Asian Double Eyelid Surgery

What is Asian double eyelid surgery?

Asian double eyelid surgery, also known as Asian eyelid surgery, double eyelid surgery or Asian blepharoplasty, is a highly specialised area of upper eyelid surgery, which Dr. Michael Xu is well regarded for both locally and internationally.  This procedure involves creating a symmetrical and natural looking upper eyelid crease, which is often absent in people of Asian descent.

Asian double eyelid surgery can significantly improve the overall shape and look of the eyes bringing you freshness and life to your eyes.

What are the indications for Asian double eyelid surgery?

The lack of an upper eyelid crease is often seen in the East Asian population (at least 50%).  The upper lid drapes like a single, unruffled curtain from the upper border of the eye ridge to the eyelashes – the so-called “single eyelid”.  This is largely due to the skin not being closely fixed to the muscles that open the eyes, therefore the skin does not get pulled into the crease with eye opening.  Instead, the skin just gathers up above the lashes as the eye is opened.  This makes application of make up a challenge, and can give the appearance to the eye being “heavy” or having too much skin when it doesn’t.  Surgical creation of a crease divides the single eyelid into two well-defined segments, thus producing the “double eyelid”.

Revision double eyelid surgery is indicated when previous surgery is unsuccessful or when the result has changed in appearance due to aging.  This requires an even higher level of skill and precision.  Dr. Michael Xu has the ability to fix the most complex complication and hence he is frequently regarded as one of the best in this area of surgery.

What are the different techniques?

The basic principle of Asian double eyelid surgery is to create a palpebral crease by connecting the levator mechanism to the skin. 

Double eyelid surgery can be generally divided into closed and open approach.  In closed approach, there is no incision and buried sutures are used to create the crease.  With the open approach, incision will be placed either partially or full along the eyelid.  Variable amount of fat and muscle can be removed.  More detailed information for each technique is described below.

What is the “closed suture” technique?

This is a technique that allows formation of double eyelid using sutures without a surgical incision.  It was considerably popular in Asia but because of inherent limitations, it has become less popular.

Generally performed under local anaesthetic, this technique involves inserting fine sutures through the skin along three points of the planned crease to create an adhesion between the underlying structures.  Because the fold created by this technique is dependent upon a nonsurgical adhesion, it is more likely to be unreliable, falling out after a variable period of time.

What is the “incision” technique?

This surgical technique can be comfortably and safely performed under local anaesthetic and is recommended by Dr. Xu because opening and closing the eyes at frequent intervals during placement of fixation sutures will help to evaluate symmetry and achieve a more precise result.

Incision is made on the carefully planned markings.  Depending on the size of the eyelid crease you desire, a variable amount of eyelid fat can be removed.  Fixation sutures will be placed in multiple key structures to create a “dynamic” fold – a fold line that changes with the movement of the eyelids, which mimics the natural fold mechanism.  This technique provides several advantages such as: the eyelid looks smooth without fold depression when looking down or when eyes are closed; absence of depressed scar formation on the fold line; fold that is not too deep with the opening of the eyes; and similar tension across the fold line.

What is the “partial incision” technique?

This is an effective procedure in properly selected patients (generally younger individuals with relatively thin skin without excessive fat on the eyelids).  It offers an ideal balance between the full incision and the suture methods.  The limited incision that spans only about one-third of the total eyelid length offers a rapid and reliable method for double eyelid creation and limits postoperative swelling and risk of scarring.

The abbreviated incision involved with this technique affords easy access to the fat compartment to reduce the “puffy” eyelid appearance characteristic of the Asian upper eyelid.

What is epicanthoplasty?

Epicanthoplasty is a surgical procedure for the treatment of the flap or skin fold from the upper eyelid, covering the inner corner of the eye.  Although a moderate expression of the epicanthal fold might be a unique and attractive feature to the Asian eye, a more pronounced epicanthal fold can make the eyes appear too far apart, round and small.  In this situation, double eyelid surgery and epicanthoplasty may be indicated.

Where is the surgery performed?

If done under local anaesthesia, the surgery is performed in one of our fully equipped procedure rooms.

If you chose to have it done under general anaesthesia, the surgery will be performed in a fully accredited day surgery operating theatre.

How do you prepare for the surgery?

Formal consultation in our rooms is necessary to properly assess and discuss the issues concerning your upper eyelid.  Dr. Xu advocates individualised approach in designing the type of double eyelid you wish to have (i.e. height and shape of the crease). 

You will receive a comprehensive package, which includes written information about the procedure and detailed post-operative care instructions.  Preoperative photographic documentation will be obtained during the consultation as well as answering all your questions regarding the procedure.  A cooling off period of at least 7 days will be given as per Medical Board of Australia guidelines.  A second or subsequent visit may be arranged if you have any further questions.

How long does the recovery take?

Most patients can resume light activities in 48-72 hours.  Sutures can be gently removed on the seventh day after surgery.    Social activities may also be resumed during this time.  Generally, recovery takes around 7-10 days.

There may be minimal swelling and bruising which will continue to improve with time and rest.  Discomfort can be managed by taking simple analgesics.  Detailed post-operative instruction will be provided and clearly explained by Dr. Michael Xu and his team.

Why choose Restore Cosmetic for your double eyelid surgery?

Our fully equipped facility and our team at Restore Cosmetic provides you with the highest level of personalised patient care in order to make your experience a safe and pleasant one.  Our team also consists of highly knowledgeable staff who can speak different languages such as Mandarin, Cantonese and other ethnic dialects to facilitate easy communication.

Dr. Michael Xu is a highly trained certified cosmetic surgeon with 30 years of experience, and his advanced skills in Asian double eyelid surgery is well renowned.  He is regarded as one of the best in Asian cosmetic surgery both locally and internationally.  His individualized approach gives you the best opportunity to choose the type of eyelid transformation you desire.

We offer complimentary consultations with Dr. Xu in order to thoroughly assess and further discuss with you about Asian double eyelid surgery.  We encourage you to ask questions in order to be fully confident with your level of knowledge because at Restore Cosmetic, we believe that being well informed is the primary step to starting your journey in cosmetic surgery.

Visit our Asian double eyelid surgery before and after gallery

Asian Double Eyelid Surgery FAQs

All surgery carries potential risks. Under general circumstances, risks for double eyelid surgery are rare and may include infection, bleeding and abnormal scarring.  Incidence of complication is exceedingly small.  Regular follow up with Dr. Michael Xu will be arranged not only to monitor progress but also to allow early detection of potential complications.
We frequently receive patients who have had unsuccessful double eyelid surgeries done elsewhere for revision double eyelid surgery.  These patients often have asymmetry of the upper eyelids or prolonged upper eyelid swelling and puffiness after double eyelid surgery.  Furthermore, the presence of the epicanthal fold renders the appearance of an unsightly rounded eye.
Dr. Michael Xu has a comprehensive understanding of all the intricate aspects of Asian eyelid surgery.  He is known for his precision, skill and ability to produce results that are as natural as they are exquisite.

After the procedure, our team will review the post-operative instructions and care with you to make sure everything is clear.  Post-operative follow-up will also be arranged.  You will be given our 24-hour service contact number for any questions or concerns.

With the closed approach, there will be no scars visible on the eyelid.
With the open approach, virtually inconspicuous scars are hidden along the newly created upper eyelid crease.  With time, it blends with the natural upper eyelid crease and will be barely noticeable or easily concealed with everyday light make-up.

The longevity of the developed eyelid crease depends on the technique used.  In closed suture or incision less technique, because the fold created is dependent upon a nonsurgical adhesion, it is limited by inability to produce precise durable results.
In open or incision technique, important structures can be better visualised and improved thus results are often long lasting.  For the past 30 years, Dr. Xu has utilised special advanced techniques to create the double eyelids, these results are still visible and natural today.  The results of his technique is aimed to last for a lifetime.

In addition to creating a double eyelid, with effects of aging, the excess upper eyelid skin must also be addressed.  At times, previous double eyelid surgery has been performed but starts to disappear.  This renders another level of challenge as prior surgery can leave scars underneath the skin.  The fullness of the upper eyelid caused by drooping brow can also add to the complexity of the upper eyelid surgery in the older Asian population.
With more than 30 years of experience, Dr Michael Xu believes a balance of precise skills, careful design and planning are the keys to achieving natural looking upper eyelids, something Dr Xu is well recognised for.

Depending on the shape and size of the eyelids and the nature of the epicanthal folds, double eyelid surgery may be accompanied with other surgeries such as medial epicanthoplasty. It is important to identify the different factors that contribute to the problem.  Drooping eyebrows can cause a fold of loose skin to hang beyond the upper eyelid margin.  Similarly, overactive forehead muscles may occur to try to lift the brow to keep the excess upper eyelid skin out of the visual field, thereby forming forehead wrinkles.  In these circumstances, a precisely well-balanced brow lift and double eyelid surgery would be best to correct these problems. Anti-wrinkle injections to the forehead may also be required.
Double eyelid surgery can also be performed along with other procedures such as lower eyelid surgery or removal of eye bags, rhinoplasty or nose job, facelift, neck lift or skin resurfacing.

The cost for double eyelid surgery depends on different factors such as your eyelid size, shape and disposition of the epicanthal fold.  These factors determine the type of surgical technique and time required.
For us to give you an exact quote, please make an appointment to see Dr Xu for a free consultation.