on your age, forehead findings including the position of the eyebrows, the amount of excess skin, muscle and fat, and your current crease height as well as your desired height and shape of the crease.
Depending on these findings, you may need browlift(forehead lift), upper eyelid surgery or both.
Hooded Asian eyelids can be due to aging or simply an absence of a crease
Asians who either lack a crease or have a small crease will have hooding, or excess upper lid skin which obscures vision, at an earlier point than someone with a larger crease. Upper eyelid surgery will require both placement of a crease combined with removal of excess skin and or fat. The brow will frequently descend as the forehead muscle relaxes once the upper visual field becomes unobstructed.
I would recommend someone who performs asian eyelid surgery on a regular basis and who also performs browlifts in order to get the maximum information on your options for correction. Good luck!
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.