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 The double eyelid procedure.
The procedure of eyelid enhancement is generally day surgery and local anaestheic is recommended.
The procedure involves removing a minimal and measured amount of skin, some tissue under the skin, and a again in some cases a minimal amount of fat.
The incision line is generally once healing completed is hidden in the newly created eyelid crease and not generally visible in the eye open gaze.
So Exactly how do we achieve the double eye lid fold?
Prior to the procedure and before any anaesthetic, the patient is sat in front of a large mirror and the resultant eyelid crease height confirmed.
Determined by the desired height of the fold an incision line is marked and symmetrical positioned on each upper eyelid.
The incision is carried deeper into the eyelid through the orbicularis muscle and orbital septum until the orbital fat is exposed.
When necessary, small strips of orbicularis muscle and orbital septum are excised, along with a conservative amount of orbital fat. The amount and location of fat removed has a significant influence on the height, shape, and depth of the new crease.
In most cases, no fat is removed.
The muscle/tendon that lifts the lid (levator aponeurosis) is identified just beneath this fat." The levator aponeurosis is gently exposed at its attachment to the tarsal plate. Wound closure employs a "fixation" technique in which the suture engages the levator aponeurosis near the top of the tarsal plate in 3-5 spots along the length of the incision, thus creating an attachment between the levator aponeurosis and the skin.
A traditional incision double eyelid procedure known as "anchor blepheroplasty," is an older operation which is not recommended. In modern approaches the levator aponeurosis is less aggressively exposed and or detached from its connection to the tarsal plate, in our opinion, excessive exposure invites a higher incidence of serious complications such as droop of the eyelid (ptosis), lid retraction, or peaking of the eyelid margin.
Sutures are removed at 4-6 days at which time there will still be some swelling and the result invariably looks over done and there may be a temporary difference in the two sides.
Following suture removal, the internal scarring at these points of deep-fixation act as "spot welds" during healing.
The final crease is the result of both selective tissue removal, release of the orbital septum and precise internal tissue rearrangement.
Initially the crease will look slightly higher than expected but then, over a one to two months period, it should achieve an ideal level and shape.
An alternative suture procedure (often named the Japanese technique) creates the crease with the use of a simple suture technique, unfortunately the results are variable in duration and recurrence occurs and is not recommended by the clinic.
The incision approach is considered the "gold standard" in Asian double eyelid surgery.
Common questions answered
Q: How long does the surgery take? Approximately one hour. On average patient spends just over two hours in our office.
Q: Where is the surgery performed? Usually our office however you may elect to go to Hospital for a day
Q: What type of anesthesia is used? Local anesthesia. We like to evaluate the result as it develops.
Q: How much does a patient feel during surgery? No Pain but a little pressure.
Q: Is there much pain afterwards? No we recommend Panadol and Cool compresses
Q: How long is the initial recovery? Swelling peaks on the morning after surgery. Bruising reaches its peak on the second day after surgery and is usually mild. Sutures are removed on the 5th- 7th day. Most bruising is gone by a week, while noticeable swelling will persist for several weeks.
Q: How long does it take until all healing is complete? Although one can resume a normal life within a few weeks, it takes much longer for the eyelids to heal to their final state.
Q: How accurate are the results? Even an expert will obtain variability in results. Especially with double eyelid surgery, tiny differences in fat and skin removal or the placement of incisions will generate noticeable effects on the final appearance. Previous surgery or unusual circumstances may influence the outcome.
Surgical correction
To see actual photos of the procedure: However
If you are bothered by photos of actual surgery, you should skip this page.
Actual photos of procedure
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Comparison Occidental and Asian eyelids
Choices of folds
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