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Is Asian upper eyelid surgery right for me?

The goal of Asian upper eyelid surgery is to create a fold in the upper eyelid. About 50% of those of Asian descent do not have a crease in the upper eyelid. As a result, their eyes might appear narrower and less open. In addition, many women find that it is more difficult to apply makeup to eyes that lack the upper lid fold. Dr. Jill Hessler performs Asian double eyelid surgery for both male and female patients. This treatment can be performed once the eyelids have fully developed and the patient has reached an age where he or she can make an informed, confident decision. 

When performed in younger patients, double eyelid surgery often eliminates years of feeling self-conscious about their eye appearance. In older patients, double eyelid surgery can be combined with eye rejuvenation techniques that help remove excess skin, lines, and wrinkles. Depending on the aesthetic concerns and needs of each Asian blepharoplasty patient, Dr. Jill Hessler performs either the minimal incision or no-incision procedure. The treatment that is best for you can be determined during a one-on-one consultation.

Minimal incision double eyelid surgery

During the minimal incision double lid surgery, Dr. Hessler creates very small (6-8 mm.) incisions in the middle of the eyelids. She uses these openings to carefully re-arrange the underlying eyelid structure so as to create a fold. Because of the fundamental changes to the eyelid structure, the crease is permanent and dynamic. It is visible only when the eye is open.

The main advantage of the incision double eyelid surgery is that it creates a permanent eyelid crease. Because the crease is dynamic, it also appears more natural than the crease created through the no-incision method (below). In addition, the incision allows Dr. Hessler to remove any redundant skin or fatty tissue, which is important for many older patients who wish to also rejuvenate their eye appearance. Finally, the incisions allow Dr. Hessler to fully customize the eyelid creases and folds so that they beautifully complement each patient’s eyes and face.

The main disadvantage of the minimal-incision double eyelid surgery is that the recovery takes slightly longer than recovery after the no-incision technique. Generally, most incision Asian blepharoplasty patients recover within 7 to 10 days, while no-incision patients generally recover within 5 to 7 days. Typically, the incision Asian blepharoplasty is recommended for mature patients who desire a pronounced change in the eyelid appearance, combined with the rejuvenation of the eye area.

No-incision (suture) double lid surgery

During the no-incision Asian blepharoplasty, Dr. Hessler creates eyelid creases by using special surgical sutures, inserting the sutures through tiny openings in the eyelids. The sutures lift and re-arrange the eyelid skin, thus creating an appearance of a crease. The underlying eyelid structures are left unchanged during the suture Asian blepharoplasty. The main advantages of suture Asian eyelid surgery are that this is a very quick and relatively economical procedure. The treatment can often be completed within half an hour, and the results are almost immediate. While some swelling is present for about 5 to 7 days, the new crease is visible immediately after the procedure. 

The main disadvantage of no-incision double lid surgery is its temporary and static nature. Because no changes to the eyelid structures are made, the crease depends entirely on the sutures. Over time, the lid is opened and closed millions of times. This process wears out the sutures and they break or re-adjust, causing unpredictable changes in the crease or an elimination of the crease altogether. As such, this procedure has a higher chance of requiring repeat procedures.

In addition, the crease created with sutures is static: it’s present all the time, even when the eye is closed. Overall, the suture eyelid surgery is more appropriate for younger patients who are not looking for a dramatic change and who do not need to remove any redundant eyelid skin or fatty tissue.

Combining Asian eyelid surgery and other procedures

Dr. Hessler often performs Asian double lid surgery in conjunction with the lower lid surgery. While individual areas of the face may begin to bother us more, it’s important to remember that one area of the face doesn’t age in isolation. For Asian patients, eyelids are the first place to show signs of aging, but mid-facial volume loss can also be a significant component of the aging process. In order to combat volume loss in the cheeks, Dr. Hessler frequently combines fat transfer with lid surgery. Other procedures that can be combined with Asian blepharoplasty include a mid-face lift and/or forehead lift. Dr. Hessler will make sure to take your individual concerns into account within the entire aging process of other areas of the face.

Asian lower blepharoplasty

In addition to Asian double lid surgery, Dr. Hessler also performs Asian lower lid surgery. Even though the lower eyelids do not present the double lid concern, the anatomy of Asian lower eyelids is unique to each patient. As an experienced Asian blepharoplasty provider, Dr. Hessler takes into account these anatomical characteristics and creates an individual treatment plan for each patient.

The main concern among Asian lower eyelid patients is usually under-eye fat bags. Generally, people of Asian descent have more fatty tissue in the upper and lower eyelids. While this characteristic means that Asian patients experience fewer lines and wrinkles around the eyes, it also means that prominent fat bags under the eyes might become an aesthetic issue. Some of the reasons why the fat bags bulge forward include genetics, smoking, persistent stress, and other unhealthy lifestyle choices.

Asian eyelids can often show the bulging fat pockets much earlier in life. While the rest of the skin of the face looks very youthful, this irregularity caused by the eyelid fat pocket can make someone look significantly older.

The advantage of addressing this eyelid fat pocket earlier in life is not only the lifelong improvement in appearance but also less extensive surgery needs to be performed. When younger Asian patients seek eyelid surgery, the fat pockets can often be removed without needing to remove extra skin. This allows the procedure to be performed without any incisions on the outside of the eyelid skin. Since all incisions are made on the inside of the eyelid, this procedure is often referred to as a transconjunctival or Asian incision-less eyelid surgery. Similarly to Asian upper eyelid surgery, Dr. Hessler performs lower lid surgery while the patient is under local anesthesia and light sedation. The level of anesthesia can be tailored to each patient’s needs during their plastic surgery procedure. The patient does not feel anything in the eye area, and he or she feels very relaxed or sleepy. However, the patient remains responsive which is important because Dr. Hessler might ask the patient to open and close the eyes several times to verify the correct eyelid crease or the lower eyelid skin adjustment position. Asian lower eyelid surgery is often less extensive than the upper eyelid surgery because no skin needs to be removed, especially in younger patients.

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