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Asian Eyelids Surgery

Asian Eyelids Surgery Double eyelids surgery

Asian Eyelids Surgery

Many Asians do not have a fold in the area above the eyelashes. This can be treated by creating an eyelid fold in a procedure called blepharoplasty (Eyelids Surgery). It is also known as Asian blephroplasty (Asian Eyelids Surgery) . The objectives of the procedure is to create a natural-looking crease. Dr. Barnouti performs Asian double eyelid surgery in Sydney, Australia.

How to Book? Call us on free phone 1300 002 006 if you are outside Sydney or 9561 0222 if you’re in the Sydney area

Asian vs. Caucasian Eyelids

Asians have single eyelid (compared to double eyelid), mongolian fold(excess skin/fold inner eyelid) and puffy upper/lower eyelids. Their upper eyelid also appear thin. These are due to unique upper eyelid anatomy that is different from the caucasians.

Anatomically, the difference between Asian and Caucasian eyelids is in the position of the eyelid fold. Asians who do have a crease above their eye have very different looking eyelids than Caucasians. The Asian eyelid typically starts at the crease very close to the eyelashes. As the crease gets further away from the nose, it gets larger and larger until the midpoint of the pupil, at which point the fold runs parallel to the eyelash origin.

A Caucasian lid crease is slightly different in both shape and size. It typically tapers closer to the eyelashes as the fold goes out laterally so that it is more of an upside-down “U” shape, rather than a parallel shape to the eyelash lid. The Caucasian lid crease is also about 20% larger than an Asian eyelid crease. The purpose of surgery is to create a natural looking eyelid crease.

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

Asian Double Eyelid Surgery Methods

There are three surgical approaches to double eyelid surgery. Full incisional/scar, Partial Incisional/scar or No scar technique (Durable Suture Technique). Each approaches has pros and cons. Which procedure is best for you depends on numerous factors that will be explained to you by Dr Barnouti. 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.

The traditional suture method. It is a scarless procedure. It has great advantages in terms of natural crease results, quick recovery and reproducibility. Healing time is few days. In a suture method eyelid procedure, a crease is created by burying permanent non-reactive sutures (prolene, used in heart valve surgery) pinching a bit of the undersurface of the eyelid skin to the deep tissue. It is performed under local anaesthetics. It takes 45min.
The open approach eyelid crease method.
Benefit of an open approach: reliability and longivity. Drawback includes a scar on the upper eyelid. This scar is in line with the fold and tend to fade with time. It is ideal for Asian patients who prefer a dramatic and deep crease.
The most natural shape of the fold is a tapered fold and the parallel fold, referring to the shape in relation to the margin of the inner half of the eyelid. The ideal size of the fold allows 2 – 3mm of skin above the eyelashes to show on direct frontal view with the eyes open. This also usually corresponds to a crease set at 10mm from the lash line when the eyes are closed (with the skin on light tension).
Modern technique for double eyelid surgery is to create a fold by repairing and fixing the orbital septum or levator aponeurosis to the skin/muscle edge. Another techniques include anchor blephroplasty
The partial incision technique/small scar technique is Dr Barnouti favourite technique.

Medial epicanthoplasty (also known as Mongolian fold surgery)The medial epicanthus is an excess fold of skin that covers the inner corner of the eyelid. This creates an illusion of narrower eye and makes the eye appear wider apart. The degree of severity can be ranged from non existent or mild, moderate and severe, depending on how much of the caruncle (the pink “bump” inside the eye corner) is exposed. The severe cases should be corrected; for moderate folds, correction is optional. One popular technique for correcting the fold is by augmenting the nose with a nasal implant as it takes some of the eyelid slackness away. Another way is by repositioning the fold by what is know as a jumping man flap or vy advancement flap with a double opposing z plasty technique.
Mongolian fold surgery 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.
Essential factors for successful Mongolian Fold Surgery are:

The shape and characteristics of your Mongolian Fold
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, Upper blephroplasty.

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
60 minute procedure
sutures are removed in 7 days.

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.

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”.

Asian Lower eyelid surgery

Muscle weakness, excess fatty tissue and laxed skin are some of the factors that leeds to bagy lower eyelids in Asian.
There are two solution to such problem:

Non Surgical lower eyelid rejuvenation. This is achieved by skin tightening by laser or peel and volume restoration of the eyelid by soft tissue fillers or fat injection
Surgery. The excess fat is removed or redistributed through a small incision hidden on the inside surface of the eyelid or just under the eyelashes.

Asian eyelid anatomy differs from Caucasians. Asian eyelids charectarised by a “severe form” of lower eye bags directly resulted from excess fatty tissue and dark circles from the younger age. For this reason, eye bag removal is a popular Asian Cosmetic Procedure in all age groups whereas the lower eyelid surgery for wrinkle removal and skin tightening tends to be more popular in the middle age and above.
The most popular lower eyelid procedures are:

Lower eyelid bag removal. This often requires surgery
Lower eyelid skin tightening and wrinkle removal.
Lower eyelid non surgical skin tightening with peel or Laser

Surgery: Lower eyelid bag removal. There are 2 surgical approaches to this procdure

Internal approach – small incision is made inside the lower eyelid (no visible external scar) and through this incision fat is removed.
External approach – incision is made just under the eyelashes and through this incision, fat can be removed, loosened muscle can be tightened and the excess skin can be trimmed and tightened.

Soft or Non surgical treatment of lower eyelid skin can produce a great outcome in some cases. Most effective method of improving the appearance and tone of the lower eyelid skin is to use lasers or skin peels. Unlike surgical procedures, there is little downtime.

Consultation, examination and clinical analyses by Dr Barnouti is essential before choosing the correct surgical approach for you. Call 1300 004 008 or 02-9561 0200 to book for consultation

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