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How Asian Eyelid Surgery Can Transform Your Look Safely
20th January 2026
Asian eyelid surgery, also known as double eyelid surgery or Asian blepharoplasty, is one of the most commonly performed cosmetic procedures amongst individuals of East Asian descent. This delicate surgical procedure creates a natural-looking eyelid crease whilst preserving the unique characteristics that define Asian beauty.
At Linia Cosmetic Surgery, we understand that Asian eyelid surgery is not about conforming to Western beauty standards but rather about enhancing your natural features in a way that reflects your personal aesthetic goals whilst maintaining your ethnic identity.
To appreciate what Asian eyelid surgery entails, it’s important to understand the anatomical differences that characterise Asian eyelids.
Approximately 50% of individuals of East Asian descent are born without a defined eyelid crease, a feature known as a single eyelid or monolid. This occurs due to specific anatomical differences:
Epicanthal Fold – A skin fold that covers the inner corner of the eye, extending from the nose to the inner portion of the eyebrow. This is more prominent in Asian eyes and contributes to their distinctive appearance.
Pretarsal Fat – Asian eyelids typically have a fuller distribution of fat in the upper eyelid area, which can contribute to a puffier appearance and prevent natural crease formation.
Levator Aponeurosis Attachment – In eyes without a crease, the muscle responsible for lifting the eyelid (levator muscle) has different or absent attachments to the skin, which is why a visible fold doesn’t form when the eye opens.
Skin Thickness – Asian eyelids often have thicker skin compared to Caucasian eyelids, which affects both the surgical technique required and the healing process.
Orbital Fat – There is typically more orbital fat present, which can create a fuller upper eyelid appearance.
These characteristics are not deficiencies but rather beautiful variations in human anatomy. Asian eyelid surgery works with these features to create results that are harmonious with your overall facial structure.
Asian eyelid surgery is a cosmetic procedure designed to create a natural-looking crease in the upper eyelid. The goal is to enhance the eyes whilst maintaining ethnic identity and creating results that appear natural rather than “Westernised.”
The procedure can address several aesthetic concerns including lack of eyelid definition, a tired or sleepy appearance, asymmetry between the two eyes, excess skin or fat creating a heavy appearance, difficulty applying eye makeup, and in some cases, functional issues where excess skin impairs vision.
It’s crucial to understand that Asian eyelid surgery is highly personalised. The ideal crease height, shape, and position vary depending on your individual facial features, personal preferences, and ethnic background. There is no single “correct” outcome—rather, the goal is to achieve a result that enhances your natural beauty and aligns with your aesthetic vision.
Many patients seek Asian eyelid surgery to create more defined, alert-looking eyes. A subtle eyelid crease can enhance the appearance of the eyes without dramatically altering your ethnic features. This can include making the eyes appear larger or more open, creating better symmetry between both eyes, achieving better balance with other facial features, and facilitating eye makeup application.
Some individuals simply prefer the aesthetic of a double eyelid and wish to have this feature for personal reasons. This is a valid motivation that deserves respect and consideration.
In some cases, excess skin on the upper eyelid can impair peripheral vision, a condition known as dermatochalasis. Whilst this is less common in younger patients seeking Asian eyelid surgery, it can be a legitimate concern for some individuals.
As we age, the eyelids can become heavier and more hooded due to skin laxity and fat redistribution. Asian eyelid surgery can help restore a more youthful, refreshed appearance whilst addressing age-related changes.
Many people naturally have asymmetric eyelid creases—one eye may have a double eyelid whilst the other doesn’t, or the creases may be at different heights. Surgery can create better symmetry.
There are two primary surgical approaches to creating an eyelid crease, each with distinct advantages and considerations.
The non-incisional technique, also called the suture or DST (Double Suture and Twist) method, creates an eyelid crease using internal sutures without making external incisions.
How It Works – Small punctures are made in the eyelid, and permanent sutures are passed through these points to connect the eyelid skin to the underlying levator muscle or tarsal plate. When the eye opens, this connection creates a natural-looking crease.
Advantages:
Limitations:
Ideal Candidates:
The incisional technique involves making a precise incision along the desired crease line, allowing the surgeon to remove excess skin and fat whilst creating a permanent connection between the skin and deeper structures.
How It Works – An incision is made along the predetermined crease line. Excess skin and fat are carefully removed as needed. The skin is then sutured to the levator muscle or tarsal plate, creating a permanent crease. The incision is closed with fine sutures that are removed after about one week.
Advantages:
Limitations:
Ideal Candidates:
Some surgeons offer a hybrid approach combining elements of both techniques. This involves making smaller incisions to remove fat whilst using sutures to create the crease. This method may be suitable for patients who fall between the criteria for non-incisional and full incisional techniques.
This procedure addresses the epicanthal fold—the skin fold covering the inner corner of the eye. Epicanthoplasty can be performed to elongate the appearance of the eyes, create better symmetry, enhance the overall result of double eyelid surgery, and achieve a more open, alert appearance.
There are different epicanthoplasty techniques with varying degrees of fold reduction. It’s important to maintain some natural epicanthal fold to preserve ethnic characteristics.
Ptosis refers to drooping of the upper eyelid due to weakened or stretched levator muscle. If ptosis is present, it can be corrected simultaneously with double eyelid surgery by tightening or repositioning the levator muscle, creating better eyelid position and symmetry, and improving both aesthetics and function.
Some patients benefit from strategic fat grafting to create better eyelid contours, add volume to areas that appear hollow, achieve more balanced proportions, and enhance overall aesthetic results.
Lower eyelid surgery can complement upper eyelid surgery by addressing under-eye bags, removing or repositioning fat, tightening loose skin, and creating a more comprehensive rejuvenation.
For patients with a low or descended brow position, a brow lift may enhance results by lifting the brow to a more youthful position, reducing hooding of the upper eyelid, and creating better overall upper face harmony.
Ideal candidates for Asian eyelid surgery typically meet several criteria:
Good Overall Health – You should be in good general health without medical conditions that could impair healing or increase surgical risks. Specific conditions that may affect candidacy include uncontrolled diabetes, thyroid disorders, bleeding disorders, or autoimmune conditions affecting healing.
Realistic Anatomy – The best candidates have adequate eyelid skin and tissue to work with. Patients with extremely thin or damaged skin may have limitations.
Stable Eye Health – You should not have active eye infections, chronic dry eye (or it should be well-managed), glaucoma (well-controlled is acceptable), or recent eye surgery.
Realistic Expectations – Understanding what the procedure can and cannot achieve is crucial. Surgery can enhance your features but won’t completely transform your appearance or solve underlying self-esteem issues.
Personal Motivation – You should be pursuing surgery for yourself, not to please others or conform to external pressures. Your decision should be well-considered and reflect your personal aesthetic goals.
Cultural Identity – Good candidates understand that the goal is enhancement, not erasing ethnic identity. You should feel comfortable with maintaining Asian features whilst achieving your desired aesthetic.
Emotional Stability – You should be in a stable emotional state and not pursuing surgery during times of significant stress or life changes.
Age – Most surgeons prefer patients to be at least 18 years old to ensure facial growth is complete and decision-making maturity. However, some patients may be appropriate candidates at 16-17 in consultation with parents.
Non-Smoker – Smoking significantly impairs healing and increases complication risks. You should be a non-smoker or willing to quit for at least 4-6 weeks before and after surgery.
Realistic Timeline – You should have adequate time for surgery and recovery, including time off work or school, ability to attend all follow-up appointments, and no major events immediately after surgery where you want to look your best.
Financial Readiness – As a cosmetic procedure, Asian eyelid surgery is typically not covered by insurance. You should be financially prepared for the cost without creating undue stress.
Your consultation is a crucial opportunity to discuss your goals, understand the procedure, and determine the best approach for your unique needs.
Medical History Review – Your surgeon will review your complete medical history, including current medications and supplements, previous surgeries, especially any eye or facial procedures, allergies and adverse reactions, eye health history including dry eye, infections, or injuries, and family history of eye conditions or healing issues.
Physical Examination – A thorough examination of your eyelids and surrounding structures will be performed, assessing eyelid anatomy and skin thickness, presence and distribution of fat, natural eyelid crease (if present) and symmetry, levator muscle function, brow position and forehead dynamics, and overall facial proportions.
Photographs will be taken from multiple angles to document your current appearance and assist with surgical planning.
Discussion of Goals and Expectations – This is your opportunity to clearly communicate what you hope to achieve. Be honest about your motivations and specific desires regarding crease height and shape, degree of change desired (subtle vs. dramatic), and any functional concerns like impaired vision or difficulty with makeup.
Your surgeon will explain what can realistically be achieved with your anatomy, show you before-and-after photos of previous patients with similar features, and discuss different surgical approaches and their respective outcomes.
Surgical Planning – Based on your anatomy and goals, your surgeon will recommend the most appropriate technique (non-incisional vs. incisional), discuss crease height and design, determine whether additional procedures would be beneficial, and explain the expected timeline from surgery through final results.
Many surgeons will use computer imaging or manual drawing to help you visualise the planned results, though it’s important to remember these are approximations, not guarantees.
Questions to Ask – Don’t hesitate to ask comprehensive questions about the surgeon’s experience and qualifications, specific technique recommendations for your case, expected results and any limitations, risks and potential complications, recovery timeline and what to expect, before-and-after photos of patients with similar features, revision rates and policies, and total costs including all associated fees.
Proper preparation can significantly impact your surgical outcome and recovery experience.
Medication Adjustments – Stop taking aspirin, anti-inflammatory medications (ibuprofen, naproxen), vitamin E, fish oil, and certain herbal supplements at least two weeks before surgery, as these can increase bleeding risk. Your surgeon will provide a comprehensive list.
Continue taking prescribed medications unless specifically instructed otherwise. Inform your surgeon of all medications, including over-the-counter drugs and supplements.
Smoking Cessation – If you smoke, you must stop at least 4-6 weeks before surgery and continue abstaining throughout recovery. Smoking constricts blood vessels, impairs healing, increases infection risk, and can lead to poor scarring or tissue loss.
Alcohol Limitation – Avoid alcohol for at least one week before surgery, as it can increase bleeding and interact with anaesthesia.
Health Optimisation – Ensure chronic conditions like diabetes or hypertension are well-controlled. Maintain good nutrition and hydration. Get adequate sleep in the days leading up to surgery.
Arrange Support – Organise for someone to drive you home after surgery and stay with you for at least the first 24 hours. You may need assistance with basic tasks during early recovery.
Time Off Work – Plan for at least one week off work for non-incisional methods and two weeks for incisional techniques. More time may be needed depending on your profession and comfort level with residual swelling or bruising.
Home Preparation – Stock your home with necessary supplies including prescribed medications, over-the-counter pain relievers (as approved by your surgeon), cold compresses or ice packs, clean gauze and cotton pads, artificial tears or lubricating eye drops, comfortable button-up shirts (to avoid pulling clothing over your head), extra pillows to keep your head elevated, and easy-to-prepare nutritious foods.
Prepare a comfortable recovery area with everything within easy reach. Ensure your bedroom is dark and quiet for rest.
Pre-Surgery Instructions – Follow your surgeon’s specific pre-operative instructions, which typically include fasting from midnight before surgery (no food or drink), arriving with a clean face free of makeup, contact lenses, or skincare products, wearing comfortable, loose-fitting clothing, leaving valuables and jewellery at home, and bringing your ID and any required paperwork.
Set Realistic Expectations – Review expected outcomes with your surgeon and understand that final results take time to appear. Remember that some asymmetry is normal in all faces, and perfect symmetry is rarely achievable.
Plan for Recovery – Understand that you will experience swelling, bruising, and possibly temporary asymmetry. Prepare yourself mentally for the recovery period, which can be emotionally challenging as you wait for swelling to resolve.
Support System – Consider having trusted friends or family available for emotional support during recovery. Some patients find it helpful to connect with others who have undergone similar procedures.
Local Anaesthesia with Sedation – Many Asian eyelid surgeries are performed under local anaesthesia with oral or intravenous sedation. This approach allows for a quicker recovery and lower risk compared to general anaesthesia. You’ll be relaxed and comfortable but able to respond to simple requests, which helps the surgeon assess crease symmetry.
General Anaesthesia – Some patients prefer general anaesthesia, particularly for more extensive procedures or if they feel anxious about being aware during surgery. This may be recommended if combining eyelid surgery with other facial procedures.
Your surgeon and anaesthetist will discuss the best option for your specific situation.
Marking – The desired crease height and position are carefully marked with you in a seated position to ensure natural, symmetric results. Typical crease heights range from 6-8mm from the lash line, though this varies based on individual anatomy and preferences.
Anaesthesia – Local anaesthetic is injected into the eyelid area to ensure comfort throughout the procedure.
Suture Placement – Small punctures (typically 3-5 points) are made along the marked crease line. Permanent sutures are carefully passed through these punctures and the deeper eyelid structures. The sutures are positioned to create a smooth, natural-looking crease.
Adjustment – The patient may be asked to open and close their eyes to assess the crease formation and symmetry. Adjustments can be made to ensure optimal results.
Completion – Once the surgeon is satisfied with the crease appearance, the sutures are secured and trimmed. The puncture sites require no additional closure.
The non-incisional procedure typically takes 30-60 minutes.
Marking – Precise measurements and markings are made to indicate the incision line, amount of skin to be removed (if any), and areas of fat requiring attention.
Anaesthesia – Local anaesthetic with or without sedation is administered.
Incision – A carefully planned incision is made along the marked crease line using a fine scalpel or surgical blade.
Tissue Adjustment – The incision allows the surgeon to access the underlying structures. Excess fat is carefully removed or repositioned as needed. Any excess skin is conservatively excised to avoid a hollow or overdone appearance. The levator muscle may be identified and addressed if ptosis correction is needed.
Crease Formation – Sutures are placed to connect the skin edge to the deeper structures (levator aponeurosis or tarsal plate), creating the crease.
Closure – The incision is meticulously closed with very fine sutures, ensuring minimal tension and optimal healing.
Assessment – The patient may be asked to open their eyes to assess symmetry and crease position.
The incisional procedure typically takes 60-90 minutes, longer if additional procedures are being performed.
After surgery, cold compresses are applied to minimise swelling. You’ll receive detailed post-operative instructions and prescriptions for pain medication and antibiotics. Most patients can go home the same day once fully recovered from anaesthesia.
Expected Symptoms:
Care Instructions:
Activity Restrictions:
Expected Progress:
Suture Removal:
Activity:
Appearance:
Expected Progress:
Activity Resumption:
Scar Management:
Social Activities:
Final Results:
Scar Maturation:
Long-Term Care:
Several factors can influence your recovery experience:
Surgical Technique – Non-incisional methods typically have faster, easier recovery compared to incisional techniques.
Individual Healing – People heal at different rates based on age, genetics, overall health, and skin type.
Adherence to Instructions – Following post-operative care instructions precisely significantly impacts outcomes.
Lifestyle Factors – Smoking, alcohol consumption, poor nutrition, and inadequate sleep can all impair healing.
Whilst Asian eyelid surgery is generally safe when performed by a qualified surgeon, all surgical procedures carry some risks.
Temporary Swelling and Bruising – Expected and resolves over weeks to months.
Dry Eyes – Common in the first few weeks, managed with artificial tears.
Temporary Blurred Vision – Usually from ointment or swelling, resolves quickly.
Sensitivity to Light – Often improves within the first week.
Mild Asymmetry – Some asymmetry during healing is normal; most resolves as swelling subsides.
Infection – Rare but can occur; treated with antibiotics. Signs include increasing pain, redness, warmth, or discharge.
Bleeding or Haematoma – Excessive bleeding or blood collection under the skin may require drainage.
Poor Scarring – Whilst rare, some patients develop thick, raised, or widened scars. This is more common in those with a genetic predisposition to hypertrophic or keloid scarring.
Crease Asymmetry – Persistent asymmetry may require revision, though minor asymmetry is normal and present in all faces.
Crease Loss or Weakening – More common with non-incisional methods; may require revision or conversion to incisional technique.
Undercorrection or Overcorrection – Results may be less dramatic or more dramatic than desired, potentially requiring revision.
Vision Changes – Extremely rare but can include temporary or permanent vision loss.
Ptosis – Drooping of the eyelid can occur if the levator muscle is damaged.
Lagophthalmos – Inability to fully close the eyes, usually temporary but occasionally persistent.
Corneal Injury – Very rare; protection measures are taken during surgery.
Allergic Reactions – To anaesthesia, medications, or suture material.
You can minimise your risk of complications by choosing a highly qualified, experienced surgeon, following all pre-operative and post-operative instructions precisely, disclosing your complete medical history, avoiding smoking and alcohol, attending all follow-up appointments, and reporting any concerns promptly to your surgical team.
Asian eyelid surgery can create beautiful, natural-looking results, but it’s important to have realistic expectations:
Natural Enhancement – The goal is to enhance your natural features, not completely transform your appearance. Results should look like “you, but refreshed.”
Ethnic Identity Preservation – A skilled surgeon will create results that maintain your Asian features whilst achieving your aesthetic goals.
Individual Variation – Your specific results will depend on your unique anatomy, chosen technique, healing process, and surgeon’s artistic approach.
Time to Final Results – Initial results are visible once swelling subsides, but final results take 3-6 months as tissues completely settle and scars mature.
Most patients experience more defined, alert-looking eyes, enhanced eye symmetry, a refreshed, youthful appearance, better ease with eye makeup application, and improved confidence in their appearance.
The crease created should appear natural when the eyes are open and closed, blend smoothly with surrounding tissue, and be symmetric between both eyes (within the natural variation present in all faces).
Non-Incisional Method – Results are generally long-lasting but may weaken over time in some patients. Studies suggest 80-90% of patients maintain their crease long-term, whilst 10-20% may experience some weakening requiring revision.
Incisional Method – Results are typically permanent. The crease will remain throughout your life, though natural ageing will continue, potentially causing skin laxity or changes in eyelid appearance over decades.
Despite best efforts, some patients may be dissatisfied with their results. Common concerns include asymmetry between the eyes, crease too high or too low, crease too deep or too shallow, unnatural appearance, or visible scarring.
If you’re unhappy with your results, communicate with your surgeon. Many minor issues can be addressed through revision surgery once complete healing has occurred (typically 6-12 months after the initial procedure).
Revision Asian eyelid surgery may be considered for unsatisfactory crease height or shape, asymmetry between the eyes, crease loss (particularly with non-incisional methods), visible or poor-quality scars, or changes in aesthetic preferences over time.
Most surgeons recommend waiting at least 6-12 months after the initial procedure before considering revision. This allows complete healing, final results to manifest, and swelling to fully resolve.
Revision surgery is typically more complex than the initial procedure due to scar tissue and altered anatomy. It may require conversion from non-incisional to incisional technique or more extensive tissue manipulation.
Choosing an experienced surgeon familiar with revision techniques is crucial for achieving satisfactory outcomes.
Posted In: Face Treatments Blogs
Written By: Firat Ekinci
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