Why double eyelid surgery can aesthetically improve the appearance of the eyes and face in Asians.


In this article, Dr. Kenneth Kim will discuss why double eyelid fold surgery can improve the appearance of one’s eye and overall facial impression.

To begin with, Asians that lack double eyelid folds (e.g., monolids or very small folds) often have skin that hang over and obstruct the upper aspect of the eye. When the upper aspect of the eye is partially covered, the natural contour of the eye is not revealed. Double eyelid surgery results in the removal of this obstruction revealing the eye’s natural and true shape. Ironically, some individuals oppose undergoing double eyelid surgery because they believe monolids are their natural eye shape and fear double eyelid surgery would result in an unnatural look, not an improved look. While this view can be appreciated it is not completely accurate. With the help of a surgeon who knows how to properly perform double eyelid surgery, double eyelid folds can actually enhance and bring out one’s natural eye.

A distinction should be made between natural, God-given eyes and natural looking eyes after double eyelid surgery. Certainly it makes sense that a natural eye is an unoperated eye, whether one has a natural double eyelid fold or not. But if a person has excess skin that obstructs revealing the entire eye, the eye may be in its natural state but not in its aesthetically optimized state. Consider an older individual with even minor amount of skin hooding down of their eyelids. It would be obvious if asked whether they look better now or when they were younger, without the hooded skin. Individuals that experience a onset of hooding are very aware of the obstruction and the unattractiveness to their eye shape because they had a baseline of what their eyes used to look like when they were younger. On the other hand, Asians that lack double eyelid folds do not have this baseline of comparison thus lack the ability to see the potential for improvement. Although some people may experiment with tape or glue to to mimic a double eyelid fold, it is difficult to obtain an ideal or optimal double eyelid shape or height with these temporary non-surgical methods.

What about individuals that do not have double eyelid folds but also do not have any excess skin or hooding? Would the appearance of these individuals improve with double eyelid surgery? The simple answer would be “yes”. You can come to this same conclusion by simply studying a person’s face without double eyelid folds or creases. Ask yourself what kind of image, impression, or feeling a fold or lack of folds gives. Most people would agree that double eyelid folds or creases provides a softer feel to one’s eye and face. It can be objectively said that someone with that has undergone double eyelid fold surgery when compared their eyes to prior to surgery, appear softer, prettier and that their overall facial expression has improved. For women, double eyelids provides for a more beautiful look. For men, double eyelids create a look kinder and more intelligent facial expression. It is advised that men request a very small fold which will provide them a slightly gentler feel without making them look feminine.

These positive changes in the face from double eyelid surgery are due to the following factors:
1. As previously discussed, double eyelid fold or crease makes the eye appear bigger by revealing the entire eye (taking away any excess skin or hooding);
2.Double eyelid fold or crease everts the eye lashes—again taking away any obstruction and opening up more of the eye;
3. Double eyelid fold or crease gives an impression of a softer and gentler feel to the person;
4. Various height, shape, and design of the fold gives them a more beautiful eyes that is harmonious to their other facial features;
5. Double eyelid surgery can correct any asymmetry of the eyes as even natural eyelid shapes and folds can be asymmetric;
6. Harmony and symmetry of facial features are key to the objectively beautiful face;
7. Patients who receive double eyelid surgery often receives epicanthoplasty and lateral canthoplasty which not only enlarge the eye horizontally but also makes the eyes look more balanced and improves the tilt of the eyes;
8. For women, double eyelid fold or crease allows them to apply eyeliner or makeup in ways which they could not do with monolids which even more so accentuates the eyes.

As mentioned above, the height, shape, and design of the one’s eyelid folds can give varying impressions of a person. Of all the features on the face, the eyes (and then the nose) have the strongest component to one’s appearance and how others view them. When one’s eye shape and nose match each other and are congruent, it creates a synergistic effect and dramatically improves one’s appearance.

The ultimate truth lie within before and afters and the responses not only from the patients themselves but from their close friends and family members. When surgery is done well, the response is that the eyes look beautiful and natural. With men, many times people cannot tell that they have had surgery as their folds are intentionally made very small. For women, people who have not known them before surgery will think that they were simply born with beautiful double eyelid folds. Ultimately, a feature where they may have had the most issue with becomes the feature that receives the most amount of compliments.

Our next article will discuss some other reasons people undergo double eyelid surgery. (e.g., eyelid ptosis and eyelash eversion).