Asian Blepharoplasty
Oriental Blepharoplasty
Double Eyelid Surgery
Cosmetic Oriental Eyelid Surgery
The eyelid crease is an important landmark in eyelids. Its presence, height and contour can dramatically alter the way an eyelid appears. Half of patients of Oriental descent lack an eyelid crease, whilst the remaining half do have a crease of some description.
Because of the way an eyelid crease alters the appearance of an eyelid giving the appearance of two parts to the eyelid i.e. those above and below the crease, some have termed eyelids with creases as 'double eyelids' and those without creases as 'single eyelids'.
The cultural significance of an eyelid crease in Oriental society
For many Oriental societies, the presence of an Oriental eyelid crease is seen to be cosmetically desirable and indeed this is reflected in modern day culture with many Chinese/Japanese pop icons & models undergoing surgery or using eyelid glue/taping to achieve a skin crease. Asian blepharoplasty, also known as double eyelid surgery, is the most commonly requested cosmetic surgery by oriental patients worldwide. The term blepharoplasty just means 'eyelid refashioning'. The term 'Asian Blepharoplasty' arose from the US, but probably a more accurate term would be Oriental blepharoplasty. This type of cosmetic eyelid surgery is performed on many types of patients of both oriental and mixed oriental descent and is now the most commonly performed cosmetic procedure on patients of Oriental descent.
An Oriental eyelid without a skin crease-a so called 'single eyelid'. Note the eyelashes are slightly hidden and are orientated downwards by the upper eyelid fold. Patients often complain of difficulty wearing eye make-up.
This model of Chinese descent has a parallel eyelid crease. The eyelid crease is still almond shaped and is still characteristically Oriental in nature. Due to the presence of the eyelid crease, the eyelid is seen to have two parts to it, the part above and the part below the skin crease. Hence the term, 'double eyelid'. Cosmetic eyelid surgery in patients of Oriental descent, is most commonly to create a skin crease which is cosmetically pleasing but also consistent with what is normal both culturally and ethnically.
There are many Oriental patients with different variations of eyelid shape seeking Asian blepharoplasty e.g. without an eyelid crease, with a poorly defined eyelid crease, with an eyelid crease but with hooding, etc. Most Oriental patients requesting blepharoplasty surgery seek better definition of an eyelid crease or to create a new eyelid crease. This can often lead to differences in how the patient is perceived and how the patient feels in him/herself. Just the presence of an eyelid can give the impression that the patient is more awake, more alert, more expressive with a softer, more attractive eye appearance. Many Oriental women comment on how they can wear make-up properly after Asian/ Oriental blepharoplasty surgery/ double eyelid surgery due to better definition of their eyelid and exposure of the eyelashes that were previously hidden by eyelid skin. 
A normal child of Oriental origin. Notice the variation in eyelid shape even within the same patient. She has no skin crease over her right eyelid and a skin crease over her left. Even though her left eye is as open as her right, the presence of the skin crease gives the impression of it being larger.
Asian/Oriental blepharoplasty (Double eyeld surgery) is NOT Westernisation Surgery
It is very important to recognise that the Oriental eyelid is very different to the Western occidental eyelid with very different anatomy. Similarly, it is also crucial that the surgeon recognise that there are many different variations of normal Oriental eyelids, both in those with eyelid creases and those without, depending on the patient's family origin.
Most Oriental patients do NOT wish to look like their Western/Occidental colleagues. Indeed, a standard blepharoplasty designed for an Occidental/Western eyelid would look very strange in an Oriental patient and inharmonious with the rest of the patient's face. Instead, most Oriental patients seek better eyelid crease definition i.e. to create an Oriental looking double eyelid. The surgery to create an Oriental looking eyelid crease is therefore very different to a conventional Occidental/Western blepharoplasty. Counselling a patient for an Asian/Oriental blepharoplasty (double eyelid surgery) during the preoperative visit is probably just as important as the surgery itself, since it is during the preoperative visit that the important decisions about the design of the eyelid crease are made such as where to set the height and shape of the new eyelid crease.
The ultimate aim of an Asian/ Oriental blepharoplasty (double eyelid surgery) is to create a skin crease to enhance the appearance of the eye, yet at the same time, preserve the features of oriental ethnicity for the patient. It is therefore very important that when seeing a patient for the first time for their eyelid surgery, that time and meticulous attention is spent to ensure that both patient and surgeon are clear about what the desired eyelid configuration since there are so many variations of Oriental eyelid creases with varying skin crease lengths, shape (tapered, flared, parallel) and amounts of upper eyelid show.
Surgical Methods
There are two basic methods for creating an eyelid crease:
- a closed thread/suture technique (where simple stitches are used to create a crease in the eyelid by creating a depression in the skin via attaching the skin to some of the deeper structures within the eyelid) or
- an open, incision technique (where the skin is cut and new skin crease is made by directly attaching the cut edges of skin to the deeper structures).
Mr Cheung prefers the latter open incision technique since it allows for excellent intricate design and construction of the eyelid crease and is thought to be longer lasting due to the creation of stronger attachments to the deeper eyelid structures.
The operation is usually done as a day case procedure under local anaesthetic injections and is very well tolerated. Each operation usually takes about an hour to do both upper eyelids. Recovery time is usually very quick with minimal bruising/swelling that rapidly reduces over a few weeks.
There are several types of patients who request Asian/ Oriental blepharoplasty/ Double Eyelid Surgery:
- Patients who don't have a well defined skin crease but seek one (see example case 1)
- Patients who do have a skin crease but seek increased exposure of the eyelid itself (also known as upper eyelid show) so that they can wear eyeshadow and mascara better (see example case 2)
- Patients seeking 'tidier eyelids’ - Often these patients have multiple skin creases and folds. They complain that applied eyeshadow looks messy. Multiple creases can occur naturally anyway but can also result from prolonged contact lens wear (see example case 3)
- Patients seeking symmetry of their eyelids: Occasionally patients have significantly differing eyelids and want one eyelid to look like their other eyelid (see example case 4)
Example Cases
Case 1: 23 year old female- Incisional Asian Blepharoplasty. This lady did not have an eyelid crease at all and seeked one.
Case 2: 35 year old female- Incisional Asian Blepharoplasty. Although this lady had an eyelid crease, she seeked improved exposure of the eyelid and eyelashes, thus improving the effect of eyeshadow and mascara, whilst still retaining a typically oriental appearance to the eyelid.
Case 3: 28 year old female - incisional Asian Blepharoplasty. This lady wanted improved eyelid crease definition. She complained that her eyelid looked untidy with multiple skin creases and multiple eyelid folds.
Case 4: 28 year old female - incisional double eyelid surgery to right upper eyelid only. This lady was born with a skin crease in her left upper eyelid but no crease on her right. She complained that her right eye looked smaller and she preferred the appearance on the left. Double eyelid surgery was therefore performed on her right upper eyelid to make it match the left.
Prices
The total typical cost for patients to undergo treatment for double eyelid surgery / Oriental blepharoplasty with Mr Cheung is £2300. This comprises of:
Consultations
As with all our cosmetic consultations we offer free consultations via a cashback plan. The cost for a cosmetic consultation with Mr Cheung is £100. However, this is later refunded back to the patient once any recommended treatment has been performed.
Surgery
- The cost of double eyelid surgery varies from patient to patient but most patients usually prefer for the surgery to be done as a day case under local anaesthesia. This means that the patient is awake during the operation but does not feel anything due to the numbing injections administered at the start of the operation. Most patients are very happy with this option since they can go home a couple of hours after the operation or stay one night in a local hotel.
- This method is not only the most convenient but also the least expensive at £2300 (all inclusive, fixed cost). In the past, we have had to charge over £3000 for this surgery but can now offer this at £2300 by cutting our costs, whilst still retaining the same level of safety and success. This fixed cost price will include the cost of all medications, photographs and 3 postoperative appointments.
- Though not usually necessary, if one does prefer to stay overnight in the hospital there will be an additional charge of £450 for the use of an overnight private room.
- If one wishes to be asleep during the operation, an additional charge of £350 is necessary for the services of an anaesthetist to administer general anaesthesia or sedation. However, most patients find the surgery very acceptable using numbing injections only.
Advice leaflets for patients undergoing double eyelid surgery/ Asian Blepharoplasty