Asian Blepharoplasty (Double Eyelid Surgery)

Reviewed by Foad Nahai, MD

Asian blepharoplasty — also known as "double eyelid surgery" — is the most common aesthetic plastic surgery procedure performed in Taiwan, Thailand, Hong Kong and other parts of the region where plastic surgery is taking off in popularity, according to a recent report from the International Society of Aesthetic Plastic Surgery (ISAPS). Asian blepharoplasty is also growing in popularity in the U.S.

Asian blepharoplasty does not have universal application. As many as 50 percent of Asians are born with double eyelids, and there is considerable variation in the crease position above the eyelash line from patient to patient. Some people who pursue Asian blepharoplasty may want to appear more "Western," while others are interested in preserving their ethnicity and adding an eyelid crease.

Asian Eyelid Surgery: The Procedure

Asian blepharoplasty reshapes the skin around the eyes to create an upper eyelid with a crease when no natural crease exists. This "double eyelid surgery" transforms a "single eyelid" into a "double eyelid." Sometimes a procedure called an epicanthoplasty is performed at the same time as Asian blepharoplasty to remove the epicanthal fold of the upper eyelid that partially covers the inner corner of the eye.

Several Asian blepharoplasty techniques are available to create the double eyelid, including the full-incision, partial incision and no incision (DST) methods. Each has its advantages and applications depending on your unique anatomy and desired outcome. The specific procedure chosen depends on whether the surgeon is creating a crease, changing the height of an existing crease or completing an incomplete crease.

For example, a surgeon may use internal sutures within the eyelid to create a new, permanent crease. A different approach involves making a tiny incision where a natural crease might appear to remove a small amount of fat and muscle, thereby creating the crease. In other cases, extra skin or fat on the eyelid is removed surgically or by using a laser.

In general, Asian eyelid surgery takes about one hour to perform under local anesthesia.

Choosing a Surgeon for Asian Blepharoplasty

Choosing a board-certified plastic surgeon with considerable experience performing this specialized procedure is important. The consultation is your chance to ask questions about the surgeon's experience. Some of the other areas you will want to cover during the consultation include the technique he or she recommends in your case, the risks and complications associated with the procedure, length of recovery you can expect and the overall cost of the procedure. Also ask the surgeon if you can see an album of before and after pictures of previous patients to get an idea of his or her aesthetic approach.

When your initial consultation is over, you should have a better idea of whether this is the surgeon you want to perform your Asian blepharoplasty, as well as solid information about how you should prepare for surgery and beyond, the medications to avoid before and after surgery, and what steps you should take during recovery to make sure you heal well.

Risks of Asian Double Eyelid Surgery

Asian blepharoplasty, like all surgery, has risks and benefits that should be understood upfront. While a bad reaction to anesthesia is not a common complication, it can occur. Asian blepharoplasty is also a more complicated surgery than traditional blepharoplasty, one that takes longer and requires going deeper into the eyelid to perform. Complete recovery after double eyelid surgery may take up to six weeks, though the average time may be half as long.

Other risks of Asian blepharoplasty include those commonly associated with traditional eyelid surgery: scarring, swelling, droopy eyelids, sagging eyebrows, asymmetry and general dissatisfaction with the cosmetic results.

During your initial consultation, your surgeon will provide you with a comprehensive eyelid surgery risk profile. He or she will also make sure you know what to expect during your eyelid surgery recovery.

Asian Blepharoplasty Cost

The cost of Asian eyelid surgery varies depending on where you have your surgery, but plan on spending somewhere between $3,000 and $5,000, with the higher end of the scale predominating in urban areas due to greater demand and higher overhead costs.

Typically, the eyelid surgery costs quoted by your surgeon include fees for the surgeon, anesthesia and operating facility. Be sure to pin down exactly what's covered before committing to surgery. If you've paid a consultation fee, check to see if it can be applied against the final bill.

There may be other costs involved such as painkillers, antibiotics and other medications related to the surgery like artificial tears, and ancillary surgical supplies like cold compresses. You also may need sunglasses to protect your eyes postoperatively and possibly camouflage make-up to cover any bruising that may occur. If costs are prohibitive, financing options may be available.

About the Reviewer of This Article

Foad Nahai, MD, FACS, is a board-certified plastic surgeon and a Fellow of the American College of Surgeons. Dr. Nahai was the 2008-2010 president of the International Society of Aesthetic Plastic Surgery (ISAPS). In addition, he is a past president of the American Society for Aesthetic Plastic Surgery (ASAPS), a former director of the American Board of Plastic Surgery, and current editor-in-chief of Aesthetic Surgery Journal. He completed medical school in England and his post-graduate surgical training at Johns Hopkins University in Baltimore and Emory University in Atlanta. Before joining Atlanta's Paces Plastic Surgery in 1998, Dr. Nahai practiced at the Emory Clinic, where he was professor of plastic surgery at Emory's School of Medicine.