Some people of Asian descent lack a pretarsal fold, which is the natural crease between the upper eyelid and the brow. Also referred to as a “single eyelid,” this can make the eyes appear puffy and tired, and can be corrected with oculoplastic surgery. These features can also be present in some patients of Latin American, African and Eastern European descent.
In addition, differences in anatomy and fat distribution of the upper eyelid further contribute to the full appearance of the upper eyelid. Double-eyelid surgery allows the eyes to open wider, and results in a more alert appearance.
Asian blepharoplasty is a highly advanced procedure that should be tailored for each patient’s unique anatomy. Boca Raton oculoplastic surgeon Dr. Steven Fagien is highly experienced at performing double-eyelid surgery in a way that maintains each patient’s ethnic integrity while improving the appearance of their eye area as desired.
Several advanced techniques are used for Asian eyelid surgery today, and the variations include full incision, partial incision and non-incision.
Commonly recommended for older patients, the full incision technique is ideal for patients with thick or excess eyelid skin and those suffering from severe ptosis (drooping) of the eyelids. During this procedure, an incision is made on the eyelid where the crease will be created. Excess skin and fat are removed, and the reshaped eyelid is attached to the underlying tissues. When performed by an experienced surgeon such as Dr. Steven Fagien, this technique leaves a virtually undetectable scar.
The partial-incision Asian blepharoplasty technique is less invasive than the full-incision approach, and is often recommended for those with puffy eyes or eyelids with excess fat (but no excess skin). Instead of one long incision across the entire eyelid, several small incisions are made along the line of the planned pretarsal fold to allow for the removal of fat before the new fold is created.
The “double sutures and twisting method” (DST) is the least invasive Asian blepharoplasty technique, and best for patients with little to no excess skin, droopiness or fat in the eyelids. This innovative technique uses double sutures with a central twist (like a figure 8) on each upper eyelid. These sutures are placed where the new crease will be and secured to underlying cartilage for long-lasting results.
The epicanthal fold, which has been traditionally ascribed more exclusively to the Asian population, is a visible “webbing” that extends from the medial upper eyelid into the inner corner of the eye. Epicanthal folds also commonly present with excess fullness of the inner aspect of the upper eyelid.
Dr. Fagien has pioneered and developed a technique to treat mild to moderate epicanthal folds that does not place an additional scar over this location, therefore avoiding potential complications including visible scarring over this area.
Men seeking cosmetic procedures, including eyelid surgery, often have different goals and considerations than women. While both men and women may want to achieve a more youthful and refreshed appearance, men may prefer more subtle and conservative results to avoid appearing overly "done".
In addition, it is important to consider key differences in male eyelid proportions and male anatomy, such as thicker skin and stronger muscles. This is why it is imperative to consult with a highly specialized surgeon who has a great deal of experience with male patients to achieve the desired outcome while maintaining a natural and masculine appearance.
An in person evaluation is necessary to help us determine the recommended treatment option for the individual patient.
Patients with hollowed upper eyelids may benefit from fat grafting, where a small amount of fat is harvested from another area of the body via liposuction and meticulously transferred to the eyelid area to help restore lost volume and a more youthful contour.
Hollowed appearing upper eyelids may also be due to ptosis, or drooping of the upper eyelid. Ptosis can result in an aged appearance and smaller appearing eyes. Ptosis can be surgically corrected and result in a significantly brighter and more youthful appearance of the eyes.
The risk of any major complication with eyelid surgery is very rare – nonetheless, all surgical procedures carry a degree of risk.
Eyelid scars are not visible or barely visible (on close inspection) in the vast majority of patients. However, scars may rarely be more visible in some patients.
Infection and bleeding are rare but can occur.
Eyelid surgery can result in temporary numbness of the eyelashes, but this recovers over time.
Irritation and inflammation around the white part of the eye (sclera and conjunctiva) can occur after surgery. This is known as chemosis and can occur mostly after lower eyelid surgery. It manifests as swelling around the eye that can sometimes look like conjunctivitis (“pink eye”) and can be a normal and expected response to surgery in this area. If this occurs, it typically presents 5 – 14 days after surgery and gradually improves over time with either medicated or lubricating eye drops or both.
We all have natural asymmetries between each side of our face and eyelids – some people more than others. While one of the goals of surgery is to minimize any pre-existing asymmetry between the eyelids, it is important to know that some asymmetry will still exist. After surgery, patients tend to scrutinize their face more intently and may notice some pre-existing asymmetries for the first time.