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Asian Eyelid Surgery in Beverly Hills

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The anatomy of the Asian eyelid is quite different from that of people of non-Asian descent. Non-Asian eyelids almost always have a natural fold near the lower portion of the upper lid, known as a “double fold.” However, while some people of Asian descent may have double-fold lids, about 50 percent of the Asian population lacks the natural fold just above the lashes in the upper eyelid, creating a “single fold” upper eyelid. Depending on the aesthetics of your face, this single-fold structure can prevent you from having the bright, defined eyes you desire.

Asian Eyelid Surgery (also called double eyelid surgery) addresses the unique needs of those with single folds to provide the facial appearance you want—enhancing your natural beauty while maintaining your ethnicity.

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Am I a Candidate for Asian Eyelid Surgery?


Candidates for Asian Eyelid Surgery should be physically healthy and have realistic expectations of their results. Potential candidates for Asian Eyelid Surgery may also have one or more of the following issues:

  • Small or non-existent upper eyelid folds,
  • Uneven or asymmetric eyelid folds
  • A fatigued or dulled expression due to weakness in the eyelid muscle
  • Excessive eyelid skin on the inner corner of the eye (inner epi)
  • Forehead wrinkles formed because of the constant raising of your brows to widen your eyes
  • Eyelids that droop over the top portion of your eye
  • Puffy eye appearance due to excess fat in your lids
  • Fatigue or headaches

Even if you don’t have any of the above issues, you may choose Asian Eyelid Surgery simply because you wish to have your eyes appear wider or more open for aesthetic reasons.

Choosing the Right Surgeon for Asian Eyelid Surgery


Because there is a wide variety of eyelid types, not every surgeon is qualified to perform double eyelid surgery. An internationally recognized expert trained Dr. Lee in double eyelid surgery, and his experience in Asian Eyelid Surgery procedures is unmatched. Choosing a highly skilled and experienced surgeon in double eyelid surgery will maximize your chances of an excellent outcome.

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How Is Asian Eyelid Surgery Performed?

Depending on your needs and desired results, Dr. Lee will use one of two double eyelid surgery techniques for your procedure.

  • Non-incisional Eyelid Surgery (DST – Double Sutures and Twisting)

    This procedure relies on weaving a fine thread on the undersurface of the eyelid to have it crease at the desired location. Typically, the procedure works best on patients under age 25 who need no skin removed, have thin skin and little fat, and desire a crease on the smaller end of the spectrum. It also works best if both eyes are symmetrical and have little ptosis (muscle weakness). While minor lid asymmetries and ptosis can be corrected, the results are less precise than an incision technique. It does not work well if you have had prior surgery, whether an incision surgery or multiple prior suture surgeries. The average longevity of this procedure is approximately seven years, in Dr. Lee’s experience. The advantages of this procedure are its short downtime, potential reversibility, and natural look.

  • Anchor Incisional Eyelid Surgery

    This class of procedures gives the most flexibility to size, shape, and precision. It can correct varying degrees of asymmetry and muscle dysfunction (ptosis). The drawbacks are the slightly longer recovery period and the importance of finding an experienced surgeon due to the long learning curve in getting a natural-looking result. Scarring is usually minor in non-smokers and patients who do not have healing issues. (Due to its thin nature, generally, the eyelid skin heals very well, even if other body parts scar easily.)

    In some cases, you may need more correction, in which case, Dr. Lee may need to perform an inner epi or eye enlargement procedure.

  • Inner Epi (Removal of a Mongolian Fold)

    An inner epi or medial epicanthoplasty is performed if excessive skin at the inner corner of the eye interferes with a smooth crease formation. A newer technique called the redraping method makes incisions along the borders of the Mongolian fold and leaves minimal visible scarring.

  • Eye Enlargement by Cutting Outer Corners

    This works best on patients with eyes that slant upward excessively. The attachment to the outer eye socket is lowered to a more horizontal position, effectively widening the eye. It is less preferable to drop a horizontal eye to a downward-slanting eye, which increases the visibility of the whites of the eye but can create an artificial, operated-on look.

Non-incisional Eyelid Surgery (DST – Double Sutures and Twisting)

Anchor Incisional Eyelid Surgery

Inner Epi (Removal of a Mongolian Fold)

Eye Enlargement by Cutting Outer Corners

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How Long Will My Asian Eyelid Surgery Results Last?

The results of non-incisional eyelid surgery typically last up to seven years. Incisional Asian Eyelid Surgery results are considered permanent, though age and genetics may eventually cause some eyelid ptosis.

How Much Does Asian Eyelid Surgery Cost in Beverly Hills?

The cost of Asian Eyelid Surgery with Dr. Charles Lee may vary depending on the patient’s needs and the selected surgical approach. A price quote will be provided during your consultation with Dr. Lee.

Learn More About Asian Eyelid Surgery in Beverly Hills

When you’re ready to undergo double eyelid surgery, it is vital that you choose the right surgeon. Dr. Charles S. Lee is trained specifically in Asian Eyelid Surgery, and has extensive experience performing double eyelid procedures. To schedule an appointment, call today at (310) 271-5954 or complete the online contact form.

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Asian Eyelid Surgery FAQ

  • What techniques are used in Asian Eyelid Surgery?

    Asian Eyelid Surgery can be either incisional or non-incisional. Anchor blepharoplasty is an incisional method of creating a crease, giving the patient a double eyelid. To achieve this, the skin is cut, tissue is excised, and the skin is attached to a firm structure within the eyelid (tarsus, AKA tarsal plate). While many doctors simply attach the skin to the levator muscle, Dr. Lee prefers to additionally attach the skin to a deeper structure, the tarsal plate, along with the levator muscle. Whereas the levator muscle moves with the eyelid, the tarsal plate is static. Attaching the skin to both structures allows for greater precision when placing the crease and also reduces the possibility of fold failure. Medial epicanthoplasty, another incisional technique, is often used in conjunction to crease surgery to remove any excess inner fold skin (Mongolian fold) and allow the new eyelid crease to fold more smoothly.

    The Double Suture and Twisting (DST) technique is a non-incisional method of creating a crease in the eyelid. Instead of being cut, the eyelid is simply stitched together. While the DST technique requires specific conditions in the patient to work to its full potential, it is an excellent technique for younger, qualified patients, as it is less invasive and involves less swelling and a shorter recovery than incisional techniques.

  • What are the limitations of DST suture-only surgery?

    1. 1. Small crease height. No skin is removed, so the crease will be smaller and more mobile than an incision technique. There is less control over the final size and shape.
    2. 2. Limited ptosis repair. If you have asymmetry of the eyes, and particularly if one eye is droopier than the other, there will be more limitation in how evenly the eyes can be matched up to each other. The resting tension of the eyelid-elevating muscle can be adjusted from the undersurface of the eyelid and incorporated into the DST procedure, but the correction is more difficult to control precisely, as can be done with an incision approach.
  • What is “fold failure” and why does it happen?

    Double eyelid surgical methods can lead to fold failure for various reasons. Some incisional procedures fail because of limited dissection, while others fail because of the location where the skin/muscle is secured. For instance, the popular technique of securing the skin to the levator aponeurosis can lead to an imprecise crease and a higher rate of fold failure. This is why Dr. Lee additionally secures the skin to the tarsal plate and levator tendon when performing anchor blepharoplasty.

    Similarly, traditional suture techniques often fail because the sutures are merely buried in the lid, creating the potential for the sutures to tear through the soft tissue of the upper eyelid. The DST technique resolves these issues by securing the skin/muscle to the tarsal plate to create a more permanent crease with a far lower risk of fold failure.

    The two most common types of eye anatomy prone to fold failure are: 1. Deep-set eyes and 2. Patients with eyelid ptosis (weak eyelid muscle). Deep-set eyes strain the incision line and have a higher risk of breaking it. Patients with ptosis have incomplete opening of the eyelid so that the crease cannot form very firmly and is prone to breaking.

  • Does insurance cover double eyelid surgery?

    If you wish to undergo Asian Eyelid Surgery for purely aesthetic reasons, it is highly unlikely that your insurance will cover the procedure. However, in some cases, corrective eyelid surgery can be covered by insurance. Patients with a condition known as ptosis have a drooping eyelid that interferes with vision, sometimes caused by a weakened levator muscle. Weakened levator muscles are often seen in younger patients with congenital ptosis. Other causes of a drooping eyelid is the dehiscence of the levator from the tarsus, which is the loosening or detachment of the eyelid muscle, and commonly occurs in older patients as part of the aging process. A visual field test can determine whether your ptosis is severe enough to have correction be covered by PPO health insurance.

  • Can BOTOX® Cosmetic help with excess forehead wrinkles and an angry look?

    If the angry look is a by-product of having your upper visual field blocked, then you need to correct the eyelid surgically. BOTOX® Cosmetic will reduce the frown lines at the expense of dropping the brows and a return to a loss of your upper visual field.

  • My upper eye socket is hollow and my brows are very high. Why is this? Can I use fillers and BOTOX® Cosmetic for this?

    Frequently, a retracted brow is caused by its attempt to help open a weak upper eyelid. This also creates an upper eyelid socket hollow. Correction requires adjusting the upper eyelid muscle tension and then repositioning the eye fat which, has been sucked up under the eye socket. BOTOX® Cosmetic will have the unwanted effect of drooping the eyelid; fillers will create a similar problem by making the upper eyelid heavier and burdening the already-weak eye muscle.

  • What types of eye anatomy are more difficult to operate on and at higher risk of a poor outcome?

    Eyes that bulge forward are at risk for creasing at the wrong location. Similarly, patients with ptosis requiring correction at the time of crease surgery are also at risk for this. In these instances, there is not much clearance between the elevating muscle and the overlying skin. Therefore, the muscle can “catch” the upper lid skin as it is opening. For these reasons, very little fat should be removed for patients with at-risk anatomy. In some cases, fat grafting to the upper lid is necessary to create more distance between the skin and the moving muscle.

  • What is ptosis?

    This is a droopy eyelid. The cause of this is related to either a weak eyelid muscle (which you are born with) or a detachment of the muscle from the tarsus (the cartilage skeleton of the lid margin), usually associated with aging. Ptosis, in Dr. Lee’s opinion, is more common in Asians, affecting as many as half the patients undergoing Asian Eyelid Surgery. Depending on the cause, the muscle needs to be reattached (if detached), or it needs to be strengthened/shortened so that the eyelid is in the proper position at rest.

  • Will I end up sleeping with my eyes open?

    This is not likely to happen unless you have ptosis requiring significant shortening of your eyelid muscle. In many such cases of ptosis repair, the eyes will be able to close over time.

  • Is Asian Eyelid Surgery painful?

    Pain is minimized during the procedure by placing you under IV anesthesia, which makes you sleepy and comfortable. Post-operatively, the minimal pain is controlled with simple TYLENOL®.

  • What other risks are associated with Asian Eyelid Surgery?

    The chances of a poor outcome decrease with the skill and experience of the surgeon. Asymmetry or an unnatural look are the most common complications, but an experienced surgeon can point out whether your anatomy is more difficult than the typical patient’s. Patients with ptosis or protruding eyes are at higher risk for revision surgery. Certain patients have poor healing characteristics, especially those who bruise easily, smoke, or have very distensible joints.

  • What scars should I expect from Asian Eyelid Surgery?

    If Dr. Lee uses the non-incisional method, you will not have scars after your double eyelid surgery. The incisional method does leave scars, but they are very small and hidden in the natural creases of your eyelids. Incision scars may appear pink or noticeable initially but will fade quickly as they continue to heal.

What techniques are used in Asian Eyelid Surgery?

What are the limitations of DST suture-only surgery?

What is “fold failure” and why does it happen?

Does insurance cover double eyelid surgery?

Can BOTOX® Cosmetic help with excess forehead wrinkles and an angry look?

My upper eye socket is hollow and my brows are very high. Why is this? Can I use fillers and BOTOX® Cosmetic for this?

What types of eye anatomy are more difficult to operate on and at higher risk of a poor outcome?

What is ptosis?

Will I end up sleeping with my eyes open?

Is Asian Eyelid Surgery painful?

What other risks are associated with Asian Eyelid Surgery?

What scars should I expect from Asian Eyelid Surgery?

Before & After Photos

Patient Testimonials

I know several people who had work done on the face and body by Dr. Charles Lee of Beverly Hills. I can say that every one of them looks terrific. They are the best advertisement for Dr. Lee, and the reason why I went to him for my eyelid surgery. Now, I look terrific too…
Dear Dr. Lee
I wanted to take this time to express my deepest gratitude to your for the epicanthoplasty you did for my eyes. It takes such tremendous precision, skill and experience to do what you did and I am truly pleased with the results. Not only are you one of the world’s finest surgeons, you are also compassionate. I admire your keen eye and mastery as a surgeon…
I had kind of puffy eyes and didn’t think double eyelid surgery would help with that, but Dr. Lee somehow gave me not just beautiful double eyelids but took away the puffiness! Now, even my profile has changed: The side view of my eyes used to look like I had been crying for hours but no more! Dr. Lee is truly gifted and I wish I had gone to him years ago instead of agonizing about it for all that time…

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