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Asian eyelids

Asian eyelid surgery is a very common operation. The majority of patients of Asian origin have no creases in the upper eyelids and, therefore, no palpebral furrow.

The main cause is the lack of classic fixation of the levator muscle of the upper eyelid at the level of the skin. The insertion is either absent or very low under the cartilage known as the tarsus. Two other causes can be associated: a very significant skin laxity and a malpositioned fat distribution.

The procedure to recreate a crease in the upper eyelid in Asian patients is performed very commonly in Asia. In France, however, it is a little-known surgical procedure that only certain cosmetic surgeons perform. It requires a great amount of practice, rigorous training and extreme surgical precision.

It was described for the first time in 1896 and several different names exist for the operation:

  • Double eyelid surgery
  • Asian eyelid surgery
  • Asian blepharoplasty
  • Debridement of the eyelids or eyes

In every case, the main principles to be observed are the lightest possible anesthesia, the shortest possible recovery time, the fewest visible scars, the least possible pain and a very natural result.

How the operation is performed

The first step regarding Asian eyelid surgery is to consult a specialist cosmetic surgeon. The feasibility of the procedure, the modalities, and the choice of technique will be discussed. The operation is most often performed under local anesthesia but general anesthesia can be used for particularly stressed or anxious patients.

The eyelid skin is prepared several days before the operation by homeopathy. Do not take drugs that can cause bleeding a week before the procedure and avoid smoking for 15 days before and 15 days afterwards because it negatively impacts the scarring process. The operation takes place in the clinic during the day.

Convalescence is 3 to 12 days depending on the bruises and swelling which are more or less significant depending on the skin of each individual patient and the operating technique used. In some cases there are wires to be removed after 5 to 7 days. The result is visible almost immediately after the operation, but the final result can only be judged after 1 to 3 months of evolution.

Surgical blepharoplasty techniques

The principle of an Asian blepharoplasty is always the same; to reattach the tarsus (cartilage), the skin and the muscle of the eyelid at the right level.

Pre-operative skin markings are essential because they allow the patient to define the desired level of the new eyelid crease. Local anesthesia is performed. It is not painful.

Several Asian eyelid surgery techniques exist and Dr. Masson uses all three, case by case depending on the patient. In classic cases with a skin that is not too elastic and without excess fat, a closed approach without a scar is possible for example, while in cases where there is excess skin and fatty pockets with a heavy eyelid, it is mandatory to use a technique known as the open approach. Each case is different.

  • The closed approach consists of introducing the wires through 2 to 6 micro-incisions, so there is no real scar.
  • The semi open approach consists of introducing the threads through a small short incision of 1 cm.
  • The open approach consists of incising all along the crease. We can then remove excess skin or fatty pockets and fix the crease more securely if necessary. Over time, the scar is almost invisible.

An intervention that is often associated with a blepharoplasty is a canthoplasty procedure. This is to correct a slant at the level of the internal canthus and is designed to open the eyes more. Different designs are possible depending on the shape of the slant.


Complications are rare as long as the technique is well mastered by the surgeon. Complications can, however, include recurrence, asymmetries, abnormal shape, prolonged swelling (edema) and defective scars. For more details please click here to read the page on blepharoplasty.

How much does Asian eyelid surgery cost?

Asian eyelid surgery is not reimbursed by the health insurance system because it is a cosmetic surgery procedure. The price is variable depending on the technique to be used (open or closed approach, associated canthoplasty etc.) and the anesthesia method chosen (local or general). On average, it costs from 2,500 to 3,200 euros.

asian blepharoplasty


Dr Vincent Masson is a plastic surgeon with a post-graduate diploma in plastic, reconstructive and aesthetic surgery and a gold medal in surgery from the Paris Hospitals. He is a former senior registrar and attaché at the Hôpital Saint Louis.

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