Eyelid Surgery

eyelid surgery service Dr Natasha Lim was a Fellow in Oculoplastic Surgery at Moorfields Eye Hospital, London UK , working with renowned oculoplastic surgeons, Mr Richard Collin and Mr Geoff Rose. She has also undergone training at the Korea Academy of Plastic Surgery, specializing mainly in Asian Blepharoplasty.

oriental eyelid surgery performed by Dr Natasha LimAsian Blepharoplasty refers to a range of oriental eyelid surgery, such as double eyelid surgery, treatment of hooded eyelids and droopy eyelids with blepharoplasty.

Dr Natasha Lim also performs wrinkle relaxing injections and anti-wrinkle injectable fillers for treatment of under eye dark circles and hollows known as Tear Trough Rejuvenation.

The Oriental Eyelid Crease

The eyelid crease is an important landmark in eyelids. Its presence, height and contour can dramatically alter the way an eyelid appears. Half of patients of Oriental descent lack an eyelid crease, whilst the remaining half do have a crease that is lower than in Caucasian eyelids. For many Oriental societies, the presence of a double eyelid crease is considered to be cosmetically desirable. Many Chinese / Japanese / Korean pop icons and screen actors have popularised this surgery in the Orient.

oriental eyelid with a single creaseOriental eyelid with a single crease

The eyelashes are facing downwards instead of outwards as a result of the upper eyelid fold. Patients often complain of difficulty wearing eye make-up.

oriental eyelid with double eyelid creaseOriental eyelid with double eyelid crease

The eyelashes are facing outwards and the presence of the upper eyelid fold makes the eye look bigger. This patient can apply and wear eye make-up easily with better results.

There are many Oriental patients with different variations of eyelid shape seeking Asian blepharoplasty e.g. without an eyelid crease, with a poorly defined eyelid crease, with an eyelid crease but with hooding, etc. Most Oriental patients requesting blepharoplasty surgery seek better definition of an eyelid crease or to create a new eyelid crease. This can often lead to differences in how the patient is perceived and how the patient feels in him/herself. Just the presence of an eyelid can give the impression that the patient is more awake, more alert, more expressive with a softer, more attractive eye appearance. Many Oriental women comment on how they can wear make-up properly after Asian/ Oriental blepharoplasty surgery/double eyelid surgery due to better definition of their eyelid and exposure of the eyelashes that were previously hidden by eyelid skin.

The Western eyelid crease is very different to the Oriental eyelid crease. The double eyelid crease in a Caucasian eye is higher and the actual lid height is also higher, exposing more of the eyeball, as compared to an oriental eyelid crease which is lower with less exposure of the eyeball.

Most Oriental patients do not wish to achieve western looking eyes because the latter would not compliment or suit the rest of the Oriental patent’s face. Instead, most Oriental patients seek better eyelid crease definition i.e. to create an Oriental looking double eyelid, simply to enhance the appearance of the eye.

There are many variations of Oriental eyelid creases with varying skin crease lengths, shape (tapered, flared, parallel) and amounts of upper eyelid show.

Surgical Methods

There are two methods for creating a double eyelid crease:

  • a no-incision suture technique (where simple stitches are used to create a crease in the eyelid by creating a depression in the skin via attaching the skin to some of the deeper structures within the eyelid) or
  • an incisional technique (where the skin is cut and new skin crease is made by directly attaching the cut edges of skin to the deeper structures).

Dr Natasha Lim will advise which method is more suitable for you according to your age and your virgin eyelid configuration. During your consultation with Dr Natasha Lim, a meticulous assessment of the eye will be carried out with detailed discussion between both patient and the surgeon about the desired eyelid shape and height post-op. Many surgeons simply decide on an arbitrary height at which to remove skin without reference to thinking about the crease, but not Dr. Lim. She will discuss with you during the Asian blepharoplasty consultation an appropriate height for the eyelid crease that will achieve a natural appearing result that fits your face. Traditional eyelid surgery has consisted of aggressive removal of skin, muscle, and fat, which often led to a volume loss in the upper lid with a deep sulcus and higher crease. Dr Natasha Lim uses the latest modern approach aimed at restoring a more youthful and healthier appearing upper-eyelid region, by performing conservative excision of skin, formal crease formation when necessary, coupled with some level of volume augmentation at certain parts of the lid-brow region. This approach creates a less deflated and “fuller” eyelid, providing a beautiful and youthful Asian appearance.

The operation is usually done as a day case procedure under local anaesthetic injections and is very well tolerated. Each operation usually takes about an hour to do both upper eyelids. Recovery time is usually very quick with minimal bruising/swelling that rapidly reduces over one week.

Whether you are Asian / Oriental or Caucasian, you may be seeking eyelid surgery by Dr Natasha Lim if you have one of the following:

  • You were not born with a well defined skin crease but you would like one
  • You have a skin crease but want increased exposure of the eyelid itself (also known as uppereyelid show) so that you can showcase your eyeshadow and mascara better
  • You have multiple skin creases and folds, and they look “messy”. Multiple creases can occur naturally anyway but can also result from prolonged contact lens wear
  • You have significantly differing eyelids and want one eyelid to look like their other eyelid

Authored by: Dr Natasha Lim