What Technique is Best to Avoid Misdirected Lashed After Asian Eyelid Surgery?

Is there any truth to the claim that Asian eyelid surgery can cause one to have misdirected eyelashes? What types of procedures can be done to correct this if it happens?

Doctor Answers 5

Prevention is the best for misdirected eyelashes after Asian eyelid surgery

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Misdirected eyelashes can occur after asian blepharoplasty in the form of lash eversion, in which the eyelashes point too far upward and a portion of the lid border is exposed. This occurs when the lid skin incision is not properly aligned with the underlying cartilage (tarsal plate) during the lid fixation process. Although this may be a  technical error on the part of the surgeon, accurate measurements can be difficult if you have unusual elasticity of the skin or other procedures such as ptosis repair were required during surgery. If you experience lash eversion, a revision must be performed within 2 weeks to prevent permanent distortion of the cartilage, which makes it quite difficult to correct later.

Can my eyelashes change position after Asian Eyelid Surgery?

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Hey There,

The general answer is yes. . .if the surgeon wanted to do that on purpose so I don't think you have much to worry about.    Normally the lashes should not move or rotate up much with upper lid surgery and almost never with lower.  Now, if a patient desires the lashes rotate position as a planned part of the surgery that can be done but it requires a little extra work and slightly more healing time.  I wouldn't worry about it happening as a result of a planned procedure to create a crease or remove excess skin. 

Here are a few exceptions:

1.  The patient has both a very heavy upper lids and no crease.  In the act of creating a new crease you can have some slight upward rotation.  This is usually a desired result and is most noticable (if at all) in the first few weeks after surgery and then it settles.   Take a close look at some of the side photos of patients with more dramatic changes and you can note a slight up rotation of the lashes that looks great.

What to do if the lashes are misaligned?

1.  At some later date (months down the line) you can do a release of the skin and muscle of the upper lid that will allow the lashes to settle back into place.  It's relatively small procedure without much healing time.

Finally, make sure you find someone who works primarily on the Asian eyelid.  Every Asian patient's eyes are different are requires and experienced, tailored approach.  


Best of luck

Chase Lay, MD

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 76 reviews

Asian Blepharoplasty

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If you go to a board certified specialist who does Asian Blepharoplasty, this should not happen.  If you have eyelashes misdirected so that it scratches the cornea of the eye, it can be corrected by addressing the tarsal plate.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Trichiasis and Blepharoplasty

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Trichiasis is most comon on the lower eyelids and Blepharoplasty is done in the upper eyelids. The procedure consists of cosmetic lid crease incision, upper eyelid blepharoplasty allows the surgeon to remove excess skin and fat to reshape the profile of the upper eyelid. The skin of the upper eyelid is very thin, which means the incision (hidden in the upper eyelid crease) heals with no visible scarring. We have never seen blepharoplasty cause Trichiasis or inward turning of the eyelash.

Philip Young, MD
Bellevue Facial Plastic Surgeon

Asian eyelid surgery should not cause misdirected eyelashes.

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The work needed for double fold surgery of the upper eyelid should not interfere with the eyelashes.  Properly done, anchoring the upper eyelid platform skin to the levator aponeurosis supports the upper eyelid lashes.  Overdone, this actually can over rotate the upper eyelid lashes.  This is very undesirable.  This risk is avoided by not perform this surgery under general anesthesia.  By having surgery under light iv sedation, you can cooperate during surgery.  The surgeon should ask you to open and close the eyelids during surgery.  If the lashes are over rotated during surgery, the supporting sutures to the levator need to be repositioned.  The goal is support not over rotation.  Fixing this problem if it is not addressed at the time of surgery is problematic.  Hope that information helps.

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