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What is Asian Eyelid Surgery

Blepharoplasty is often done as an elective surgery for cosmetic reasons. When an advanced amount of upper eyelid skin is present, the skin may protrude over the eyelashes and causes lateral hooding of the eyelid and / or a loss of peripheral vision. This causes an aged appearance and sometimes affects the outer and upper parts of the visual field. In this circumstance, upper eyelid blepharoplasty is performed to restore the natural younger appearance of the eyelid and to improve peripheral vision.

Lower eyelid blepharoplasty is done to improve puffy lower eyelid “bags” and reduce the wrinkling of skin.

Asian blepharoplasty or double eyelid surgery is a special type of blepharoplasty that creates a crease in the upper eyelid. This “supratarsal fold” is common in many races but absent in about half of Asians. Surgery can artificially create this crease and make a ‘single-lidded’ patient appear ‘double-lidded’. It is the most popular form of cosmetic surgery among those of East Asian background.

Blepharoplasty is usually performed through external incisions made along the natural skin lines of the eyelids, such as the creases of the upper lids and below the lashes of the lower lids. Incisions may be made from the inside surface of the lower eyelid (transconjunctival blepharoplasty); this allows removal of lower eyelid fat without an externally-visible scar, but does not allow excess skin to be removed. External skin resurfacing with a chemical peel or laser may be performed simultaneously. This allows the skin surface to be addressed for wrinkling.

The operation typically takes one to three hours to complete. Initial swelling and bruising resolve in one to two weeks but at least several months are needed until the final result becomes stable.

The anatomy of the eyelids, skin quality, age, and the adjacent tissue all affect the cosmetic and functional outcomes. Factors which are known to cause complications include:

  • dry eyes – which may become exacerbated by disrupting the natural tear film
  • laxity (looseness) of the lower lid margin (edge) – which predisposes to lower lid malposition
  • prominence of the eye in relation to the malar (cheek) complex – which predisposes to lower lid malposition

Infrabrow excision blepharoplasty is a periorbital rejuvenation surgery. It addresses the shortcomings of the conventional blepharoplasty operation. The technique is widely used by many Japanese, Korean and Chinese plastic surgeons. The idea rests on alleviation of the lid redundancy through excision of infrabrow skin, subcutaneous tissue, and orbital orbicularis as opposed to that of the upper lid or the suprabrow area. This is followed by layer-by-layer approximation of the structures with no undermining. The procedure is performed under local anesthesia. Skin sutures are either absorbable or are removed on in one week.

As a board-certified, fellowship trained oculoplastic surgeon with extensive training and experience, Dr. Selena Fu customizes each treatment to reflect each patient’s unique anatomy, skin condition, aesthetic concerns and lifestyle— an approach that consistently delivers excellent results for her patients.

Call for a personal consultation today, Dr. Fu will discuss the surgical and non-surgical options that will provide your best possible outcome. Insurance may cover all or a portion of reconstructive eyelid surgeries.

Contact Dr. Selena Fu

What to Expect for Asian Eyelid Surgery (Blepharoplasty)

Asian eyelid surgery, also known as Asian blepharoplasty or double eyelid surgery, is a specialized cosmetic procedure designed to create or enhance the upper eyelid crease. It is one of the most popular cosmetic procedures among individuals of East Asian descent.

Before the Surgery

1. Consultation & Planning
  • Your surgeon will evaluate your eyelid anatomy, skin thickness, and overall eye structure.
  • You will discuss your aesthetic goals and choose between the incisional or non-incisional (suture) method.
  • The surgeon may recommend additional procedures, such as lower blepharoplasty or brow lift, for a more balanced look.
  • If you have droopy eyelids (ptosis), the surgeon may suggest ptosis correction along with the eyelid surgery.
2. Pre-Surgery Preparations
  • Stop smoking and alcohol consumption at least 2-4 weeks before surgery to promote better healing.
  • Avoid blood-thinning medications (such as aspirin and ibuprofen) at least one week before surgery to reduce bleeding risks.
  • Arrange for transportation home after the procedure, as you may experience temporary vision blurriness or light sensitivity.

During the Surgery

1. Anesthesia
  • Local anesthesia with sedation is most commonly used. You will be awake but relaxed.
  • In some cases, general anesthesia may be recommended, especially for combined procedures.

2. Procedure Techniques

a) Non-Incisional (Suture) Method
  • Uses special sutures to create an eyelid crease without cutting the skin.
  • Best for individuals with thin eyelids and little excess skin.
  • Less invasive, minimal scarring, and faster recovery time.
  • Results may not be permanent as the sutures can loosen over time.
b) Incisional Method
  • An incision is made along the upper eyelid to create a well-defined crease.
  • Excess skin, muscle, and fat may be removed or repositioned.
  • Permanent results with a natural-looking crease.
  • Ideal for those with thicker eyelids, excess skin, or fat deposits.
c) Combination with Lower Eyelid Surgery
  • Some patients opt for lower blepharoplasty at the same time to reduce under-eye bags and wrinkles.
3. Duration of Surgery
  • The procedure typically takes 1-3 hours, depending on the method and whether additional procedures are performed.

Recovery Process

1. First 24-48 Hours
  • Swelling and bruising will peak during this time.
  • Cold compresses can help reduce swelling.
  • Sleep with your head elevated to minimize swelling.
  • You may experience temporary blurred vision due to swelling or eye ointments.
2. First Week
  • Mild discomfort or tightness in the eyelids is normal.
  • Sutures (if used) are removed in 5-7 days.
  • Avoid rubbing your eyes, wearing contact lenses, or applying eye makeup.
  • Most patients can return to work within 7-10 days.
3. Weeks 2-4
  • Swelling and bruising continue to subside significantly.
  • You may gradually resume light activities but should avoid heavy exercise.
  • If using the suture method, your eyelid crease will begin to settle into a natural fold.
4. 3-6 Months (Final Results)
  • The eyelid shape fully stabilizes within 3-6 months.
  • Scars (if any) fade significantly over time.
  • The eyelid crease looks more natural and refined.

Possible Risks & Complications

While Asian blepharoplasty is generally safe, some risks include:

  • Temporary dryness, irritation, or sensitivity to light.
  • Mild asymmetry (one eyelid may heal slightly differently).
  • Loosening of sutures (for non-incisional methods).
  • Visible scarring (rare but possible in the incisional method).
  • Eyelid ptosis (drooping) or excessive skin removal (rare and correctable).

Choosing a highly experienced surgeon reduces these risks significantly.

Long-Term Results & Maintenance

  • The incisional method typically provides permanent results.
  • The suture method may last 5-10 years, but the sutures can loosen over time.
  • Normal aging will continue, but results can be maintained with proper skincare and sun protection.

When to Contact Your Doctor

Seek medical attention if you experience:

  • Severe pain or excessive swelling beyond the expected healing process.
  • Signs of infection (redness, pus, or fever).
  • Vision changes that do not improve within a few days.

Asian Eyelid Surgery (Blepharoplasty) – FAQ

1. What is Asian Eyelid Surgery (Double Eyelid Surgery)?

Asian blepharoplasty, also known as double eyelid surgery, is a cosmetic procedure that creates a crease in the upper eyelid. This procedure is common among individuals of East Asian descent who naturally lack a defined supratarsal fold. The surgery can make a single-lidded appearance into a double-lidded one, enhancing the definition of the eyelid and creating a more open-eyed look.

2. How is Asian blepharoplasty different from traditional eyelid surgery?

Asian blepharoplasty focuses on creating a natural-looking eyelid crease, while traditional blepharoplasty is usually performed to remove excess skin, fat, or wrinkles from the eyelids. The goal of Asian eyelid surgery is not only cosmetic enhancement but also to maintain the ethnic characteristics of the eyelid structure.

3. What are the different techniques for Asian blepharoplasty?

There are two primary methods:

  • Incisional Method – A permanent crease is created by making an incision in the eyelid and removing excess fat or skin. This is ideal for those with thick or excess eyelid skin.
  • Non-Incisional (Suture) Method – Sutures are used to create the fold without cutting the skin. This is a less invasive option, ideal for those with thinner eyelid skin and minimal fat. However, it may not be as long-lasting as the incisional method.

4. How long does the surgery take?

The procedure typically takes one to three hours, depending on the technique used and whether additional procedures, such as lower blepharoplasty, are performed simultaneously.

5. What is lower eyelid blepharoplasty, and how is it different?

Lower eyelid blepharoplasty is performed to remove or reposition fat deposits in the lower eyelid to reduce puffiness, under-eye bags, and wrinkles. Unlike upper eyelid surgery, this can be done using a transconjunctival approach (inside the eyelid, leaving no visible scars) or an external incision.

6. What is an infrared excision blepharoplasty?

This is a periorbital rejuvenation surgery popular in East Asia, particularly in Japan, Korea, and China. Instead of removing excess skin from the eyelid directly, skin and tissue are excised below the eyebrow to lift the upper eyelid while preserving a more youthful look. It is performed under local anesthesia, and the sutures can either be absorbable or removed after a week.

7. What is the recovery time for eyelid surgery?

  • First 1-2 weeks: Swelling and bruising gradually subside.
  • 1 month: Most patients see significant improvement, though minor swelling may still be present.
  • 3-6 months: The final results become more stable and natural-looking.

8. Will there be visible scars after the surgery?

  • The suture method leaves no scars since no incision is made.
  • The incisional method leaves a scar along the crease, which fades significantly over time.
  • Lower eyelid surgery using a transconjunctival approach leaves no visible scars, while external incisions may leave a faint line that improves with time.

9. What are the potential risks or complications?

  • Dry eyes – The surgery may temporarily disrupt the tear film, leading to dryness.
  • Lower lid malposition – Loose lower eyelid margins can lead to ectropion (outward turning of the lid).
  • Prominent eyes – Some individuals with a more pronounced eye structure may be at higher risk for lower lid malposition.
  • Asymmetry – The healing process may cause slight differences between the two eyelids, though most are minor.

10. When can I return to normal activities?

  • Office work or light activities – Within 5-7 days.
  • Strenuous activities – Avoid for 2-4 weeks.
  • Wearing makeup – After 10-14 days, once incisions are fully healed.
  • Contact lenses – Avoid for at least 2 weeks post-surgery.

11. Can Asian eyelid surgery be combined with other procedures?

Yes. Many patients choose to combine their eyelid surgery with:

  • Lower blepharoplasty (for under-eye bags).
  • Brow lift (to enhance the upper eye area).
  • Laser resurfacing (to improve fine wrinkles and skin texture).

12. Will my results look natural?

A skilled oculoplastic surgeon can create a natural-looking crease that complements your facial features while maintaining your ethnic identity. Proper planning and an individualized approach are key to achieving the best results.

13. Is Asian eyelid surgery permanent?

The incisional method provides long-lasting results, often for a lifetime. The suture method may last between 5-10 years, depending on individual factors. However, natural aging will continue to affect the eyelids over time.

14. How much does Asian blepharoplasty cost?

The cost varies depending on the surgeon’s expertise, location, and technique used. In the U.S., the price typically ranges from $3,000 to $6,000 per procedure. Insurance may cover upper eyelid surgery if it is performed for functional reasons (such as vision impairment).

15. How can I schedule a consultation?

If you are considering Asian eyelid surgery, it’s best to consult with a board-certified oculoplastic surgeon. They will evaluate your anatomy, skin condition, and aesthetic goals to recommend the best approach for you.

For more information, contact a qualified oculoplastic or plastic surgeon to discuss your surgical and non-surgical options.