There are two types of Asian eyelids. Those with a double eyelid fold and those with only monolids (no double eyelid folds or crease).
In Asian eyelid surgery, the first thing to decide whether there are excess skin hooding or not.
If there is excess skin hooding, then it is obvious that the excess skin hooding has to be removed. If the patient does not have any double eyelid fold or crease, then doing a double eyelid surgery is the most logical choice. In this situation, the excess skin and fat are also removed simultaneously at the time of the Asian eyelid surgery.
However, in patients with natural double eyelid fold or crease, then there are two options:
One option is to remove the excess Asian eyelid skin just above the double eyelid fold. Although this option is simple, the negative is that the plastic surgeon is taking away the thin skin and leaving the thick skin. And since the brow had dropped with age, the eyelid looks puffy.
The other option is to remove the Asian eyelid skin just below the brow. The advantage of this technique is that the thick heavy Asian eyelid skin is removed while the patient’s natural double eyelid fold is preserved. The end result is that the patient’s Asian eyelid will look non-operated / natural.
It is important for the patient to have a careful evaluation of their Asian eyelid with a plastic surgeon.
Dr. Kenneth Kim is a board certified plastic surgeon in Los Angeles, California. If the patient has a natural double eyelid fold, he will determine whether the height of the double eyelid fold is adequate or optimal. Then Dr. Kenneth Kim will evaluate the brow distance to the double eyelid fold and determine what is the optimal choice to remove the excess skin hooding from age.