Asian Eyelid Surgery


Asian blepharoplasty, also known as double-eyelid surgery, is popular among women of Asian descent who are born without a distinctive upper eyelid fold. About 50% of women of Asian descent are born with this fold, and some may feel that lacking an upper eyelid crease makes their eyes look smaller. To transform monolids, Beverly Hills and Koreatown plastic surgeon Dr. Charles Hsu can create an upper eyelid fold and the appearance of double eyelids through surgery or a stitch-based method. In conjunction with the Asian blepharoplasty, many patients choose to get an epicanthoplasty to remove the webbing of skin over the innermost corner of the eyes (epicanthal folds) and complete the double eyelid look.

Best Candidate

Patients for Asian eyelid surgery have some of the following common concerns:

  • Patients with a single eyelid (no crease), low crease, asymmetric creases (different in each eye), double creases, or creases that come and go

  • Older patients with extra skin hanging over the crease or in front of the eye


Dr. Hsu will first ask the patient about their specific goals for the Asian blepharoplasty and examine the upper eyelid area with the eyes open and closed. Dr. Hsu will then give his assessment to the patient on treatment options and then discuss how the surgical plan should be individualized for the patient. 

Surgery Details

There are two different methods for performing the Asian blepharoplasty procedure, both of which are usually performed under local anesthesia in about an hour. In the first of these methods, the surgical method, Dr. Hsu will make a small incision at the eyelid crease, remove a small degree of fat depending on the degree of heaviness of the upper eyelids, and then use stitches to create the fold by creating a connection between the muscle and the overlying skin. The other method is the suture method (stitch-based method).  Using stitches, Dr. Hsu creates the attachment from the muscle to the skin by passing stitches through the skin without the need for surgery. This method is less invasive and offers a quicker recovery, but has a small chance of the fold fading over time. 

Recovery and Post-Op

After the surgery, patients should use a cold compress for the first 48 hours in 20-minute intervals on the eyes to help minimize swelling. Patients must keep their head elevated and dry during the recovery period. Around two weeks after surgery, bruising and swelling has subsided in most patients enough for makeup to cover any remaining bruising. Dr. Hsu will usually remove stitches during the first week follow up appointment. Patients usually stop taking pain medication after 5-7 days and plan their work schedules accordingly. It takes about 4-6 weeks to gradually return to full exercise. Follow-up appointments are scheduled for 1-2 weeks after the procedure, and then several months after.

From Dr. Hsu

“The Asian blepharoplasty or double-eyelid procedure is a common one among Asian patients. In certain Asian countries like South Korea, it is estimated by some that over half of the female population has this procedure done!

I’ve heard some patients tell me that they think the Asian blepharoplasty is done to make their eyes look more Caucasian, but this is not my approach to this procedure. The purpose is really to create an eyelid fold that gives the eyes a more open and larger appearance, and provides an aesthetic location for eyeshadow.

In recent years, I have seen an increase in the number of patients who have had previous Asian blepharoplasty done elsewhere years ago, and have asked me to increase the height of the eyelid fold. This can be done as well, in the appropriate patient. The increase in these requests probably reflects the growing popularity of this procedure in general.

In some Asian patients, they also have skin covering the inner part of their eyes, almost like a small area of soft skin web. I see it in perhaps about 50% of patients requesting the double-eyelid procedure. This web can be opened up in a procedure called the medial epicanthoplasty. It is often done at the same time as the double-eyelid procedure.”

Frequently Asked Questions

  • What will my Asian Eyelid Surgery results be like?

    Initially the crease will look slightly higher than expected due to the swelling and bruising but over a period of 1-2 months, it will achieve an ideal level and shape. For best results, patients should apply cold compresses for about 2 days to prevent swelling and avoid vigorous activities for at least 6 weeks. The outer edge sutures are usually removed in 4 days and the deep fixation sutures are removed after a week. With your new double eyelid you can expect your eyes to appear bigger, brighter, and more youthful.

  • How long does Double Eyelid Surgery take?

    Asian eyelid surgery is done on an outpatient basis under local or general anesthesia. Dr. Hsu prefers the procedure done under local so he can interact with the patient to verify the shape and position of the crease and eyelid during surgery. The procedure takes about 2 hours and involves removing a small amount of excessive skin, some tissue under the skin (muscle and septum), and a small amount of fat pads. After the sutures are placed, the new crease will hide the incision line.

  • Are there any Asian Eyelid Surgery risks?

    Fortunately, most of the major risks of Asian eyelid surgery are minor or fairly infrequent. For the incisional method, which is more technically demanding but useful for a wider variety of eyelids, there is the risk of ptosis, or drooping of the eyelid, caused by injury to the levatoraponeurosis, which aids in elevating the eyelid under normal conditions. For all techniques, especially the suture ligation techniques, there is the risk of losing the fold or developing multiple folds