Double Eyelid Surgery

Monolid eyes are also known as epicanthal folds or epicanthic folds. Eyelids with epicanthal folds have smooth skin from the inner corner to the part of the eyebrow nearest to the nose. This can make eyes look smaller as no creases/folds separate lids into two sections, decreasing the space between upper and lower eyelids. Monolids are very common in East Asian people and people with certain conditions such as Down syndrome. 

Changing a monolid to a double eyelid is possible through plastic surgery. Double eyelid surgery creates a fold in the upper eyelid for those with monolid, making the eyes appear larger and more open. Many opt for this procedure to achieve an aesthetically pleasing look and emphasize their eyes.

People with monolid may desire double eyelids for various reasons, such as cultural influence or personal preference. Double eyelids can create a more defined look that makes the eyes appear attractive, which can be an important source of self-confidence. Double eyelids also provide a natural crease that makes it easier to apply eye makeup. People have different motivations - some simply prefer double eyelids because they believe they better represent their aesthetic preferences. 

Double eyelid surgery, or East Asian blepharoplasty, is a cosmetic procedure that creates a crease in the upper eyelid. This crease, also known as a double eyelid, is not present in people of East Asian descent. The surgery is performed to create a more defined eyelid, which many believe makes the eyes appear alert, and bright and adds to the beauty of the eyes. The procedure can be done through the incisional or non-incisional method. It is a popular procedure in East Asian countries, particularly South Korea.

Good candidates are generally people of East Asian descent who have monolid eyes, which means they do not have a defined crease in their upper eyelid. The procedure is typically performed on people who are in good overall health and have realistic expectations for the outcome of the surgery.

It is also good for people with asymmetry; for example, one eyelid has a double eyelid, and the other does not.

People with certain medical conditions or poor health should not undergo double eyelid surgery, as it is a cosmetic procedure. Considering this procedure, you should consult an experienced, board-certified plastic surgeon.

If you're considering double eyelid surgery, there are some important steps to take before the procedure. This section will discuss what preparation is needed for a successful outcome.

1. Consult with a board-certified plastic surgeon who is experienced in performing this procedure. During the consultation, discuss your goals and expectations for the surgery, and ask any questions you may have.
2. If you smoke, stop smoking at least two weeks before (until 2 weeks after) the surgery, as smoking can interfere with the healing process.
3. Avoid taking blood-thinning medications, such as aspirin or anti-inflammatory drugs, which can increase bleeding risk before surgery.
4. To ensure successful surgery, it is critical to abstain from alcohol consumption for at least two days before the surgery. Avoiding alcohol 48 hours before your procedure can help reduce potential risks and complications.
5. Make sure to have someone drive you to and from the surgery place and arrange for someone to stay with you for at least the first 24 hours after the procedure.
6. Follow any additional instructions given to you by your surgeon, such as avoiding makeup or contact lenses and preparing your home for your recovery.
7. Prepare a list of questions that you may have for your doctor.

Double eyelid surgery is typically performed under local anesthesia and sedation. The procedure typically takes 1-2 hours to complete. There are two main methods of double-eyelid surgery.

1. Incisional Method: An incision is made along the actual crease line of the upper eyelid, and excess skin and fat are removed. The surgeon then repositions the remaining tissue to create a defined crease, and the incision is closed with sutures.

• Full-Incisional method: This technique is a permanent solution for those with excess fat and skin in the upper eyelid. It involves an incision along most of the length of the new eyelid crease, resulting in a visible scar that is typically cosmetically acceptable. The surgeon removes any excess skin or fat before suturing to mimic natural creases.
• Partial incisional: This method best suits patients with excess fat in their eyelids but not too much skin. It involves a small incision along the upper border of the new eyelid crease and sutures to mimic fibrous attachments that are naturally found in double eyelids.

2. Non-incisional Method: A double eyelid involves making several tiny holes and passing sutures through them to mimic natural fibrous attachments. There is no incision or need for suture removal, but the results may not be as resilient as with other methods

After the procedure, the surgeon will apply bandages to the eyes and will provide you with instructions on how to care for yourself at home during the recovery period.

East Asian blepharoplasty surgery usually causes minimal pain. There is a variation in swelling between patients, which depends on the trauma experienced during surgery (e.g., a partial incision method without fat removal is significantly less traumatic). You can expect some swelling and bruising around the eyes, which will typically subside within the first week or so. It's common for the eyes to feel dry and irritated for a few days after the procedure. 4-6 days after surgery, the stitches are removed. Within two weeks, the bruises resolve completely.

During the first few days, you should keep your head elevated, apply cold compresses to the area, and avoid activities that could increase blood flow to the face, such as bending over or lifting heavy objects. It's also important to avoid makeup, contact lenses, and exposure to sunlight for at least a week after the procedure.

After one week, you may resume desk work. Within 1-2 weeks, you can drive. But it would be best to avoid strenuous activities and exercise for at least a month after the surgery. 

It's important to follow the postoperative instructions provided by your surgeon, including any medications or ointments to apply and when to come back for follow-up visits. Additionally, it's important to remember that the surgery result may not be fully visible for several weeks or months until the incision heals and the swelling subsides.

Double eyelid surgery is a comparatively safe procedure if performed by a board-certified plastic surgeon. However, like any surgery, there are certain risks and side effects associated with the procedure.

Common side effects include swelling and bruising around the eyes, which typically subside within the first week. Some people may also experience dry eyes, irritation, or a temporary change in their vision.

Risks associated with the procedure include:

• infection
• bleeding
• scarring
• asymmetry
• dissatisfaction with the result
• injury to the eye or surrounding structures.
• anesthesia complications

It is important to note that these risks are rare and can be minimized by choosing a qualified surgeon and carefully following postoperative instructions.

It's also worth noting that the non-incisional method has less chance of complications, but this method may not be suitable for everyone, and it has a chance of not working, or the crease may not be as defined as the incisional method.

It is important to discuss all the possible risks and side effects with your surgeon before the procedure.

The cost of double eyelid surgery can vary depending on a few factors, including the surgery's location, the surgeon's experience, qualifications, and the specific technique used.

On average, double eyelid surgery costs from $2,500 to $5,500. However, the cost can be higher or lower depending on the abovementioned factors.

It's also worth noting that the cost of the procedure may not be covered by health insurance if it is elective or cosmetic surgery. Verify with your insurance provider to see if any part of the procedure is covered.

It is important to note that the cheapest option may not be the best, and it is important to choose a qualified and experienced surgeon to ensure the best possible outcome.

How long do double-eyelid surgery results last? 

Double eyelid surgery results are generally permanent, but the eyelid crease may change with age or weight gain/loss.

How to choose a qualified surgeon for the procedure?

Choosing a board-certified plastic surgeon with experience and expertise in performing double eyelid surgery is important. You can ask for before and after photos of their past patients, ask for references, and read online reviews. You can also check the surgeon's credentials and certification by visiting the American Society of Plastic Surgeons (ASPS) website or other reputable sites.

Is there any age limit for double-eyelid surgery? 

Double eyelid surgery has no age limit, but the best candidates are typically adults who have reached facial maturity.

Can this procedure be combined with other facial procedures? 

Many facial procedures may be combined with double eyelid surgery, including brow lifts, facelifts, and nose surgeries.

Can double eyelid surgery be undone or corrected if you are unsatisfied with the result? 

Depending on the technique used, revision surgery may be possible to correct or undo double eyelid surgery results.

Can people with oily skin or acne-prone skin get double eyelid surgery?

The procedure can still be performed on individuals with oily or acne-prone skin, but they may be at a higher risk for developing postoperative complications, such as infection.

Will double-eyelid surgery leave any visible scars? 

The incisional method may leave a scar, but it is usually hidden within the eyelid crease. The non-incisional method will not leave any visible scar.

How long before the patient can return to normal activities and wear contact lenses or makeup again? 

Most people can return to work and normal activities within a week or two, but you should avoid strenuous activities and exercise for at least a month after the surgery. Contact lenses and makeup should be avoided for at least a week after the procedure.

Are there any alternative non-surgical methods to create a double eyelid? 

There are non-surgical methods, such as using tape or glue to create a double eyelid temporarily, but these methods are not permanent and may not produce the same results as surgery. Additionally, they can be uncomfortable and may irritate.