View in ChineseA specialized procedure such as Asian eyelid surgery requires a facial plastic surgeon with unique skills and experience. Dr. Chase Lay has devoted much of his career to specializing in this procedure and he’s among the leading providers of Asian eyelid surgery in the San Francisco Bay Area. Dr. Lay’s experience includes traveling to Vietnam and Thailand to refine his expertise.
Surgery of the Asian eyelid has been performed literally for well over 100 years and was first well documented in Japan before 1900. Also known as double eyelid surgery or Asian blepharoplasty, this surgery involves carefully reshaping the upper eyelid skin to create a more defined crease. Specialized surgical techniques are required to make visible changes to the crease while maintaining a natural appearance that also maintains the patient’s personal and cultural identity. The approach and goal of Asian eyelid surgery is different from traditional blepharoplasty. Eyelid surgery for the Asian eye is a delicate procedure requiring detailed knowledge of Asian eyelid anatomy. Not only is the Asian eyelid anatomically distinct, but each patient’s eyelid anatomy poses unique surgical issues. Your anatomy, along with your skin tone and specific cosmetic goals, will dictate the technique Dr. Lay uses for your surgery. The techniques fall into 2 general categories:
Suture Technique for Asian Eyelid Surgery
Patients often ask about this approach because it is less invasive than techniques requiring incisions and typically has less swelling after the procedure. The disadvantage, however, is the crease created by the surgery is more likely to disappear over time. Suture technique for Asian eyelid surgery (double eyelid surgery) is a terrific technique with many advantages, but must be used on the right patient with the right anatomy.
Incision Technique for Asian Eyelid Surgery
This isn’t a single technique, but rather a group of several specific techniques that all involve using an incision, or a set of small incisions, to perform upper eyelid surgery. These techniques are more invasive than the suture technique and require lengthier recuperation, but eyelid surgery using incisions is more predictable and longer-lasting. Swelling is usually completely gone within 5 to 7 days and all signs of that you had surgery disappear by 10 days.
Real Answers From Dr. Lay
“The best technique for your eyelid surgery may depend on whether or not you wear contacts. For example, a younger patient who doesn’t wear contacts and has thinner skin is a better candidate for the suture technique than someone older than 30 with thicker skin who wears contacts.”
Young Korean woman after Asian eyelid surgery with the very acceptable appearance of her incision technique scar. She is over 3 months post-op in this photo. Results can vary.
Young Asian woman who had an incision and anchoring technique Asian eyelid surgery with Dr. Chase Lay. She is approximately 6 weeks post-op and looking good with her natural tapered crease.
What Should I Expect from Asian Eyelid Surgery?
A simple double eyelid surgery using a suture-only procedure will typically result in mild swelling that lasts about 2 or 3 days. In many cases, you can return to work and regular activities within 12 to 24 hours. Avoid using contact lenses for 72 hours. There are no sutures to remove.
Surgery using incisions normally involves swelling that lasts for about 5 to 7 days, with the worst period about 2 to 3 days after the surgery. The final suture will be removed about 6 or 7 days after the surgery, depending on the technique used. You will probably need to rest for at least 48 hours before returning to work and daily activities. Exercising or other strenuous activities require about 5 to 7 days of recuperation in most cases. The incision line typically fades about 2 weeks after the surgery and becomes much more difficult to see over the following weeks and months.
Frequently asked questions about Asian eyelid surgery also known as Double Eyelid Surgery
How is this procedure performed and what are my options?
Asian eyelid surgery also known as double eyelid surgery is performed one of two ways. The most effective and long-lasting would be the incision technique where either your own existing crease is used to alter the appearance of your eyelid crease or a new crease is created for you. Another option is the suture technique. With this technique, a series of small holes anywhere from 3-6 are made in the eyelids, and sutures are passed through the skin to the tarsus or levator tendon below and a crease is literally quilted into position and the sutures are left under the skin permanently. This is one of the oldest techniques with its earliest documented use in Japan well over 100 years ago. Whether you are a good candidate for suture technique or incision technique depends on your anatomy.
How do I know which Asian eyelid surgery technique is best for me?
This depends very much on your anatomy and Dr. Lay’s assessment of you. The incision technique is the most reliable and effective and nearly everyone is a candidate for the incision technique. The suture technique is really only best used on very young patients with thin skin who do not wear contact lenses.
What is my healing time?
In general with the incision technique, your sutures are removed after 7 days and you can expect noticeable swelling and in some cases bruising. Most patients start to look natural again as the approach the two-week mark after surgery.
Is the healing time for the suture technique faster?
Dr. Lay’s response to this question is usually “sometimes.” The healing can be faster but bruising is equally common with suture technique when compared to the incision technique. Also, it’s important to point out that the satisfaction rate with suture technique and the risks overall really is no better versus incision technique.
How long does it take to perform my Asian eyelid surgery or double eyelid surgery?
The procedure is performed under local anesthesia and can take anywhere from 30 minutes up to 1 hour.
Is it common to need a revision or a touch-up for my Asian eyelid surgery?
Globally, revision rates have been reported as high as 10%. Dr. Lay is open about his own revision rate of less than 2%. Most of the time any need for a revision or touch-up or ear surgery is to make small improvements of a relatively successful surgery. Dr. Lay has a lot of experience repairing poorly performed surgeries from overseas and even other practices in the United States.
Why is Asian eyelid surgery so different from non-Asian eyelid surgery?
The anatomy of the Asian eyelid is very different from non-Asian eyelids. In fact the anatomy of the eyelid and one Asian person versus another can be very different. It takes a tremendous amount of experience, knowledge of anatomy, and expertise to perform Asian eyelid surgery successfully and consistently. Dr. Lay customizes each of his surgeries based on the patient’s goals and anatomy. Some request very subtle and natural changes while others request more dramatic changes.
Which is right for me, a tapered crease or a parallel crease?
This again depends on your anatomy and what your overall goals are. The pros and cons of this characteristic of the Asian eyelid crease really depend on multiple factors including facial features and your eyelid anatomy.