Epicanthoplsaty and Lateral Canthoplasty - Dry Eyes?

Dear Radical

There are a number of issues here:

Dry eye-any eyelid surgery can worsen an already dry eye.  If the eyelid surgery is sufficiently aggressive, the eyes never recover from this.  Presumably your potential surgeon took a detailed history, carefully examined your eyes including measuring your vision, studied your corneal surface to look for evidence of dryness, and measured the ability of your eyelid to produce tears, and discussed what to expect regarding eye comfort and dryness.  If this has not been done, then your surgeon as not adequately examined you.

Epicanthoplasty.  This is a procedure to change an inside fold to an outside fold.  The epicanthus is the fold that extends from the inner corner of the upper eyelid.  Taking an inside fold to an outside fold is generally not a good idea.  One simple reason for this is that the scar has no place to hide.  It can be done and it can look great or it can be horrible.  Generally I do not recommend it.  Some surgeons do it because they think that it is their job to erase any Asian vestiges from an eyelid.  WIll you be happy with the result?  I would advise an abundance of caution here.

Lateral canthoplasty.  A good idea if you want to do surgery on someone but you really are not sure what surgery to perform.  WIth any luck, you will have a non-result.  Yes there are clinical circumstance where a canthoplasty is appropriate but in a healthy person simply looking to enhance their Asian eyelid, it is seldom indicated.

Is there a reason your surgeon is not performing double fold surgery for you?  You live in Los Angeles.  I recommend that you see some additional eyelid surgeons to reduce the likelihood that you are about to wreck your eyelids with a surgeon who does not know what they are doing.  Something is troubling you or you would not have posted a question.  Try looking up eyelid surgeons in Los Angeles on this site.  Be certain that your potential surgeon is board certified in ophthalmology and a Fellow of the American Society for Ophthalmic Plastic and Reconstructive Surgery. 

If your blink mechanism is not affected then you have little chance to develop dry eyes. Good Asian eyelid surgery is not to physically make your eyes bigger because that would make your eyes appear unnatural and even scary rather to make your eyes look bigger and your face brighter and more energetic.

Any surgery on your eyelids can put you at risk of dry eyes or more commonly worsening of an already existing dry eye problem.  Both lateral canthoplasty and epicanthoplasty can weaken the orbicularis muscle enough to cause a less than optimal blink. The surgery can leave your eyes open slightly wider leaving more surface area to evaporate your eyes.  You should have an Oculoplastic surgeon in your area evaluate your preoperative dry eye status.

Dry eyes may be caused by a number of different factors, and may also be a result of eyelid surgery. Neither epicanthoplasty nor lateral canthoplasty will necessarily cause the condition, but you should undergo a thorough examination and have a comprehensive discussion with your surgeon prior to surgery.

Your question or concern is half correct. I recommend seeing 3 boarded surgeons in your area to fully discuss these issues. That way you can hear, see, and be examined so to better understand the risk/benefit ratios. 

Cosmetic eyelid operation can make your eyes more dry.  If the goal of the surgery is make your eyes look more open then the eyes are a little bit more exposed to the environment and your eyes natural moisture evaporates more easily.  For most people this is not a problem.  However if you already have a problem with dry eyes, making them more dry with surgery can cause increased symptoms.   The trick is to be sure that you don't have dry eyes or, if you do have dry eyes, to have them treated so that they are under good control before the surgery is performed.

Make sure that you see a surgeon who is experienced with eyelid surgery and tell him, or her, if you have symptoms of dry eyes like burning, stinging, or a feeling that something is in your eyes.