Asian eyelids are anatomically different than Caucasian eyelids. The upper eyelid orbital fat is more prominent and the upper eyelid crease is lower or nonexistent in Asian eyelids. About half of all Asians are born without an upper eyelid crease (“single eyelid”) while the other half are born with an upper eyelid crease (“double eyelid”). The eyelid crease, when present, can be broken or continuous, partial or complete, nasally-tapered, parallel, or multiple, in contrast to classic semi-lunar shape of Caucasian upper eyelids. The shape and the eyelid corners (canthus) of Asian eyelids are also different from Caucasian eyelids.
The goal of Asian blepharoplasty should be to be achieve a natural, symmetric result and preserve the Asian features of the eyelid, with or without formation of a “double eyelid”, as desired by the patient. Making an Asian eyelid to look like Caucasian or “Westernized” is unnatural and unpleasant. The goal is to preserve the natural prominent upper eyelid orbital fat while creating an aesthetically pleasing Asian eyelid crease comparable to natural born Asian eyelid with double eyelid crease.
Asian eyelid crease surgery can be performed to create a “double eyelid” appearance in those with poorly defined creases or to even out asymmetric creases. There are two main types of techniques for Asian blepharoplasty or eyelid crease formation, namely incisional and non-incisional. In short, non-incision (suture) technique is faster with quicker recovery but its effects are less predictable and likely not long-lasting. The incisional technique, on the other hand, is more predictable and long-lasting. Both operations are usually performed under local anesthesia with or without sedation. Similar to most eyelid surgeries, there is a recovery period of about 7-10 days with swelling and bruising.
It is important to note that Asian blepharoplasty may not be adequate to achieve the desired result as some may have concurrent ptosis (droopy upper eyelid) due to weak or aging levator muscle, which is responsible for upper eyelid lifting and its position. In these instances, the blepharoplasty or eyelid crease surgery needs to be combined with ptosis surgery. Asian upper blepharoplasty can also be combined with lower blepharoplasty or other eyelid surgery.
Dr. M. Ray Taban is an assistant clinical professor of oculoplastic surgery at UCLA, who uses the latest minimally invasive technique in Asian blepharoplasty. His membership in the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) indicates he or she is not only a board certified ophthalmologist who knows the anatomy and structure of the eyelids and orbit, but also has had extensive training in ophthalmic plastic reconstructive and cosmetic surgery. He is also member of the American Academy of Cosmetic Surgery (AACS).