Can’t decide on the right crease height for my Asian eyelid surgery. How do I choose the crease while keeping my asian features?

Question

I’m planning to have Asian eyelid surgery with epicanoplasty in a few months. I would like to keep my Asian features but at the same time would like them to be a bit bigger and wider. I’m struggling with choosing the right height for my crease. What crease height would be the best? How many millimeters should I go for?

Basil Pakeman, MD · Answer

The fold height of the eyelid  is often determine by the height of the tarsal plate of the eyelid which on average is 5-8 mm in Asians. The other determining factor is the attachment of the skin to the tarsal plate and the levator  tendon. With this being said, the lid crease height would be between 5-8 mm normality. The best height is best determined by you and your surgeon. He can demonstrate the effect of the different heights on you in the office in your consultation.

Andrew Choi, MD · Answer

Your eyes are round.

If you wish to make a larger crease, you may consider increasing the horizontal length of the eye.

If you increase the vertical length only, that will make for a much rounder eye.

You can make the horizontal length of the eye longer by opening the inner corner of eye with Medial Canthoplasty or by increasing the length at the end of eye with Lateral Canthoplasty.

Jimmy C. Sung, MD · Answer

Looking at the photo you provided, you already have a "double eyelid" crease.  I understand that you want the fold to be more dramatic.  This can be done by keeping your current crease height which is about 5mm, reposition the fatty tissue to improve the hollowness which is more pronounced in the left upper peri-orbital region. Keep the tissue resection to a minimum. You will be fine.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question and posting your photograph.  In general, you should not have your crease elevated too high. You really should have a complete, detailed in person consultation with an experienced Oculoplastic Surgeon. It is easier to judge the best treatment plan for you in the office setting. Good luck,

Wenjing Liu, MD · Answer

Dear Shapi,
It sounds like you would like your upper eyelid crease to be a bit higher. In my opinion, it is usually best to be conservative and to not raise the upper eyelid crease too high and to not take off too much upper eyelid skin since it is easier to make the crease higher or to remove more skin than to put it back or lower the crease after the surgery is done. During your consultation with an oculoplastic surgeon, the surgeon can show you what different eyelid crease heights would look like on your eyelids so you can visualize what the result after surgery will look like.
Best,
Dr. Liu

David Kahng, MD · Answer

hi,
fold height has its limitation but it is also what you want.  you can try using tape or glue to play with the height size.  I usually recommend 9 mm in height size and infold design to keep more of the Asian look but others want an outfold.  after the surgery it does come down so a 9mm fold initially will look like 8 mm in a year.  hope this helps.

dr david kahng

Amit Gupta, MD - Account Suspended · Answer

Good evening and Thank you for your question, usually your chosen Plastic Surgeon will be the best person to guide you to selecting the height of your eyelid fold. In my opinion and in my practice there is usually a small fold which is an indicator of where your fold would have been naturally, so we can follow that easily. Having said that the eventual fold will depend on where the muscle is inserted on to the tarsal plate and that is usually not less than 6 to 7 mm.Best Regards,Amit Gupta

Can’t decide on the right crease height for my Asian eyelid surgery. How do I choose the crease while keeping my asian features?

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