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Posts Tagged ‘double eyelid surgery’

Double Eyelid Surgery with Epicanthoplasty

Tuesday, May 24th, 2016


Double Eyelid Surgery Dr Barry Eppley IndianapolisIn Asian blepharoplasty, more commonly known as double eyelid surgery, the influence of the fold at the inner eye (epicanthus) can affect the aesthetic outcome. As a result many double eyelid surgeries are combined with a medial epicanthoplasty for an improved aesthetic appearance. While the epicanthus is a small structure, there is a large number of operations described for its correction. There does not appear to be a universally agreed upon method for the epicanthoplasty which suggests that all of them have some downside.

Z-Epicanthoplasty Dr Barry Eppley IndianapolisHistorically, some surgeons have avoided epicanthoplasty because of the fear of visible scar formation at the inner eye. But the Z-epicanthoplasty has proven to be a safe and effective technique for eliminating the epicanthal fold during double-eyelid operations without problematic scarring at the medial canthal area. They are numerous small variations of the Z-epicanthoplasty most of which focus on  hiding the scar line in the inner cants area.

In the January 2016 issue of the journal Aesthetic Plastic Surgery, an article was published entitled ‘A Modified Method Combining Z-Epicanthoplasty and Blepharoplasty to Develop Out-Fold Type Double Eyelids’. In this paper the authors describes his technique for combining double eyelid surgery with a Z-epicanthoplasty in over 1100 women. The goals of the surgery was to create a parallel double eyelid fold with an exposed inner canthus and lacrimal caruncle. The upper eyelid incision is carried out to the new inner canthus location and the skin excised. The muscle fibers that adhere to the inner canthal ligament are severed to release any tension on the epicanthal skin flap. A small z-plasty is then performed on the inner canthal skin flaps. The revision rate was eight patients. (less than 1%)

Double Eyelid Surgery and Lower Eyelid Love Band Surgery Dr Barry Eppley IndianapolisThe Asian upper eyelid has a characteristic single fold with an epicanthus and saggy skin. When an epicanthus is not present, a double eyelid surgery alone can suffice. But with an  epicanthal fold present, double eyelid surgery will create a short and narrow double fold appearance. Thus combining double eyelid surgery with an epcanthoplasty is now common practice. This allows for a smooth connection between the double fold eyelid and the inner canthus. The goal of the Z-epicanthoplasty is to relieve the tension on the medial cantonal area which contributes to the epicanthal fold being present and prevent any adverse scarring in this highly visible area.

Dr. Barry Eppley

Indianapolis, Indiana

Double Eyelid Surgery Recovery

Tuesday, January 19th, 2016


Double eyelid surgery is one of the most common facial surgeries in Asian patients. Changing a monolid to one that has two distinct eye areas by making a distinct crease creates a more appealing eyelid shape. It is not done with the attempt to make a Western eye appearance but to give the Eastern eyelid a better and more defined shape.

There are many techniques in double eyelid surgery so it can be confusing to patients. But they fundamentally can be divided into non-incisional (suture only), limited incisional (three to five small incisions) or a full incisional approach. Each double eyelid surgery has its advantages and advocates. But it is generally agreed that the incisional technique is the most reliable method of achieving a consistent and permanent eyelid crease.

Double Eyelid Surgery swelling Dr Barry Eppley IndianapolisPatents who consider undergoing double eyelid surgery can expect some temporary swelling and bruising after surgery. That is particularly with the complete incisional method technique. Since the eyes are such a focal point of human interaction, prospective patients can anticipate that it will take several weeks for most of the swelling and bruising to resolve and they can look non-surgical in appearance. This is an example of a young female who is one week after double eyelid surgery with epicanthoplasties. She will look normal in a few more weeks.

Patients for double eyelid surgery should anticipate that it will take nearly a full month after surgery to have a full recovery. And six weeks until  the eyelids relax and look natural. While the full incisional technique takes longer to recover, its more consistent and defined upper eyelid creases make it worthwhile in most cases.

Dr. Barry Eppley

Indianapolis, Indiana

The Goal and Effectiveness of Asian Blepharoplasty (Double Eyelid Surgery)

Wednesday, September 18th, 2013


A plastic surgery story appeared on the internet and other news venues in regards to TV anchor Julie Chen having had eyelid surgery when she was younger. Other than the fact that she had it and she is highly visible, Asian eyelid surgery or Asian blepharoplasty is very common. It is estimated that ten of thousands of such eyelid procedures are performed each year around and is the most common cosmetic surgery in numerous Asian countries.

The Asian eyelid has some very significant differences from the Western eyelid due to the amount of fat in the upper eyelid and the frequent lack of a well defined eyelid crease. The upper eyelid crease is formed by the levator muscle, which lifts the eyelid, but in the Asian eyelid the fold may be missing due to the fat. This creates a flat appearance from the lashline to the brow and makes the eye looks heavy or partially closed. In addition, there is a fold of skin at the inner edge of the eyelid close to the nose known as an epicanthal fold which makes the eye look smaller and also pushes the eyelashes down.

The Asian double eyelid surgery is done to create the appearance of a fold on the upper eyelids if it does not exist or to adjust the height of the fold that is present in cases of eyelid asymmetry. Even though the procedure just creates an eyelid crease, its effects can be dramatic as it opens up the appearance of the eyes and makes them look bigger.

There are a wide variety of double eyelid surgery techniques, which have varying success at creating a permanent fold by attaching the skin to the deeper tissues. Despite the many nuances between these eyelid procedures they fundamentally break down into either suture techniques or open incisional methods. The suture technique (known as DST) does not use an incision and relies on sutures to cause the tissues to scar together to form a permanent crease. Its main disadvantage is that the result may be lost if the sutures break or they degrade over time. The incisional method is permanent and allows better customization of the lid crease but is more involved with a longer recovery. With either technique it requires precise marking before surgery and great attention to detail in executing it during surgery.

In admitting that she had the procedure, Julie Chen discussed the reason she had it done which is both revealing and consistent with the known motives amongst Asians for getting the double eyelid procedure. Because she was once told she would never be a TV anchor because she was Chinese. Her intention was to simply have bigger eyes so she didn’t look sleepy or angry in her interviews on camera…not to look less Chinese or Asian. This was not about trying to look more Western but to have a more alert eye look.

Dr. Barry Eppley

Indianapolis, Indiana

Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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