The upper eyelid fold can enhance the beauty of the eyes. Apart from allowing the eyes to appear naturally bigger, the eyelid creases also create a platform for better application of cosmetics. Most Orientals and some Caucasians are born with no upper eyelid creases, or very shallow creases. Surgical creation or enhancement of the eyelid fold has always been very popular, especially among Asians.

No Scar Stitch Technique

The newest technique of creating a double eyelid is using a very fine nylon suture. By starting at the outer corner of the eye and going inward in and out in a waveform fashion, and doubling back to the entry point, the knot can be tied and buried underneath the skin, with no visible scar. Most patients can go out the next day with makeup. This tehcnique is more advanced than the old internal stitch technique using 3 stitches. The success rate is 90%-95%. 70% of the patients are suitable candidates.

External Technique

The external technique is performed through incision at a designated width above the eyelash. This technique allows the correction of more difficult eyes that are more puffy and slit-like. Fat, muscle and skin can be adequately removed through an external incision. This also allows the creation of both an inside and outside fold. Folds of different widths can only be created through an external technique. To create the outisde fold, an additional procedure called epicanthoplasty is done to remove the epicanthal fold (Mongolian fold) of the inner part of the eye. With an incision, a fine scar is expected at the end. This incisional scar can be easily camouflaged with makeup in the first few months, while the scar is healing.

The goal of upper blepharoplasty is to reattach the eyelid muscle in order to create an attractive skin fold of the upper eyelid. The double eyelid operation is often done in conjunction with rejuvenation of the upper eyebag. Both procedures are termed upper blepharoplasties.