Thank you for your question. After reviewing your question, I understand you’re a 49-year-old Japanese woman and you’d like to achieve a very specific look for your eyes. You have been using eyelid glue to get this particular look, but it doesn’t look natural and gives you difficulties in opening and closing your eyes. You also say that your eyes look droopy and saggy. You’d like to know what type of procedure to get, and whether to have it done in the US or Japan.Asian eyelid surgery in particular is an area of focus in my practice, so I can certainly give you some guidance on this matter. To give you a little information about my background — I’m a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial plastic and reconstructive surgeon, practicing in Manhattan and Long Island for over 20 years.There are several ways to perform Asian eyelid surgery, and they are dependent on the achievement or development of a more defined crease so the eyes look more open; whether or not there is the presence of extra skin or extra fat on the eyelid; and whether or not there is the presence of ptosis or drooping of the eyelids. There is also the option of having either a nasally tapered crease which goes towards the epicanthal fold, or a parallel crease that runs parallel to the epicanthal fold. In my practice, what I do during examinations is take a small, blunt-type instrument which I use to create a temporary crease on the eyelid, in the area where I think it would look best, in order to show the patient what it could potentially look like. There are two techniques that are usually employed: incisional and non-incisional. A non-incisional technique involves making little openings on the eyelid skin through which a stitch is passed, and an incisional technique involves opening up the eyelid and removing skin. Regardless of the technique used, the goal is the same — to create a connection between the skin and the levator muscle so the eyelids create a clearly defined crease when they open. A similar look can be achieved with eyelid glue or tape, which is what you have been using.With regard to having the procedure done in the US or abroad, this is really a matter of the doctor you choose, and how comfortable and confident you are with them. In my practice, I frequently meet with people who come from all over the world to consult with me for eyelid surgery, elective eyelid surgery, and complications of eyelid surgery. When they come to New York, I make sure that they’re around long enough for me to ensure they don’t have any problems with infections or bleeding after the procedure, and also for me to remove their stitches, since many patients prefer their operating surgeon to be the one to remove their stitches.In some cases, however, we make exceptions for patients who have family members who are doctors, or who know doctors closer to where they live and are willing to take out their stitches. I’ve also had patients who live in New York and consulted with me, then went to Korea to have the eyelid surgery, and then continued to come to me afterwards when they had questions about the desired result, the outcome, and the process.There are certainly pros and cons to each situation. There are plenty of options in the US, and many doctors who specialize in eyelid surgery, I myself being one of them. Ultimately, what matters is what makes you most comfortable. I would simply advise that you seek a specialist in Asian eyelid surgery — someone who really understands the procedure, someone who’s work you feel confident in, someone who will be there for you, and is accessible. When you find the options that work best for you, then you can move forward with the procedure.I hope that was helpful and I wish you the best of luck!This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.
