About half of Asians are born with no eyelid crease, which is known as a single eyelid or, more romantically, as bedroom eyes because of the sleepy look it gives. The other half have a crease, although it may only be partial and close to the eyelashes.
Whatever the case, Asians tend to seek eyelid surgery for much the same reason as their counterparts of other ethnic heritages — not because they would prefer a more Western look but because they want to appear more wide-awake or simply to resemble other Asian friends. Interestingly, the first known description of an operation to create a double eyelid dates from 19th century Japan, where it was believed that this eye shape enabled you to express emotion more freely.
The options range from simply creating a crease to having a full eyelid lift (blepharoplasty), including the removal of skin and fat. Occasionally, Asians suffer from severely droopy eyelids (ptosis), blocking the upper part of their vision, which makes an operation medically necessary. Others have a prolapse — a slippage — of fat, most often in their lower eyelids and even slight up-turning of lashes towards the eyeball.
Whatever your situation, it is essential to find a doctor who is familiar with the unique anatomy of the Asian eye, discuss the options thoroughly and understand exactly what can and cannot be achieved.
Asian eyelid surgery is often performed under local anaesthesia, with no need for an overnight stay in hospital. The operation normally lasts one to two hours. You can have additional sedation if you choose or opt to have a general anaesthetic.
To lift and/or create a crease in the upper eyelids, a fine incision is made where the crease would naturally occur. Excess skin and muscle is removed, as well as any fat that may be contributing to a puffy look. The incisions are then closed with fine stitches. These are generally removed in approximately a week, or dissolve.
Asian patients with fat that has slipped or dropped down in their lower eye area (prolapsed) can be treated by eyelid surgery through the inside of the eyelid (transconjunctival blepharoplasty). This procedure hides the scar inside the eyelids and usually causes less bruising, bleeding and swelling than conventional surgery. If a lower eyelid skin incision is required, this is placed very close to the lash line so as not to be visible after healing.