Asian Blepharoplasty

Upper eyelid lift procedures continue to be the most commonly sought after cosmetic procedure in patients of Asian heredity. Over time complex desires have developed for enhancement and change of racial traits. Just a few decades ago, most Asians would seek Westernization eyelid surgery. Today, many people seek to maintain a heritage maintaining look. But to approach every Asian patient with a “this is what we do today; this is the standard” approach is narrow-minded. Such simplistic thinking represents a poor understanding of the complexity of goals and desires that motivate a person of Asian legacy to consider an upper eyelid procedure. Any Asian patient has the same goals as Caucasians when seeking cosmetic eyelid surgery: To feel more confident about one’s appearance. It is then the eyelid expert’s task to investigate and truly understand what represents the best fit for this person’s aspiration. Partly due to today’s connected world where distances are easily traveled and borders crossed with a mouse click, the aesthetic goals of Asians in America and overseas are not surprisingly very similar.

“Normal” Asian Eyelids and Desire for Change

There is not just one kind of eyelid appearance that makes it “Asian”. In fact, approximately half of all Asians have an upper lid crease. Although the “average” Asian lid crease is certainly shorter and shallower than the common Caucasian crease, this is not absolute. There are Caucasians with eyelid configurations almost identical with some people of Asian descent. These variations demonstrate already how complex the questions of an ethnic eyelid or “the Asian lid” are. In people with a truly absent lid crease (a.k.a. single eyelid), only slight anatomical differences are responsible. Notably, a normal tissue adhesion between the lid skin and the lid-lifting muscle is absent. Instead, small amounts of eyelid fat protrude downwards into the lid leading to a fuller eyelid appearance. Most Asians with a single eyelid who explore eyelid surgery want a crease. It is then up to the doctor to explore with patience where this crease should be positioned to achieve the look that the person desires. Tiny differences of 1 or 2 mm can make a big difference in the appearance after a cosmetic eyelid surgery. Some eyelid fat is almost always removed during an Asian blepharoplasty. If small amounts of fat removal are combined with a relatively short lid (i.e., four or five millimeters or so) , a more conservative change is expected maintaining the Asian appearance. If more fat is taken, the eye socket deepens. When a deeper socket and a high lid crease (for instance, ten millimeters) are combined, a more Caucasian look will be the outcome. And then there is the gray zone between these two extremes which is where many patients like to see their eyelids. Most people are looking for such a “double-lid” that is normally found within their Asian peers providing therefore the natural look.

People who have already a double lid may want this feature to be enhanced. This can be achieved by a procedure that is somewhat similar to most Caucasian eyelid lifts where skin is removed and fat is sculpted. Such a procedure is relatively common in aging Asian patients; sometimes performed years or decades after initial double-eyelid surgery. Others may want the existing lid crease raised.

The outline of most Asian eyes is that of an attractive slant where the outer corner (a.k.a. canthus) is higher than the inner corner. This pleasant almond shape usually is not altered with blepharoplasty. In fact, it is a pretty silhouette that many Caucasians seek.

For more information, please contact Dr. Fechner.

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