Brow Lift and Asian Blepharoplasty with Canthoplasty to Improve Eyelids?

Do I need a Brow lift & Canthoplasty (lateral AND medial) with Asian Blepharoplasty?

If you take a look at my pictures, you will see that I have a heavy brow, hollowness in my lids, and hooded & droopy eyelids. One plastic surgeon recommended that I get an Asian bleph (using the suture method) and he said a lateral canthoplasty can be done because I want to make the lateral canthi (?) to look less droopy.

But I suspect a Brow lift + Asian bleph + the two types of cantho are what I need. Please give me some input.

Doctor Answers 10

Surgery for Asian eyelids require a lot of individual planning

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It is a little difficult to tell from your photo, but a crease enhancing Asian blepharoplasty for the upper lids would appear to be a reasonable choice. Lateral canthoplasty could be considered as well but I think you will get the most effect from the uppers. I do not advise a brow lift in your case because your brows are already in a good position.

The one issue that is difficult to determine is whether or not you also have ptosis. From your photo the lid margin does appear low and if you did have a ptosis it would also explain the superior hollowing just below the brows. If your doctor does identify a ptosis, a levator tightening should be done at the time of the upper blepharoplasty.

Seattle Oculoplastic Surgeon
4.6 out of 5 stars 12 reviews

Tough Asian Eyelid Surgery

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I agree with many of the other surgeons.  Take this for what it is worth since I have not examined you but you need a good medial canthoplasty and upper Asian eyelid blepharoplasty in which your eyelid skin is not only concervatively removed but repositioned.  What does that mean?

1.  Like folding a blanket we need to create a crease above the edge of your eyelid and attach the underside of that fold to the ligaments of the levator muscle beneath.  Don't remove fat!  You may find your eyes look less hollow when we rearrange your eyelid fold.

2.  Incorporated into your upper eyelid incision will be the medial canthoplasty.  Your epicanthal fold is prominent but can be improved a great deal.

3.  Lateral Canthoplasty?  Probably not.  At the time of surgery a modified lateral canthoplasty can be done but just enough to assist your upper lid skin laterally.  No need to actually change the position of the lateral canthus.

4. No brow lift.  You're too young and you'll look unnatural.

Best of luck

Dr. Chase Lay

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

Ptosis Repair with Double Eyelid Surgery Would Work

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According to the picture, it seems like you have eyelid ptosis. A brow lift will not help and a lateral canthoplasty will not help. Your condition will be corrected by performing a ptosis repair, and by also doing double eyelid surgery to compensate for the slight excess skin that’s hooding. You do not have heavy brow and your hollowness of the lids is very characteristic for patients with eyelid ptosis.

Another thing is that lateral canthoplasty is not a good option because it should only be performed to widen the eye. In essence, lateral canthoplasty is effective in showing more of the lateral aspect of the eye. If you look at your picture, there is already more of the white aspect of the eye that is showing on the outer side relative to the medial side. So if you do get lateral canthoplasty, then you would look way too out of proportion. Also, just keep in mind that lateral canthoplasty does not correct the hooding of the eyelid on the outer side. That is not what lateral canthoplasty does.

I recommend you to see an Asian eyelid surgery specialist and also somebody who specializes in eyelid ptosis.

Kenneth K. Kim, MD
Los Angeles Plastic Surgeon
3.4 out of 5 stars 26 reviews

A double eyelid and a medial epicanthoplasty would be fitting for you

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A double eyelid and a medial epicanthoplasty would be fitting for you. In my opinion and the opinion of many of my colleagues a lateral epicanthoplasty usually leaves something less than desired for many people. What distinguishes an Asian Eyelid from a caucasian eyelid is usually the medial canthus where an epicanthal fold is present in about 50-80% of Asians. This has an effect of making the eyes smaller horizontally. I see the hooded portion in the lateral part of your eye.

However, I believe that if you were to do a double eyelid crease formation that part of your eye would be tacked upward and will be markedly improved. I do see that you have an extra fold in the medial part of your eye that is called the epicanthus. Because the picture shows that the fold covers that fleshy part of your eye in the middle part I would classify this as a type 3 epicanthal fold. If it was partially covering the fleshy part it would be classified as a type 2. An epicanthoplasty would open up your eyes horizontally here a great deal.

I don't think you need a brow lift. I think the distance from eyelid margin and your brows is long enough and a brow lift would make you look surprised. I really think that you need some fat in your eyelid or some type of filler there to volumize this area. If you look at some pictures of you when your were a child you will see more fullness there where the volume could recreate some youth for you there.

Philip Young, MD
Bellevue Facial Plastic Surgeon

Do you need a browlift and canthoplasty with asian eyelid surgery

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You have bilateral ptosis which should be corrected, and a medial epicanthoplasty will also be needed to allow the crease to fold more naturally. These two procedures will result in your brow dropping a significant degree and the hollow will be reduced, because you will no longer be using your forehead to help assist in upper vision. On examination, if the brow looks like it will drop to an unacceptable degree, then I would recommend a browlift at the same time. The lateral canthoplasty/ canthopexy could be done to improve what appears to be laxity of the lower lid tone, but this would not be directly related to your question. 

Charles S. Lee, MD
Beverly Hills Plastic Surgeon
4.5 out of 5 stars 79 reviews

Asian Blepharoplasty

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Viewing your pictures i would do the Asian eyelid (double eyelid) operation. Hooding over the medial canthus should be corrected. However, canthoplasties and a browlift are not necessary in my opinion.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Simple Asian blepharoplasty will improve eyelids

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A simple Asian blepharoplasty would suffice according to the pictures shown. A browlift is not needed as your brows and would look unnatural.  Lateral canthoplasty is also not needed.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Improving Asian eyes

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Forget the brow lift. That will give you a surprised look and worsen the hollow eye.

As for lateral canthoplasty, only by exam will I detrmine if you really need that. May convert you to Chinese eye.

If the lateral canthus is above the medial canthus by 2-3mm you are fine. Asian Blepharoplasty is all what you need now. I would consider also Fat transfer to correct the hollow eye. Reevaluate later if you want or need anthing else.

Samir Shureih, MD
Baltimore Plastic Surgeon

Asian Eyelid

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Your pictures show a satisfactory position to your brows which are located well above the boney rim therefore I would not recommend a brow lift. From the photos, I also believe your lateral canthus is located above your medial canthi and I would not perform this procedure. Start with the upper lid bleph +/- the medial cantho plasty and proceed from there if greater correction is desired.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Browlift plus eyelid surgery?

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 From your picture, I would completely eliminate the idea of a browlift in your case.  Your brows are plenty high and there is a long distance from the brows to the lid margin, longer than in most people in fact.  I would start with the upper lids alone and see what you get.

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.