Best Procedure when Considering Eyelid Surgery for Young Patients ?

I am 19 years old. I am Asian and I have eyelids on both eyes. The only problem I have is that my right eyelid crease is weak.I have an intermittent fold. Sometimes I wake up and there isn't a crease, throughout the day it will come and go. This bothers me a lot. I don't want anything drastically done and open surgery scares me a little. Whats the best procedure for me? Thank you so much for your time.

Doctor Answers 8

Asian Blepharoplasty

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Asian "double eyelid surgery” or Asian Blepharoplasty is a cosmetic surgery procedure of the upper eye lid where the skin around the eye is reshaped (Blepharoplasty). The purpose of the procedure is to create an upper eyelid with a crease (i.e. "double eyelid") from an eyelid without a crease (i.e. "single eyelid" “the sleepy look). Anatomically, there are a number of differences in the upper eyelids of East Asians compared with the differences in the eyelids of other races. The single eye lid is the most common complaint, other differences a\is the epicanthal fold, where skin covers the inner part of the upper eye lid.

While there are some Asians with a double eyelid and some without, there is also a large variation in the crease position (double eyelid size) of the East Asian upper eyelid. The upper lid fold can range from 1 mm above the eyelash line to about 10 mm. Several methods can be used to create the double eyelid--including the full-incision, partial incision. Each has its advantages depending on the patient's anatomy and desires.

Asian Blepharoplasty have been reported to be the most common aesthetic procedure in Taiwan and other parts of East Asia. There ate some risk of complications involving the procedure, but it is generally quite safe if done by an expert plastic surgeon. The procedure to remove the epicanthal fold (epicanthoplasty) is often performed in conjunction with an Asian Blepharoplasty. It involves a form of double Z-Plasty.
The procedure opens the eye and give the orbital region a more beautiful look.

Baltimore Plastic Surgeon

For a young Asian with an intermittent crease, suture technique works well

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Suture technioque for crease formation is by far the commonest method used in young patients throughout Asia. It is minimally invasive, performed through tiny stab incisions. I often use it for creases that do not stay all day. It is especially effective in that setting. You must find a surgeon who can show you before and after pictures of eyelids like yours showing results that you like, to be sure that they have enough experience with Asian eyelids.

Jeffrey Schiller, MD
Edison Oculoplastic Surgeon
5.0 out of 5 stars 12 reviews

Asian eyelid surgery

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You are not alone. There are many patients with asymmetric folds on their upper lids. The best way to assure symmetry is to perform the same procedure on both lids. I prefer a limited open procedure as I can guarantee the permanency of the crease and stability of the result.

Gilbert Lee, MD
San Diego Plastic Surgeon
4.6 out of 5 stars 25 reviews

Non incision Suture technique

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There is a non incision suture technique developed in Japan for Double lid creation. Only problem is that although it looks great in the beginning  in some of my patients it wore off after two to three years . The procedure is fairly simple and is done under local anesthesia in the office. If you are looking for a short term solution  till you become brave enough  to have  surgery it may be an option.

Zain Kadri, MD
Los Angeles Facial Plastic Surgeon

Asian Blepharoplasty can be done with just sutures

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Asian Blepharoplasty can be done with just sutures. One thing to realize is that this method although less invasive is not as reliable and you may end up with the same thing where one side is more defined than the other just the reason that you want sometime done.

The surgical method is still minimally invasive and can be done as an outpatient under local anesthesia with or without iv sedation. This method of opening up the eyelid and recreating the crease is more reliable and less likely to have differences between sides. The one option is to do the suture method and see how your healing goes and if it is sufficient for you than that would be the best. If not you might still have the option of opening the eyelid and creating the crease in a more definitive manner.

Philip Young, MD
Bellevue Facial Plastic Surgeon

Asian blepharoplasty would be appropriate

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To recreate the crease, an incision in the crease will have to be performed with suturing of the dorsal plate or muscle layer down to the dermis, which will match the opposite side and be permanent.

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

Asian blepharoplasty is what you need

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The situation you are describing is very common. Typically the lid with the rudimenatry crease is operated on to match the well formed crease.

The challange is finding a surgeon with the experience to carry out this surgery. Too much skin removal will Westernize the eyelid and leave you looking surgical.

Three common problems arise when plastic surgeons perform these procedures. First, the lowest incision which makes the crease is made too high; second, the skin of the eyelid platform is not properly tensioned, and third, too much skin, fat, and muscle are removed from the lid.

Remember that this is really a case that less is more. A low crease can always be raised and more skin can be removed if necessary. However, it is virtually impossible to correct an over done eyelid.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Asian eyelid surgery must be individualized, is delicate but very rewarding

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No other type of eyelid surgery better fills the motto that eyelids are like snowflakes-no two are exactly the same. Asian eyelids are are all slightly different when it comes to crease configuration. And while all eyelids change with age, varying and multiple changes to the crease in the Asian lid occur over time.

That being stated,you should have a detailed consultation with your surgeon and make sure the two of you are on the same page as to your goals. From what you describe it seems like a crease fixation Blepharoplasty with minimal tissue removal should be right for you. To get the best symmetry it is often best to do both eyes with different amount of surgery on each eye .

Hope this helps.

J. Timothy Heffernan, MD
Seattle Oculoplastic Surgeon
4.6 out of 5 stars 12 reviews

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.