Asian Eyelids

Asian Eyelid Surgery

The Asian eyelid is a unique structure that differs from the Western eyelid in many ways, and a deep understanding of the anatomy and healing process is critical as there is no margin for error. Furthermore, the Asian ideal aesthetic is different from the Western ideal, and many patients desire the eyes to be more open, longer horizontally, and with a different shape. Operating on an Asian eyelid in the same manner as a Western eyelid can lead to adverse consequences such as scarring, unintended formation or destruction of the eyelid crease, or an undesirable cosmetic outcome.


How is the Asian eyelid different?

The Asian eyelid may have a full crease, partial crease, or no crease. Up to 50% of Hispanic patients have an Asian-configuration eyelid with partial or no crease. Many Asians also have an epicanthal fold which gives a characteristic appearance. This variability is caused by additional layers of fat and differences in how the deeper eyelid tissues attach to the skin. This may also cause the eyelashes of the upper or lower eyelids to scratch the delicate surface of the eye, causing tearing and a gritty sensation in the eyes.

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Congenital Entropion
Upper eyelid fold causing eyelashes to rub against the cornea.
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Lower eyelid fold causing eyelashes to rub against the cornea.

Dr. Ramesh has superspecialized experience in Asian eyelid surgery, after treating patients both in Los Angeles, CA, and Seoul, South Korea. Surgery involves removal and/or repositioning of the skin, fat, and muscles, along with precise placement of sutures to manipulate the eyelid crease; scars are hidden such that they are invisible to the naked eye.


Will I be asleep for the surgery?

We are typically able to perform these delicate surgeries under IV sedation, or twilight anesthesia. This avoids the risks of general anesthesia and being put to sleep completely, while still preventing you from feeling any pain. Twilight anesthesia also allows you to participate in the surgery in a way that allows a more symmetric result.


What is recovery like? 

Surgery takes between 1 – 2 hours, and patients can go home afterwards. Usually, patients have bruising and swelling around the eyes for 1 – 2 weeks, and pain is minimal. Most patients are ready for social events in 2-4 weeks, and “wedding-ready” by 3 months. Strenuous activities must be limited for the first week, and patients may return to normal exercise and other activities after 7 days.


What can I expect afterwards?

No matter the approach, our goal is for you to look more youthful and refreshed, without any appearance of having had surgery. Eyelid surgery, upper or lower, generally does not cause visible scarring after surgical healing is complete. Complications after surgery are extremely rare, and patients are typically very satisfied after the procedure.