From Dr. Cat Burkat: Asian Eyelid Surgery

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Eyelid Surgery 
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The Transformations Clinic and Transformations Surgery Center, Inc., are located on the far west side of Madison, in Middleton, Wisconsin

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UW Health plastic and reconstructive surgeon Cat Burkat, MDThe following information is from Cat Burkat, MD, a UW Health surgeon who has particular interest in the Asian eyelid and extensive experience that includes traveling throughout Asia to operate and teach surgery.


The eyelid in those of Asian descent has unique features that are important to consider prior to surgical rejuvenation. Approximately 50 percent of Asians have a skin fold in the area above the eyelashes, whereas half of the population does not.


For those without an eyelid fold, a popular procedure known as Asian blepharoplasty, or "double eyelid surgery," can create a natural-looking crease.


Unique Characteristics of Eyelids


The distinguishing difference between Asian and Caucasian eyelids is in the position of the eyelid fold. The Asian eyelid typically starts at the inner corner very close to the eyelashes. As the crease gets further away from the nose, it gets larger until the midpoint of the eye, at which point the fold runs parallel to the eyelashes.


In contrast, the Caucasian eyelid crease is typically more curved in shape and higher away from the eyelash edge, resulting in a greater eyelid platform to place eyeshadow. There are many surgical techniques available to create a more defined eyelid crease in Asian eyelids, and include non-incisional suture techniques that heal rapidly, and also incisional techniques that can remove excess skin simultaneously and result in greater definition.


In addition, these principles of anatomic differences in the Asian eyelid are important to consider when performing any eyelid surgery in the Asian population in order to optimize the surgical outcome while preserving the natural ethnic appearance.


Is the suture technique or the incisional technique best for me?


Surgery to create the "double eyelid" is complex and requires thoughtful individualization to each patient. Suture techniques do not require cutting the skin, and therefore result in a virtually scarless fold, a soft naturalness to the crease, more rapid recovery within days to a week rather than months, and can be performed as an office procedure without sedation.


In contrast, the incisional technique is best for individuals with excessive skin or fatty lids, those with heavy drooping brows or eyelid ptosis ("sleepy eye"), or if more intricate surgical maneuvers are required to secure a more dramatic or permanent lid crease. In addition, if excess skin overhangs the inner corner of the eye in some Asian lids, known as a medial epicanthal fold, this could also be softened simultaneously at the time of surgery.


Will eyelid surgery change my Asian appearance?


Regardless of ethnicity or race, we all wish to age gracefully while maintaining our individual unique facial features. The goal is to carefully assess the eyelid shape and crease in the initial consultation and discuss together with the patient his or her desired result and appearance, which is often enhancement of their natural features without “Westernizing” the face. Bringing in photos of friends or magazines that demonstrate the desired outcome can also be very helpful. Feel free to ask Dr. Burkat how these observations apply to you during your consultation.


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