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Asian eyelid surgery (including Double eyelid surgery)

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.

asian eyelid Blepharoplasty pre surgery
Asian heavy eyelids before blepheroplasty operation

asian eyelid Blepharoplasty post surgery
Asian revised eyelids after blepheroplasty operation

asian eyelid ptosis pre surgery
Asian drooping upper eyelids before ptosis operation

asian eyelid ptosis post surgery
Asian revised eyelids after ptosis operation

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.

Upper eyelids

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.

Lower eyelids

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.

What to expect

  • After surgery, you will experience some degree of swelling and bruising — cold compresses and elevation of the head will help to relieve any discomfort.
  • Your eyes may feel dry because they are more open than before, especially if very droopy eyelids have been corrected — this is easily remedied by using artificial tear solution, which Mr Malhotra will prescribe.
  • Some patients who don't ask for a new eyelid crease may end up with a crease anyway, because the scar in the eyelid can sometimes cause an eyelid crease to form, even if the surgeon wasn't trying to create one — any incision will therefore be placed in the natural crease lines seen in Asian eyelids.
  • It is important to avoid strenuous activity for the first week after surgery but you can return to work if you want.
  • Antibiotic eye ointments are prescribed for several days after surgery.
  • You cannot wear contact lenses for approximately one week after surgery, because the eyelids may be stiff and sore.
  • Some people experience blurred vision or sensitivity to light for a few days.
  • In rare circumstances, tiny whiteheads may appear along the line where the stitches were — these can easily be removed in the clinic, using a needle.

All procedures begin with a consultation. For full information about what to do before and after surgery, see Patient information.

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