A Guide to Double Eyelid Surgery

Double eyelid surgery, or Asian blepharoplasty, is a cosmetic procedure that aims to enhance the appearance of the eyes by creating a fold or crease. It gives the illusion of larger, brighter, and more pronounced eyes. This surgery is designed for individuals who have either no crease on the upper eyelid (monolid) or weak and uneven eyelid folds, making the eyes look tired or less expressive.

In addition to enhancing eye appearance, double eyelid surgery sometimes provides functional improvements for individuals with puffy or hooded eyelids that interfere with vision or cause drooping eyelids.

Why is Double Eyelid Surgery so Popular in Asia?

Single eyelids or monolids are particularly common among individuals of East Asian descent. The aim of this surgery is to enhance the eyes to make them appear larger, more vibrant, and appealing. With plastic surgery becoming increasingly accessible to the masses in East Asia, so too does the popularity of double eyelid surgery increase.

What are the Benefits of Double Eyelid Surgery?

• Aesthetic Enhancement: Creating a crease on the upper eyelid makes the eyes appear larger and more expressive. It also provides the eyes with a better-defined shape that complements other facial features more harmoniously.
• Better Symmetry: Some people may have uneven eyelid folds or different crease heights. Double eyelid surgery can create a similar crease in the affected eye to enhance facial symmetry.
• Improved Customisation: The surgeon can tailor the procedure to suit each patient’s unique facial anatomy and preferences. Whether someone desires a subtle or more pronounced crease, the surgeon can work with the patient to achieve beautiful outcomes.
• Natural-Looking Results: When performed by skilled and accredited plastic surgeons, a double eyelid surgery can produce natural-looking results with minimal to no visible scarring.

What are the Techniques Used?

There are two main techniques used for double eyelid surgery: the traditional and scarless methods.

• Traditional (Full Incision): This involves making an incision along the upper eyelid to remove excess skin, fat, and muscle, and to form the double eyelid crease. It is the most commonly performed technique and produces a more prominent and permanent crease. The full incisional method is suitable for patients with thicker upper eyelid skin or those who want to correct other eyelid issues, such as drooping eyelids, excessive fat, or asymmetry.
• Scarless (No Incision): The procedure does not involve any incisions. Instead, small holes are made in the upper eyelid to insert the sutures from. These sutures are then adjusted and tightened until the desired crease forms. The scarless method is ideal for patients with minimal excess fat and loose skin on the upper eyelid, as well as those who do not have ptosis (droopy eyelids).

How Can I Prepare for a Double Eyelid Surgery?

• Avoid Certain Medications: Refrain from taking certain medications and supplements that can increase the risk of bleeding and bruising. Let your doctor know what medications you are currently on so that he or she can provide personalised recommendations.
• Quit Smoking: Smoking may increase the likelihood of complications and impede the healing process. Doctors recommend avoiding the use of tobacco products or being exposed to secondhand smoke for a few weeks before and after the procedure.
• Make Transport Arrangement: Patients should arrange for someone to drive them to and from the hospital as they may still be drowsy from the after-effects of anaesthesia.

What Happens During Double Eyelid Surgery?

Double eyelid surgery is typically done on an outpatient basis. Before the procedure, the patient will usually receive local anaesthesia into the eyelids to numb the area and may be given sedatives to relax.

For the incisional technique, the surgeon will measure the upper eyelid area and mark it with a pen. The incision is then made along the upper eyelid fold. Once the surgeon obtains access to the underlying tissues, they may reposition or remove excess skin, fat, and muscle to create the desired crease. The incision will then be closed using stitches.

For the non-incisional technique, however, the surgeon will make multiple tiny holes across the upper eyelid, through which a suture is inserted to connect the skin to the underlying muscle before being stitched to form the desired crease.

What is the Recovery Process Like?

After a double eyelid surgery, the patient may encounter temporary side effects, including mild bruising, swelling, and discomfort around the eye, which will subside within two weeks. Some may also experience watery eyes, puffy eyelids, blurry vision, and light sensitivity.

The doctor will provide detailed instructions for post-operative care, such as appropriately applying a cold compress to reduce swelling, taking certain medications, avoiding prolonged sun exposure, and so on. Patients can usually return to their daily lives within two weeks.

FAQs on Double Eyelid Surgery

When Should You Consider a Double Eyelid Revision Surgery?
This is performed to redo a previous double eyelid surgery. Patients often consider this due to unsatisfactory results from the initial double eyelid procedure or changes in the appearance of the eyelids due to the natural ageing process.

When Can the Final Results of a Double Eyelid Surgery be Seen?
Non-incisional techniques typically produce results within two months of surgery, whereas traditional incisional procedures may take approximately six months. Do note that the healing process and duration can vary based on individual factors as well.

When Can I Wear Contact Lenses after Double Eyelid Surgery?
Following the surgery, patients will need to refrain from wearing contact lenses for a few weeks while the incisions heal. During your follow-up checks, your doctor will assess your state of healing and let you know when you can go back to wearing contact lenses safely and comfortable.