The eyes are commonly referred to as the window to the soul, they are one of the most important aspects of facial expression. The trendiest eye shape is the classic almond shape with longer, curved eyelashes with tapered eyebrows.
Eyelid surgery or blepharoplasty is a surgical procedure to improve the appearance of the eyelids. Having beautiful, bright eyes makes all the difference to a face. Having an upper eyelid crease is one way to achieve this and look younger. In general, many Asians have no or partial eyelid creases. It often happens that the fat inside the eyelid (orbital fat) makes the crease less visible, reducing the brightness of the eyes.
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Types of Blepharoplasty
1. Double Eyelid Surgery
It is a popular surgery among Asians due to smaller eyes, single eyelids or double eyelids that are unclear. We offer two double eyelid surgery techniques as follows:
1.1 Double eyelid surgery by the open technique: The surgeon makes an incision in the crease of the eyelid, removes fat and excess skin and renders the desired aesthetics before sewing to create a new crease of the eyelid as on picture 1.
1.2 Double eyelid surgery: by suture technique: The surgeon marks 6 stitches on the new eyelid crease then inserts the suture (thread) in and out of the muscle and passes it through the marked stitches of the skin of the eyelid anterior to posterior skin. Finally the suture is embedded under the skin to fix the double eyelids as in photo 2
2. Correction of Eyelid Ptosis
Eye ptosis surgery is a surgical procedure to correct the drooping of the eyelid that often develops with age. There are many methods for eye ptosis correction and the method used depends on the severity of eye ptosis. If the patient has only mild or moderate eye ptosis, the surgeon can fixate Levator application. If the patient has severe ptosis the surgeon will use the frontalis muscle flap from the forehead to fix with the tarsal plate making the eye more open. As in picture 1.
3. Lower Eyelid Surgery
A tell tale sign of an aging face often includes dark rings, wrinkles and sagging below the eyes. Lower eyelid surgery is a cosmetic procedure to correct loose skin, excess fat, and wrinkles of the lower eyelid making the under-eye smoother and significantly more youthful looking. This procedure can take a decade or more off someone’s perceived age. There are two methods for lower eyelid surgery as follows:
3.1 Transconjunctival lower eyelid surgery. This procedure is suitable for someone who has eye bags but skin and tissue that still has good elasticity. The surgeon will remove the excess fat through the incision in the conjunctiva and then close the incision with dissolvable stitches. The eyes will look entirely natural without any visible scar as in picture 1
3.2 Transcutaneous lower eyelid surgery. This procedure is used for those with sagging skin, bags or wrinkles who have less elasticity of the lower eyelid. The incision is made just below the lower eyelash, excess fat is removed, the muscle is fixated, excess skin is removed and sutures (stitches) are made. See picture 2
A cosmetic procedure to reduce the “Mongolian fold” or Epicanthic fold of the eyes. The Mongolian fold is the skin of the upper eyelids which covers the inner corner of the eyes. Epicanthoplasty involves making a very small incision on the inner corner of the eyes to improve the shape resulting in bigger and brighter eyes. People usually combine Epicanthoplasty with double eyelid surgery to create a more beautiful eye shape.
Pixl Clinic offers three techniques for Epicanthoplasty are as follows:
4.1 W-Epicanthoplasty. The surgeon makes a W-shape line at the inner corner of the eyes. This method is available for someone who has a severe degree of Mongolian fold. The angle and extent of medial canthus dissection can be flexibly adjusted as seen in picture 1
4.2 Z -Epicanthoplasty. This method changes the direction of the inner corner and does not require any skin resection (removal). The scar is less visible than W-shape. It is suitable for someone who has a moderate Mongolian fold. See picture 2.
4.3 V-Epicanthoplasty. This method is suitable for a mild Mongolian fold. It keeps the tip of the medial canthus pointed slightly downward. The surgeon must control the degree of the dissection to achieve natural results. See picture 3.
Canthoplasty is a surgical procedure to improve the lateral Canthus to be balanced and have a natural appearance. There are numerous methods for lateral Canthoplasty such as:
5.1 Lateral Canthoplasty. This is a cosmetic surgery to create a change in the horizontal dimension of the eye. It can enlarge the outer edge of the eye by around 2-3 mm. It can be performed alongside a double eyelid surgery. Epicanthoplasty makes the eye significantly larger and brighter. See picture 1.
5.2 Canthopexy (Cat eyes) This is a minor surgical procedure that strengthens and stabilizes the lateral canthal tendon to tighten a drooping lower eyelid or ectropion. This method repositions the outside corner of the eye where the eyelids meet, restoring a youthful look. It can uplift the eye around 5 mm. See picture 2.
5.3 Lowering Canthoplasty: In some East Asian people the Lateral Canthus is too high and can look unnatural. Lower Canthoplasty can move the Canthus downward around 3-5 mm. Incisions are made in the upper and lower eyelids. The Canthal ligament is repositioned and then adjusted to balance and shape the eye. See picture 3.
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Postoperative Instructions for Blepharoplasty
Frequently Asked Questions
Blepharoplasty is eyelid surgery. As individuals age, the eyelids can start to sag and fill with fat, which can make you look older and tired. It can also reduce your peripheral vision, especially at the ends and peaks of your visual field.
Many people choose blepharoplasty to reduce the appearance of bags under the eyes, to eliminate droopy, tired eyelids, and to restore peripheral vision that has been impaired by severe sagging eyelid skin.
Eyelid surgery only corrects peripheral vision blocked by droopy eyelids. There are many other causes of peripheral vision loss, including glaucoma, occlusions, retinal detachment, or optic nerve entrapment. If you suffer from peripheral vision loss, it is important to make an appointment with our ophthalmologist for a thorough examination and diagnosis.
Eyelid surgeries are usually performed on an outpatient basis. Since local anesthesia is used, we ask that you bring another driver with you or arrange for someone to drop you off and pick you up. The surgery usually takes two hours or less, but can take longer.
Since the surgery is performed on an outpatient basis, you will be cleared to go home and recover as soon as the local anesthetic has worn off and it has been determined that you are safe to return home. Recovery times vary. In general, your stitches, if they do not dissolve on their own, will be removed after 10 days and most patients will be fully recovered within a month. However, recovery may take longer.
After your surgery, our ophthalmologist will provide you with materials on activities to avoid and signs of serious complications. Most people experience swelling, bruising, and redness at the incision sites. You may also have some sensitivity to light, double vision, and watery eyes. Keeping your head elevated and using cool compresses can reduce swelling and bruising. In addition, we can prescribe eye drops or creams to relieve discomfort.
Eyelid surgery is generally not covered by medical or vision insurance policies. However, in rare cases where the procedure is deemed medically necessary, it may be covered. For more information on the types of insurance we accept and suggestions on how to pay for surgery, please contact our office.