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Asian Upper Eyelid Surgery

Written by Dr Peter Kim on Thursday, 01 March 2012. Posted in COSMETIC SURGERY, asian eyelid surgery

Asians have a unique and different upper eyelid.

Unlike the caucasians, many Asians have single eyelid (compared to double eyelid), mongolian fold, puffy upper eyelid, and they appear small and thin. These are due to unique upper eyelid anatomy that is different from the caucasians.

Popular Asian upper eyelid procedures are:

» Double eyelid surgery - Supratarsal fold creation
» Mongolian fold surgery - Epicanthoplasty
» Removal of excess skin- Upper blepharoplasty
» Ptosis repair - Lazy eye surgery
» Big Eye Surgery - Levator Advancement Surgery
» Brow-lift surgery

Double Eyelid Surgery

Unlike Caucasians, large proportion of Asians does not have double eyelid. Double eyelid compared to single eyelid makes one appear softer, eyes appear larger and more attractive. For this reason, Double Eyelid Surgery is one of those surgical procedures that are uniquely Asian.

There are broadly three surgical approaches to double eyelid surgery. Full incisional, Partial Incisional or Non-Incisional (Durable Suture Technique). Each approaches has pros and cons. Which procedure is best for you depends on numerous factors. Some of the essential factors are:
» The shape and characteristics of your eyelid now.
» Amount of skin needs to be removed
» Amount of fat needs to be trimmed
» What type of eyelid would you like to have after the surgery
» Previous history of eyelid procedures and eye condition.

Comprehensive consultation and examination is essential before choosing the correct surgical approach for you.

Double eyelid surgery using partial incisional technique and mongolian fold surgery (epicanthoplasty) was performed at the same time.

Double eyelid surgery using non surgical technique called Buried Suture Technique. (Left) photo immediately before the surgery (Right) photo immediately after the 15 minutes procedure.

Double eyelid surgery using full incisional techinque. With patients with excess upper eyelid skin, full incisional technique is the only method of removing that excess skin.

with minimally invasive techniques and an experienced operator, we can offer patients with naturally looking double eyelid with minimal bruising and scarring. (Right) patient with single eyelid immediately before the surgery. (Left) Patient photo immediately after the 30 minutes double eyelid surgery using partial incision technique. Note no bruising and minimal swelling of the upper eyelid, and this means rapid recovery.

Mongolian Fold Surgery

Unlike Caucasians, large proportion of Asians have mongolian fold. Mongolian fold hides the inner corner of the eye. This creates an illusion of narrower eye and makes the eye appear wider apart. Mongolian Fold Surgery removes and repositions this fold. This increases the visibility of the inner corners of the eye and reduces the distance between the eyes. So in effect, a larger appearing eye and eyes lesser apart. For this reason Mongolian Fold Surgery is a popular and uniquely Asian cosmetic procedure.

Dr Kim is a co-inventor and an author of a special technique of correcting Mongolian Fold called T-Epicanthoplasty. This is a simple and an effective technique in correcting the Asian Mongolian Fold.

Essential factors for successful Mongolian Fold Surgery are:
» The shape and characteristics of your Mongolian Fold (there are broadly 4 classifications)
» Amount of Mongolian fold needs to be removed & repositioned
» Whether you would consider having double eyelid surgery at the same time
» What type of eyelid would you like to have after the surgery
» Previous history of eyelid procedures and eye condition.

Comprehensive consultation and examination is essential before choosing the correct surgical approach for you.

Removal of Excess Upper Eyelid Skin

With aging process, the skin of the upper eyelid tend to sag. This not only appears aesthetically displeasing but also makes one appear old and tiredsome. In severe cases, it places gravitational pressure on the eyelashes hence makes eye look and feel tired as well as obscure vision.

Upper eyelid surgery to remove excess upper eyelid skin is a simple procedure:

  • performed under local anaesthesia with twilight sedation
  • excess skin is trimmed, muscles tightened and excess fat trimmed
  • exclusively use laser/RF scalpel to minimise bruising and swelling
  • 40-60 minute procedure
  • sutures are removed within one week

Lazy Eye Surgery (aka Ptosis Correction Surgery)

Whether you are born with it or whether you have acquired it, "droopy eyelid" or "lazy eye" gives one an appearance of looking sleepy and tiresome. The reason for droopy eyelid is because there is a functional weakeness of the eyelid opening mechanism called Levator. Lazy-Eye Surgery corrects these droopy eye by tightening the lavator.

This patient has a weak levator muscles of the left upper eyelid due to levator being detached from the tarsal plate. The levator was re-attached to the tarsal plate at the time of surgery, and an immediate wider opening of the eye was evident. Performing upper eyelid surgery without correcting the underlying muscle weakness (ptosis) can make one appear more tired hence the lay term "sleepy eye syndrome".

Big Eye Surgery

"Big Eye Surgery" is a surgery that is becoming more and more popular in Asian countries.

Unlike Caucasians, Asian Anatomy of eyelid dictates their smaller eye dimensions. Double eyelid surgery and Mongolian Fold correction surgery does make eye appear bigger and more open, but it does not actually increase the dimension of the eyelid. Despite these efforts, ones eye may still appear small. In this selected group of patients, "Big Eye Surgery" can help, by actually increasing the size of the eye opening.

"Big Eye Surgery" is actually a procedure that shortens/tightens the upper lid opening mechanism, Levator. As the Levator is shortened and tightened, the upper eyelid margins are pulled more open, hence the eyelid is rested at a more opened position and more of the eye is visible. Hence the name "Big Eye Surgery".

Brow-lift Surgery

Some patients have an appearance of excess upper eyelid skin as the result of drooping eyebrows. In these cases, by repositioning the eyebrow to a youthful position, it not only improves the shape and position of the eyebrow but also treats the appearance of sagging upper eyelid skin.

As you can see in this photo, the apparent excess upper eyelid skin has been lifted by having a brow-lift surgery. Scar is usually minimal and heals well, as it is placed in the eyebrow line and disguised by the eyebrows.

About the Author

Dr Peter Kim

Dr Peter Kim

Dr Peter Kim is a qualified Cosmetic Surgeon and Specialises in Asian Cosmetic Surgery.

Dr Kim is actively involved in education and researches in the field of Cosmetic Surgery. He is a well known for his contributions as a Cosmetic Surgeon, an Academic, Researcher, Author & Inventor of new surgical techniques and instruments pertient to the advancement of Asian Cosmetic Surgery.

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