Options for Enlargement of Asian Eyes

Dear Ghprime,Thanks for your questions.In your situation, a double eyelid procedure is appropriate.  You do have some ptosis, or drooping of the eyelids and this would ideally be corrected as well.  Typically, in my practice, we use a non-incisional form of double eyelid surgery where small punctures are used to pass a surgical thread through the eyelid multiple times to create the eyelid fold.  The same thread can be used to tighten one of the muscles of the upper eyelid to correct the ptosis (Muller tuck).  The advantage of this approach is that both conditions, the lack of the eyelid fold and ptosis, can be correctly without a large incision on the eyelid, which greatly shortens your recovery as there is much less bruising and swelling.Aloha,Shim Ching, MD

Thank you for the question.  You’re absolutely right regarding whether a double eyelid surgery will make the eyes look bigger.  Creating a double eyelid will help accentuate the eyes and help define the periocular region.  However, the overall size of the eyes are dependent on the vertical and horizontal dimensions when eyes are fully opened.  Sometimes the vertical dimension is dependent on the upper eyelid opening mechanism.  In some patients ,and it’s especially more prevalent in Asians, the muscles that help open the eyes are weak.  This is referred to as ptosis or “lazy eyes”.  In order the make the eyes open more there are different techniques that help tighten the muscle so that the vertical opening of the eyes are enlarged.  
The horizontal width can be enlarged by either opening the inner or outer corner of the eyes.  This is referred to as medial epicanthoplasty or lateral canthoplasty.  
Commonly depending on patient’s condition and wishes, we perform these ancillary procedures in combination with double eyelid surgeries to complete correction.  Please make sure to address these options with your plastic surgeon with experience since double eyelid surgery on its own does not “enlarge” the eyes.

You would likely benefit from Asian eyelid blepharoplasty which will automatically make your eyes look a bit "larger."  You may also benefit from a medial epicanthoplasty and a levator advancement, but I would recommend seeing a plastic surgeon with Asian eyelid expertise who can evaluate your eyes in more detail.   Good luck!

A double eyelid procedure will give the illusion of a larger eye, but in addition, you appear to have some weakness in the muscles that open the eyes. Thus the vertical dimension of your eye is smaller than ideal. This is very common situation and I find that almost all eyes have some degree of what is called ptosis. When you undergo the double eyelid procedure, the muscle that opens the eyes lie in the surgical field - this can tightened up as part of the procedure to help open the eyes more. In addition, removing the inner fold of skin - an inner epi - will increase the visible amount of the whites of the eyes.

Many of our patients request treatments to make there eyes larger. In reality we don’t make the eyes larger but can make them appear to be more open. This is done mainly through a procedure called Blepharoplasty.
This allows the surgeon to remove some of the extra eyelid skin so that the lid margin and eyelashes are more prominent visually. It gives the appearance of larger more open eyes. In addition for some Asian patients a crease in the upper eyelid can be created to give the double eyelid configuration that some prefer.

Hi Ghprime - Upper eyelid surgery can be done, as you've found out, to "open up the eyes" for Asian upper eyelids.  This will add to the size of your eyes and make the appearance "bigger."  The surgery is pretty easy with minimal downtime and discomfort.  Good luck!

The double eyelid surgery treats the redundant skin on the upper eyelid to create a crease. Women comment that there eyes appear more open and awake but you are correct. the eye does not really become any bigger.
It is difiicult to "open" up the lower eyelid. In some selected individuals, I will place Botox into the pretarsal orbicualris to weaken it and allow the lower eyelid to relax. This will give the illusion of a more open eye but it will require repetition.

Yes, it's possible, A few different ways.
1) Creation of double eyelid- the photo is a little dark, but looking at your skin it may be a touch thick for a suture only technique but I couldn't be sure. Open vs partial open vs closed technique needs to be tailored to your own anatomy.
2) Removing some excess fat to make your eyelids "brighter"
3) Eyelid fold closest to your nose, called epicanthoplasty does 2 things- 1.make your eyes look bigger and 2. make your eyes more Eurasian. Eyelid fold closest to your ears (lateral) can also be added
4) Make your eyelid opening bigger- you can advance the mechanism that keep your eye open to give you a wider aperture if you like, to give you a bigger eyes but this needs to be undertaken with extreme caution.
Wishing you the best your journey.
Dr Leo Kim, Specialist Plastic Surgeon in Sydney.

Height & width customization
There is no doubt that your eyes can actually be larger or bigger/brighter.  Doing this takes more than simply removing some skin.  Eyes can be enlarged in two dimensions: width and height. 
Height:
In a young person like yourself it would be a small amount of skin, possibly a concervative amount of fat, and a simultaneous advancement of the muscle that opens your eyelid.   Performing all these things together in a single procedure is common and in experienced hands the healing time is essentially the same as it would be had you had only skin removed. . .which would not work for you by the way.  You need the above three components.    Remember to go to someone who works regularly or exclusively with the asian face.   If your surgeon tells you what he/she will do and says something to the effect of "I perform all of my eyelids this way" get another consult.  
Asian eyelids require and increase degree of costumization.  My patients eyelids are customized to the patient's request.  Subtle, big eyes, high crease, low crease, etc.
Widening the eyes requires (simply put) spliting the lids a few millimeters at the later corner of the eyes and a special conjunctival mucosal flap to literally make the eyes wider.  Let me mention though, that this procedure can be  imperfect and should only be performed by experienced eyelids surgeons.
Hope that helps.  Yes, your eyes can look larger.
Chase Lay, MD
 

You’re correct in that traditional double eyelid surgery does not make the eyes bigger. One would think that their eyes have gotten bigger after getting traditional double eyelid surgery because double eyelid surgery takes up the excess hooding on the upper eyelid. Therefore, if there was excess skin that’s covering a significant portion of the color aspect of the eye that is being shown then after the double eyelid surgery one would think that his eyes have gotten bigger since that excess hooding skin has gone up. However, in order to truly get an eye enlargement, one would need a vertical as well as horizontal eye enlargement. Vertical eye enlargement can be done through a ptosis repair, which in Korea, is also known as adjustment of the vertical height of the iris shown. You can also benefit from lateral eye enlargement, which entails epicanthoplasty and lateral canthoplasty. Epicanthoplasty for Asian eyelids is opening the inner side of the eye while lateral canthoplasty is opening the outer side of the eye. When you combine them both, in your case, you can enlarge your eyes. This is how a lot of the Korean actresses and K-Pop celebrities attain much larger eyes relative to others.