Double eyelid surgery is the most popular of all facial plastic surgery procedures performed on patients of Asian descent in the Orient and West.
It is an operation designed to create or enhance the upper eyelid crease. It will make eye bigger and the eyelids look more opened. While most of the structured of the Asian eyelid are identical to those found in the Caucasian lid, their different structural alignment and relative lengths and thicknesses are sufficient to account for the highly characteristic appearance of the typical Asian upper lid, epicanthal fold, and crease.
Many plastic surgeons consider eyelid surgery to be the most demanding and least forgiving of all plastic surgery procedures. Patient satisfaction after eyelid surgery is surprisingly low, a refection of the expertise required to perform these operations successfully. Results can vary tremendously with the training, skill, and experienced of the doctor, and problems such as noticeable asymmetry, excessive scarring, misdirected eyelashes, unwanted accessory skin folds, hollowness, overdone or unnatural results, and a gradual loss of the crease are by no means rare.
Among many different techniques, wide undermining the lid skin and aggressive removal muscle technique deliver most attractive result
- Requires incision
- Leave scar
- Healing and recovery takes longer
- Revision surgery may be difficult occasionally
- Requires skill from surgeon
- Deliver permanent result
- Good for thick skin
- Good for fatty eye
- Able to prevent puffy crease
- Less fold failure rate
Shape and Size of the Fold
This is most desirable to the patients who are looking for typical Asian appearance and very natural looking fold. 50% of natural crease belong to this style and young patients prefer to this style. Typically the size is somewhat smaller and usual size of the crease is less than 6mm. Non cutting technique can deliver this kind of style of crease.
Somewhat larger than tapered crease and resemble Caucasian fold. It is somewhat larger than tapered look and also 50% natural crease belong to this style.
Epicanthal fold is sometimes called as a Mongolian fold and it is small web like skin covers the inner corner of the eye. Removing this fold is called medial epicanthoplasty and it enlarges the eyes in horizontal direction. 10 to 15 % of the eyelid surgery requires this procedure. This procedure is recommended to someone’s horizontal length of the eye is less then 2.5 cm and if the size belong to between 2.5- 2.7cm then occasional recommended. Anyone whose eye is larger than 2.7cnm then usually this procedure is not necessary. For general information Caucasian eye size is somewhat 3cm in length.
There are numerous techniques such as V-Y advancement, W plasty, Z plasty, and modified Z plasty V-W plasty but due to high incidence of the scarring I recommend
This technique gives least chance of scar formation but every epicanthoplasty need to be performed with very careful consideration.