Background: Double eyelid surgery is one of the most common Asian facial surgeries. Many Asian upper eyelids do not have an upper eyelid crease and can be seen as a single or monolid. (single eyelid) This specific Asian blepharoplasty procedure is to create an upper eyelid crease that is very distinct, hence making visibly apparent upper and lower eyelid regions. (double eyelid)
While some Asian upper eyelids have a double eyelid, many do not or have an incomplete upper eyelid crease. Some have just a faint line for a crease that is barely discernible while others only have a portion of the eyelid crease present. (size of the double eyelid) Besides the variability of the presence or depth of the upper eyelid crease, there is great variability in exactly where it is located. The vertical position of the upper eyelid fold can be anywhere from a few millimeters to 10mms above the lashline.
The partial presence of an upper eyelid crease takes the guesswork out of where it should be. The trick in completing the partial upper eyelid crease is to not make it too deep or more visible than the portion that is already present.
Case Study: This 19 year-old Korean female wanted to have a more complete upper eyelid crease. She also wanted to get rid of the fold on the inner corner of her eyes. (epicanthal fold)
Under general anesthesia (as she was undergoing multiple other facial procedures), the entire upper eyelid crease was created. This was done by excising 2mms of skin and orbicularis muscle and suturing the eyelid skin edges down to the tarsus and levator muscle. Medial epicanthoplasties were also performed by an L-shaped skin fold technique.
Her postoperative results at 6 months showed a more visible and complete upper eyelid crease. No portion of the upper eyelid crease was more apparent or deeper than the others. Her epicanthal folds were also partially removed.
Highlights:
- Double eyelid surgery strives to make a discernble upper eyelid crease that breaks up the upper Asian eyelid into two distinct areas.
- Double eyelid surgery creates an attachment of the dermis of the skin down to the levator muscle.
3. Double eyelid surgery can help create a more distinct incomplete upper eyelid crease.
Dr. Barry Eppley
Indianapolis, Indiana