These are patients that come in who are desiring to have a crease placed into their eyelid. There are a lot of Asians with single eyes where there is actually no crease, and they're desiring that. There's a whole menu of different ways of how to do this, and every doctor is going to have their own preferred way. My preference is to utilize stitches through an open approach. Basically, make an incision where you want the crease on the outside, and on the inside you put stitches to rearrange the tissue, so that the crease is formed when their lids are open. The most difficult thing about Asian eyelids is to have them be perfectly equal. Revisions can't always fix that, but ideally, you like to hit a home-run every time you do this.

Asian Eyelid Surgery: Creating a Crease For "Single Eyes"

Dr. Curtis Wong explains how surgery is used to fashion a crease for Asian eyelids.