Blepharoplasty is surgical modification of the eyelid that removes or repositions excess tissue such as skin and fat for functional or cosmetic reasons. Lower eyelid blepharoplasty is also done for cosmetic reasons, to improve puffiness of lower eyelid "bags" and reduce the wrinkles. Asian blepharoplasty or double eyelid surgery is a special type of blepharoplasty that creates a crease in the upper eyelid. Surgery can artificially create this crease and make a 'single-lidded' patient appear 'double-lidded'. It is the most popular form of cosmetic surgery among Asians. Blepharoplasty is sometimes needed for functional reasons. When an advanced amount of upper eyelid skin is present, the skin may protrude over the eyelashes and causes a loss of peripheral vision. The outer and upper parts of the visual field are most commonly affected and the condition may cause difficulty with activities such as driving or reading. In this circumstance, upper eyelid blepharoplasty is performed to improve peripheral vision.
Asian Eyelid Surgery
Asian eyelid surgery, also known as "double eyelid surgery," is to create a visible crease on the upper eyelid when the eye is open. This change to the upper eyelid creates more definition to usually small and flat Asian eyes. Asian eyelid surgery is a relatively simple and quick procedure that involves removing a tiny bit of excess skin, some under-skin tissue, and a tiny amount of fat pads. The procedure itself is similar to conventional upper eyelid surgery. However, Asian eyelid surgery requires the surgeon to have intimate knowledge of where to make the incisions and how much tissue and fat to remove, and where to place the crease. The majority of Asian eyelid surgery procedures are done as outpatient surgery, so most patients can return home the day of their procedure.
Non-Incision Method
Who are the ideal candidates?
- Those with thin eyelid skin with multiple fine creases
- Those with good skin elasticity on eyelids
- Those who don’t have sagging eyelids
- Those with fine creases caused by over-using eyelid glue or tape
Advantages
- Natural Look : No surgical marks and quick recovery due to small amounts of swelling.
- Convenience : The stitches are placed on the inside of eyelids to fixate the lines and there is no need to take out the stitches.
- Quick Recovery : Surgical and recovery time is relatively short.
- No Scars : Since there is less damages to the tissue, the chance of getting scars is minimal.
- Reversibility : If patient is unsatisfied with the results, you can simply remove suture to revert back to the original state.
Procedure
- Pierce tiny holes of 1~2mm on the ideal location for the crease, and create a line with the thread and needle. This method is called the 'non-incision method’.
Incision Method
Who are the ideal candidates?
- Those with drooping sagging eyelids
- Those with a thick layer of fat on eyelids
- Those with poor skin elasticity on eyelids
Advantages
- Clearer : A clearer crease can be created in comparison to the non-incision method.
- Great Results : Although the recovery period is relatively long, eyes with thick or drooping lids can see more definite results.
- Natura l: Surgical marks remain and visible along with the crease.
- Great Efficiency : As the operation is performed under direct observation of the inner tissues, it is possible to correct severe sagging and remove excessive fat.
- Permanent : It is permanent since the possibility of surgical result to come undone is rare.
Procedure
- Incision Method is effective for correcting drooping eyelids, excessive fat and muscles. Suturing the incision on the eyelid will create the crease.
Partial Incision Method
Who are the ideal candidates?
- Those who do not have excessive upper eyelid fat
- Those who do not have sagging eyelids
- Those with good muscle strength on the eyelids
- Those who do not wish to have incision on their eyelids
Advantages
- Natural Look : Quick natural recovery with small amounts of swelling.
- Quick Recovery : Surgical and recovery time is relatively short.
- Great Results : Although the recovery period is relatively long compared to Non-Incision Method, eyes with thick or drooping lids can see definite results.
Procedure
- The Partial Incision Method combines non-incision and incision methods. This method only makes the partial incision to cut off excessive skin of drooping eyelids or thick muscle tissues while pinching the rest to create smoothly connected crease.
Eye Shape Correction
Eye-Shape Corrections are surgical operations that modify the epicanthic fold around or the end of eyes, eye muscles and the drooping skin to improve overall eye shape.
Epicanthic Fold Removal (Epicanthoplasty)
Who are the ideal candidates?
- Those with small or narrow eyes
- Those whose eyes are far apart from each other
- Those with sharp eyes
- Those who wish to modify short and incomplete crease on the eyelids
Procedure
- This surgery removes epicanthic fold on the front portion of eyes. This process is normally accompanied with the double-eyelid surgery.
Outer Corner Slit (Lateral Canthoplasty)
Who are the ideal candidates?
- Those with small or narrow eyes
- Those whose eyes are slanted upward
- Those who can’t perform front slit
- Those who want larger eyes
Procedure
- This surgery enlarges eye width by cutting the outer corners of the eyes. It cuts off the tissue on the bottom portion of the outer corners and sutures the conjunctiva on the inner side of the eyelid.
Ptosis
Who are the ideal candidates?
- Those whose eyes look sleepy and whose pupils are not fully exposed
- Those who have difficulty or tend to place pressure on the forehead when opening eyes
- Those who have congenitally drooping eyes, or cannot open their eyes wide due to aging
- Those with abnormalities in nerves which are connected to the upper eyelid muscle, muscle problems, aponeurosis abnormalities, and skin problems on the upper eyelids
Procedure
- This surgery is performed to make the pupils look bigger. It controls the eye muscles by adjusting the exposure of sclera and pupil.
Upper Eyelid Surgery
Who are the ideal candidates?
- Those who have many wrinkles on the upper eyelids due to loss of skin resilience
- Those whose vision is hindered due to dropping eyelids
- Those whose eyes look smaller due to drooping of eyelids
- Those with eyes that are slanted downward
Procedure
- This surgery creates a more visible crease by removing excessive skin by measuring exact amount of drooping skin on the eyelid.
Under Eye Correction
The Under-Eye Correction is the surgery controlling and correcting skin and muscles including tear bags, dark circles and excessive fat under the eyes.
Lower Eyelid Surgery
Who are the ideal candidates?
- Those who have severe wrinkles under the eyes
- Those with drooping skin under the eyes
- Those with eyes that look aged and exhausted due to the shadow casted by the puffy eye bag
Procedure
- It removes wrinkles and bags under the eyes. It is proceeded by either removing fat tissues or pulling the skin tight to eliminate drooping skin and muscles. The incision is made on the inner corner of the eyes and towards the conjunctiva, thus, it leaves no scars behind.
Tear Bag Enhancement
Who are the ideal candidates?
- Those who have dull eyes
- Those who wish to have more visible tear bag under the eyes
- Those who are concerned about fine wrinkles under the eyes
Tear Bag Enhancement Methods
- Prosthetic: Incisions are made on both sides under the eyes to insert artificial dermis(alloderm). It is not absorbed into the tissue, thus, remains permanent.
- Fat Graft: It is safe and has no siade effects with autograft, but there is a possibility of absorption.
- Injectable Filler: Restylane filler is safe, yet it may be absorbed into the tissue. (you should expect it to last for about an year.
Dark Circles Removal
Who are the ideal candidates?
- Those with drooping skin under the eyes due to severe stress and aging
- Those who have dark circles due to exhaustion, dehydration and sinus infections
- Those who have dark circles due to racial and congenital factors
Dark Circle Removal Methods
- Caused by excessive fat: Flip eyelids to cut the inner conjunctiva to remove fat
- Caused by visible blood vessels: Use laser to eliminate blood vessels (Repeat the treatment every month for 3~5 times)
- Caused by pigmentation: Use whitening ointment once or twice a week (Oxyjet therapy can be used to apply collagen or whitening ingredient into the dermis for results)
Post Management of Blepharoplasty
- Wash face and wear make-up after taking the sutures out 3~7 days after the surgery.
- Place ice pack on the eyes on the day of/after the surgery and the day after to reduce swelling.
- Do not rub eyes or avoid any impact.
- Apply ointment 3~4 times a day using cotton swabs.
- Avoid drinking and smoking for about a month after the surgery.
KMH recommended Tips
How do I prepare for my blepharoplasty?
- Do not take aspirin or any products which contain aspirin or other blood-thinners for two weeks prior to your surgery.
- Make sure to shower and shampoo before the procedure and to wash your eyebrows.
- Cosmetics should not be worn.
- False eyelashes, contact lenses, jewelry and any other accessories should be left at home.
- In case of patients with hypertension and diabetes, please inform the hospital as well as truth about taking steroids and prescribed oriental medicine.
- Although normal life activities are possible directly after surgeries, it is best to avoid driving a vehicle. It is imperative that you arrange someone to transport you home after your blepharoplasty.
