I’m fine with tapered eyelid as long as the line is visible and my eyelashes are not weighted down. Is this possible? (Photos)

Question

Already had a consultation with a lady at the clinic I plan to go to , but the doctor was out that day, so couldn’t get too many details. she said that my eyes would be difficult for eyelid surgery, and that I would need ptosis correction, and she was concerned about the hollows above my eyes. I have only ever been able to achieve double eyes with eyelid tape used with fake eyelashes with a hard band, so I suspected that my eyes would be quite difficult to work with. Was also wondering if I would need to get an epicanthoplasty to get ideal results. For my ideal shape, I’m fine with a tapered eyelid as long as the line is visible and my eyelashes are not weighted down. I have a consultation with the doctor next month but was just wondering if I could get some opinions before then., or if this surgery is even possible for my eyes, thank you.

A.J. Amadi, MD · Answer

A low tapered crease with a subtle root z-plasty epicanthoplasty would give you a really nice result. You do have strong epicanthal folds and without it, the medial eyelid will not show as well.

Young Min Im, MD, PHD · Answer

When considering eyelid surgery, there are two main aspects to evaluate:
1. Creating a double eyelid crease (fold)
2. Enhancing the strength of the eyelid-opening muscles
The creation of a crease involves forming a natural-looking fold on monolids to help the eyelid fold in smoothly. The strength of the eyelid-opening muscles is assessed by how much of the iris (the black part of the eye) is visible when the eyes are open. In the current present, the upper eyelids are covering a portion of the iris, which contributes to a tired or sleepy appearance.
In such cases, performing double eyelid surgery along with ptosis correction can help create a more defined eyelid crease while also allowing the eyes to open more fully and appear brighter and more alert.
Additionally, the photos show some volume loss in the upper eyelid area, which can create an older appearance. This hollow area can be improved by fat grafting to restore volume and create a more youthful look.
Lastly, medial epicanthoplasty (inner corner eye surgery) may also be beneficial. The presence of prominent epicanthal folds on both sides makes the eyes appear more covered and smaller. In this situation, opening up the inner corners of the eyes could further enhance the overall aesthetic result.

Donald B. Yoo, MD, FACS · Answer

Asian eyelid surgery has nuances that are difficult to flesh out without an in-person consultation since even a "tapered" or "infold" crease can have many different iterations depending on the patient's desired height and shape. If you are able to create the desired shape with eyelid tape, then it may not be necessary to perform concomitant epicanthoplasty and ptosis repair, though it would be best to have a surgeon show you the different effects each of these would have on your results.

I’m fine with tapered eyelid as long as the line is visible and my eyelashes are not weighted down. Is this possible? (Photos)

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