Double Eyelid Surgery (Asian Eyelid Surgery)

Nearly half of asians are born with no upper eyelid crease (single eyelid), which can cause the lashes droop in the visual axis (lash ptosis) or give rise to a sleepy appearance.

Often patients have a crease, however it is very close to the eyelashes, this not visible. They can also have fat or excess skin in their lower lids, which can cause the lashes to turn inwards and touch the eyeball (epiblepharon). If left untreated this can cause scarring of the front surface of the eye, light sensitivity and ocular discomfort.

Some asians would prefer to have this appearance corrected, as it can cause the eyelashes to slip and touch the eyeball, or they just prefer to have a more “awake” appearance.


Double Eyelid Surgery (Asian Blepharoplasty)

How can Double Eyelid be treated?

A crease is created in the upper lids, where a crease would naturally occur. Excess skin and muscle are removed, as well as fat, if it is contributing to a puffy look.

For correcting a lower lid epiblepharon, often an incision is required to be placed in the lower lid, which is visible. For fat excision this scar can be hidden just below the eyelashes or hidden in the inner part of the eyelid.

What are the potential risks & complication of double eyelid surgical correction?

The risks of surgery include

  1. Infection: this is very rare, occasionally the stitches may have an infective or inflammatory response, which settles with oral and topical antibiotics.
  2. Scarring (generally hidden in the skin fold for blepharoplasty). Normally stitches are visible for the first week, then, when they are removed, a faint scar is visible. The scar may seem a bit thickened & red for 6 to 12 weeks, becoming almost invisible after that period. Not every scar heals equally well. A thickened or reddened scar can be improved with silicone scar remodelling gel, but the treatment needs to be continues for months to have a good result.
  3. Large bruise or haematoma. This is minimised by avoiding heavy exercise for 2 weeks after surgery, stopping aspirin and other anticoagulants (if safe so to do) 2 weeks pre operatively, and regular use of ice packs. A haematoma may mean you have to go back into theatre to have the blood clot evacuated and then be re-stitched with the risk of a worse scar.
  4. Theoretical risk to vision. Any eyelid surgery carries the risk that an undiagnosed infection or bleed could damage the optic nerve. This is so rare that in comparison a normal car journey is a much greater risk to your vision.
  5. Asymmetry of eyelid shape, height or upper lid fold : this is rare, but can occur. Often asymmetry may be due to lid bruising and settles spontaneously as swelling resolves. Rarely, this may require revision surgery. Occasionally pre existing asymmetry of the face, eyebrow or eyeball position, may be responsible, however this will be discussed with you prior to the operation by your surgeon.
  6. Temporary poor blink, as the muscle that shuts the eyelid has been cut to access the muscle that lifts the eyelid. Generally blink returns to normal within 12 week.
  7. Droopy eyelid or ptosis : This can happen rarely and will need to be corrected by re-operation.