Double eyelid surgery, or Asian blepharoplasty is a unique procedure used to create or enhance an upper eyelid fold in those who lack the fold from birth or who have weak or uneven folds. Common in people with Asian ethnicity, the absence of an eyelid fold is due to an anatomic difference in the eyelid structure when compared with those with a natural crease.
There are several techniques that are possible for creation of a natural and beautiful eyelid fold, however the first step is to understand what results are desired and what will look natural to suit the facial characteristics.
Unlike conventional upper eyelid blepharoplasty, where the goal is simply for skin reduction and freshening of the tired eyelid appearance, double eyelid surgery actually involves reducing only a minimal amount of skin and using the excess to create a fold that will enhance the eyes and provide the appearance of larger, more defined eye shape.
Dr Ahn specialises in double eyelid surgery or Asian blepharoplasty in Sydney and through his Korean background and additional specialist training at a number of highly reputable clinics and hospitals in Seoul, South Korea, has developed an extensive knowledge and technical expertise in how to create these results for you.
The Asian face has many unique characteristics and as such, in assessing the eye region, we must take into account the overall facial profile to consider the natural balance between the eyes, nose mouth and chin areas. Creating strong, high upper eyelid folds while the rest of the facial features remain small and soft can look unnatural and too obvious, while most that consider double eyelid surgery want others to wonder 'has she or hasnt she?'
Asian eyelids contain thicker skin, muscle and more fat that a Caucasian eyelid with a natural fold. In fact, the very first attempts at creating an upper eyelid fold therefore tried to replicate Caucasian folds which are much higher and the results looked very unnatural. Higher folds are only suited to eyes that have thinner skin and less upper eyelid fat with a deeper facial profile and over the years we have developed an understanding of the factors that create a beautiful eyelid.
The results that you wish to achieve will vary depending on individual preference and during your consultation Dr Ahn will use his experience in double eyelid surgery and Asian facial aesthetic analysis to help you make the decision through the process. Unlike many may believe, double eyelid surgery, or Asian blepharoplasty surgery is not simply about dissecting the eyelid to create a fold!
Traditional double eyelid fold creation relies on an incision along the line of the desired eyelid crease. The advantage of this technique is in its versatility. By creating an incision, Dr Ahn is able to reduce skin excess and remove excess muscle and orbital fat that is preventing upper eyelid fold creation.
Assessment of whether this technique is suitable for you is conducted during your consultation. If you have concerns about your eyelids feeling heavier or blocking your vision, or have always disliked how puffy your eyes appear, chances are that you may require an incisional Asian blepharoplasty by Dr. Chris Ahn. Although less common (20%) in younger patients, due to its ability to adjust multiple factors in the upper eyelid, the incisional double eyelid surgery can sometimes be the best choice for you to achieve beautiful, natural eyelid shape with permanent results.
Unlike the non-incisional technique, the reason that incisional surgery is permanent is that it creates an adhesion plane between the skin and the deep tissues of the upper eyelid that forms a tether point for the upper skin to fold over thereby creating an eyelid crease. This adhesion is created through your body's own healing from the surgery and therefore does not rely on a suture only to create the fold. Sutures inevitably will fail with time, whereas these adhesion tether points are permanent and will not fail. The technique allows scar formation between the skin and the tarsal plate
Having control of these factors does come at a cost however - the most significant disadvantage of this technique being that due to the dissection required, the duration of post operative swelling is generally longer than non-incisional surgery and therefore it can take longer for your swelling to reduce and up to six weeks before your final results can be expected.
Nevertheless, if this techique is right for you, Dr. Ahn will explain the reasons why and guide you through your decision. By providing the ability to finely adjust eyelid thickness and modify crease shape, incisional double eyelid surgery may be recommended as the best option to achieve natural results
A newer development for Asian blepharoplasty (double eyelid surgery) is to use a non-incisional method which relies on a permanent suture to create a tether point.
Although the scar from incisional double eyelid surgery is usually very faint and invisible with the eyes open, non-incisional Asian blepharoplasty takes this one step further, by making the entire procedure scarless even with your eyes closed.
The procedure involves making five small puncture holes, through which a permanent sutures in introduced that pulls your outer skin down on to your tarsal plate (the fibrous structure that provides framework to your upper eyelid). As there is no dissection involved, the distinct advantage of this technique is that the procedure is shorter (one hour versus two) and has faster resolution of swelling that traditional incisional surgery. Many patients will have minimal swelling by 3 days post operatively and most will disappear by 2 weeks after your operation.
The procedure however is not permanent - on average it will last 10 years. It also does not allow for any removal of excess skin and is not strong enough to create a double fold in those with thicker upper eyelid skin so it has its limitations. Failure of the suture after a period of time will not necessarily prevent your ability to have the procedure again however and some may go on to have further non-incisional surgery rather than converting to an incisional Asian blepharoplasty.
During your consultation, Dr. Ahn will use his expertise in double eyelid, or Asian blepharoplasty surgery to assess whether this option is best for you and your desired results. Generally, younger patients who are able to create folds artificially through stickers or glue are good candidates for a non-incisional double eyelid technique while those with thicker skin or requiring removal of drooping skin will have a better outcome from traditional incisional blepharoplasty.
Before and after photos of non incisional double eyelid Asian blepharoplasty operation in patient in her 20s. Shown 1 week post operation. Infold crease, medium height
Before and after photos of incisional (open) double eyelid Asian blepharoplasty operation in patient in her mid 30s. Shown 2 weeks post operation. Infold crease, low height
Before and after photos of non incisional double eyelid Asian blepharoplasty operation in patient in her early 30s. Shown 6 weeks post operation. Pre-existing mild crease. Changed to full crease, medium height