Double eyelid surgery, also known as Asian blepharoplasty, is one of the most sought-after cosmetic procedures worldwide and the most commonly requested surgery at Wave Plastic Surgery. Whether you’re looking to create a natural-looking double eyelid crease or enhance your existing eye shape, understanding your options is crucial for achieving the results you desire.
Dr. Peter Lee, founder and CEO of Wave Plastic Surgery, brings over 20 years of expertise in Asian eyelid surgery and has perfected techniques that create natural, beautiful results. As an Advanced Endotine Bioskills surgeon educator and trainer who has mentored surgeons internationally, Dr. Lee’s insights provide invaluable guidance for anyone considering this transformative procedure.
Complete Guide to Double Eylid Surgery With Dr. Peter Lee
Understanding Double Eyelid Surgery
Double eyelid surgery creates a connection between the skin and the underlying cartilage and muscle so that when you open your eyes, the skin indentates inward, forming a crease. As Dr. Lee explains, for many people of Eastern Asian descent, this double eyelid crease doesn’t naturally exist, and surgical intervention can create this aesthetic enhancement.
The procedure involves creating an attachment between the skin, cartilage, and underlying muscle to form a permanent eyelid crease. This surgical enhancement can make eyes appear larger, more expressive, and create better definition in the upper eyelid area.
The Three Main Double Eyelid Surgical Techniques
Dr. Lee outlines three primary methods for creating a double eyelid, each with distinct advantages and ideal candidate profiles:
1. Suture-Only Technique (Completely Scarless)
The suture technique involves everting the eyelid and using only sutures to create the crease. While this method leaves no visible scars, Dr. Lee notes that very few patients are actually ideal candidates for this approach alone.
The main limitation is that the double eyelid’s stability depends on scar tissue formation, and the suture technique doesn’t create enough raw surface area and internal scar tissue to ensure a crease that will last a lifetime. This method is ideal for patients who do not have excess fat or skin in their eyelids, with the main advantage being the absence of an incisional scar and minimal swelling.
2. Minimal Incision Technique
This method involves making three to five very small incisions at the level where the double eyelid crease is desired, then using sutures to create the fold. Because there are minimal incisions, the fold tends to be more stable than the suture-only technique.
However, Dr. Lee cautions that even with this method, especially for patients with thicker skin or significant fat deposits, the results may not be entirely permanent. This technique offers a middle ground between the completely non-invasive suture method and the full incision approach.
Learn More: Minimal Incision Technique
3. Full Incision Technique (Most Common)
Dr. Lee reports that approximately 60-70% of patients are better candidates for the full incision technique. Even younger patients often have some extra skin that hoods over the eyes, making them appear smaller. By removing this excess skin, the procedure consistently rejuvenates the eyes more effectively.
The primary advantage of the full incision method is stability. Because the surgeon cuts along the entire double eyelid crease, it creates a larger surface area for tissue adhesion, making the double eyelid much more permanent. This technique provides the most permanent results of the three methods; however, because there is an incision throughout most of the length of the new eyelid crease, there will be a visible scar that typically becomes very fine and well-concealed over time.
Related: What Is a Double Eyelid?
Creating Larger-Looking Eyes: A 360-Degree Approach
Many patients ask Dr. Lee how to make their eyes look bigger, but he emphasizes the importance of balance and proportion with the rest of the face. The key is accentuating the eyes while maintaining natural harmony and not dramatically changing one’s inherent features.
When discussing eye enlargement, Dr. Lee considers two dimensions:
Vertical Aperture Enhancement
The vertical opening of the eyes can be improved by addressing congenital ptosis, a condition where the eye-opening muscle (levator aponeurosis) is naturally weak. During double eyelid surgery, Dr. Lee often tightens this muscle so that more of the eye opens vertically, creating a more alert and awake appearance.
Horizontal Length Enhancement
Eyes can be lengthened in two directions:
- Medial Epicanthoplasty (Inner Corner) Many Asian patients have an epicanthal fold – extra skin that hoods over the inner corner of the eyes, making them appear shorter. Dr. Lee explains that medial epicanthoplasty involves making an incision in the inner corner to open up this area, which can significantly help appropriate candidates.
However, not everyone is suitable for this procedure. Patients whose eyes are already long or who have a narrow intercanthal distance (space between the eyes) may not be good candidates, as opening the inner corner could make everything appear too close together.
- Lateral Canthoplasty (Outer Corner) For some patients, the outer corner of the eyes appears cut off or shortened. Lateral canthoplasty can open up the outer corner, though the extent of improvement depends on the underlying bone structure, which determines the anatomical limits of the procedure.
Customizing Your Double Eyelid Design
Dr. Lee’s approach to double eyelid surgery involves three critical design elements that ensure natural, proportionate results:
1. Starting Point of the Crease
- Tapered: The double eyelid starts from inside the inner corner, creating the most natural look for many Asian patients.
- Hybrid: The crease starts right at the corner (neither inside nor outside), providing a natural appearance while making eyes look slightly longer than a purely tapered design.
- Parallel: The double eyelid starts from outside the inner corner, making eyes appear longer. For patients with strong epicanthal folds, medial epicanthoplasty may be necessary to achieve this parallel look, though it creates a more dramatic appearance.
2. Shape of the Crease
- Oval Shape: The crease is thinner toward the inner side and wider toward the outer edge. Dr. Lee considers this the most natural and suitable shape for most patients, as it opens the outer portion of the eyes while following the eye’s natural contours.
- Circular Shape: The crease width remains consistent throughout its length, creating a rounder, softer, and more “cute” appearance. This is typically better suited for patients with already larger eyes.
3. Height of the Crease
- Natural Look: 6.5 to 7.5 millimeters from the eyelashes provides a subtle, natural-appearing crease.
- Dramatic Look: 7.5 millimeters and above creates a more pronounced, striking appearance.
Dr. Lee notes that patients of different Asian backgrounds often have varying preferences: individuals of North Eastern descent (e.g. China, Mongolia, Korea, Taiwan, and Japan) prefer a smaller eyelid height ranging from 3-6 mm, whereas individuals of South Eastern descent (e.g. Thailand, Vietnamese, Myanmar, Indonesia, and Malaysia) prefer a taller eyelid, ranging from 7-10 mm.
Age Considerations and Permanence
Dr. Lee addresses common questions about age limits and longevity of results. For age-related sagginess corrections, there really isn’t any age constraint for upper blepharoplasty. However, for creating double eyelids in younger patients, Dr. Lee recommends waiting until the eyelid is fully mature and developed, typically around ages 15-16.
Regarding permanence, Dr. Lee explains that when upper eyelid surgery addresses age-related changes, the effectiveness of correcting sagginess typically lasts about 10 years, varying by individual. For Asian double eyelid creation, the results are permanent when performed using appropriate techniques.
The Double Eyelid Surgery Experience and Recovery
Double eyelid surgery is performed under twilight sleep rather than general anesthesia, making it much less involved than larger surgical procedures. Dr. Lee emphasizes that the surgery itself is relatively straightforward and not particularly painful.
Recovery Timeline
Dr. Lee provides realistic expectations for the healing process:
- First Week: The most critical period for rest and healing. Dr. Lee strongly recommends limiting computer and phone use to allow the eyes to rest properly.
- Three Weeks: Approximately 70-80% of swelling subsides during this period.
- Several Months: Complete resolution of all swelling, though patients can return to normal activities much earlier.
Most patients find that extra-strength Tylenol is sufficient for pain control, and face washing can resume the next day with careful attention to the suture lines.
Related: Recovery After Upper Eyelid Surgery
Functional Double Eyelid Surgery Benefits Beyond Aesthetics
While many patients seek double eyelid surgery for cosmetic reasons, Dr. Lee points out significant functional benefits:
- Vision Improvement: For patients with ptosis (droopy eyelids), the surgery can dramatically increase the field of vision. Dr. Lee explains that ptosis correction is considered functional surgery because it directly impacts how much patients can see.
- Reduced Eye Strain: Patients with significant upper eyelid sagging often experience visual field restrictions. Removing excess skin opens up the field of vision, improving overall perspective and reducing eye strain.
- Eyelash Health: The presence of an epicanthal fold encourages downturned eyelashes, and the creation of a double eyelid can alleviate and assist with eversion of the cilia.
Related: Ptosis Repair
Addressing Symmetry Challenges
One of the most important aspects of double eyelid surgery is achieving symmetry. Dr. Lee spends considerable time addressing this challenge because, naturally, most people’s eyes are different from each other. The goal is to make them as symmetrical as possible while maintaining natural proportions.
The most common complication is that of asymmetry, making this surgery incredibly specialized, where meticulous technique and attention to detail are vital to minimize this risk. This is why choosing an experienced surgeon like Dr. Lee, who has performed over 30,000 successful cases, is crucial for optimal outcomes.
Non-Surgical Double Eyelid Alternatives and Limitations
Dr. Lee acknowledges that some patients attempt to create double eyelids non-surgically using tape or adhesive glue. While these methods work by making the skin below the desired crease thicker and stiffer, they come with significant drawbacks.
Long-term use of tapes and adhesives can make the skin rougher, thicker, and more stretched, leading to increased sagging over time. Dr. Lee advises that occasional use for special occasions is acceptable, but for those wanting a permanent double eyelid, surgery remains the most effective solution.
The Wave Plastic Surgery Advantage
What sets Wave Plastic Surgery apart in double eyelid surgery is our comprehensive approach and unparalleled expertise. Our team of board-certified plastic surgeons has studied at prestigious institutions including Harvard, Yale, Stanford, Duke, University of Chicago, and University of California San Francisco.
Dr. Peter Lee’s international training and experience as an educator means he brings global perspectives and cutting-edge techniques to every procedure. Wave is recognized as one of the largest plastic surgery practices in the US specializing in anti-aging surgeries, with fully accredited facilities across five locations.
Our commitment to natural-looking results means we carefully evaluate each patient’s unique facial anatomy, cultural background, and aesthetic goals to create a personalized surgical plan that enhances natural beauty while maintaining ethnic identity.
Combining Procedures for Optimal Results
Double eyelid surgery can often be enhanced when combined with complementary procedures:
- Ptosis Correction: For patients with droopy eyelids due to weak muscles, combining ptosis repair with double eyelid creation ensures optimal functional and aesthetic outcomes.
- Epicanthoplasty: When appropriate, addressing epicanthal folds can enhance the overall eye shape and complement the double eyelid creation.
- Brow Lift: For older patients with sagging brows, combining a brow lift with double eyelid surgery provides comprehensive upper face rejuvenation.
The key is Dr. Lee’s philosophy of comprehensive evaluation – considering not just the eyelids in isolation, but how they relate to the entire facial structure for harmonious, natural-looking results.
Your Consultation: Setting Realistic Expectations
During your consultation at Wave Plastic Surgery, Dr. Lee and his team will thoroughly evaluate your eye anatomy, discuss your aesthetic goals, and recommend the most appropriate technique for your unique situation. This detailed planning phase is crucial for achieving results that look natural and complement your overall facial features.
The consultation process includes examining your eyelid thickness, fat distribution, muscle strength, bone structure, and existing crease patterns to determine the optimal surgical approach. Dr. Lee’s artistic eye and technical expertise ensure that your results enhance your natural beauty while creating the eye shape you desire.
Schedule Your Personalized Consultation
Ready to learn more about how double eyelid surgery can enhance your natural beauty? Dr. Peter Lee and the expert team at Wave Plastic Surgery are here to guide you through every step of the process, from initial consultation through recovery and beyond.
Discover why patients from around the world choose Wave Plastic Surgery for their double eyelid surgery. Schedule your consultation today at one of our convenient locations in Los Angeles, Costa Mesa, Rowland Heights, Arcadia, or San Francisco to begin your journey toward more beautiful, expressive eyes.
