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Double eyelid surgery is the most common cosmetic surgery among Asians, said Dr Elaine Chee, Visiting Consultant, Oculoplastic Service, Singapore National Eye Centre (SNEC), a member of the SingHealth group.

The upper eyelid, controlled by the levator muscle, is attached to the skin above the eye. In Westerners, this forms a fold that results in a double eyelid but, in some Asians, this attachment does not occur, said Dr Chee, who was trained locally and in South Korea.

In addition, some Asians have bulky fat tissue in their upper lids, resulting in protruding or puffy eyelids, which may even hide natural double eyelids. They also tend to have prominent skin folds (epicanthic folds) in the upper eyelids that cover the inner corners of the eyes. These folds can cover the upper eyelashes and part of the upper eyelids, making the eyes look "almond-shaped" and smaller.

While surgery may alter these physical traits, differences such as bone structure around the eyes, cannot be changed. Dr Chee advises Asians with these characteristics to have realistic expectations.

"We cannot look like Angelina Jolie or Cindy Crawford because we don’t have deep-set eyes. But we can enhance what we have, even as we maintain our Asian features. Doing so allows our eyes to complement the rest of our face," she said.

Surgery for double eyelids

The following surgical methods for double eyelid surgery are done under local anaesthesia.

  • Open: Some fat and excess skin is removed from the upper eyelid, and the wound stitched to create a double eyelid crease. It is suitable for patients with excess skin and fat in the upper lid area.
  • Small incisions: Three 2mm cuts are made in the upper eyelid. Small amounts of fat are removed and the incisions stitched up. Recovery time is faster compared to open surgery. It is suitable for those with a small amount of fat and skin in the upper lid area.
  • Non-incision: Three small punctures are made and a thread is passed through the openings to create the double eyelid crease. This procedure can be done quickly. Recovery time is usually very short, but the results may not last as long. It is suitable for younger patients with thin skin.
  • Epicanthoplasty: An operation to reduce prominent epicanthic folds so the new double eyelid fold created is not hidden.

Ref. T12