The Complete Guide to Double Eyelid Surgery


A qualified cosmetic surgeon can perform this procedure for those who meet specific criteria. A thorough consultation and a physical examination are conducted to discuss your goals.

You should bring someone with you to drive you to and from the surgery and stay with you for the first night following it. You should also wear loose, comfortable clothing.

What is blepharoplasty?

Your eyes’ look can be significantly enhanced with blepharoplasty or double eyelid surgery, restoring youthful appearance and improving confidence. It can also reduce the early, telltale signs of aging around the eyes and in the upper and lower lids.

The procedure is performed in your surgeon’s office-based surgical facility or an outpatient surgery center. You will be placed under local anesthesia or sedation to ensure your comfort.

For the upper eyelids, your surgeon makes a cut in the natural fold and removes or redistributes excess skin. For the lower eyelids, your surgeon creates an incision in the crease of the eye or inside the eyelid and may redistribute or remove excess fat. Your surgeon will then close the cuts.

You should anticipate facial and eye puffiness and bruises during your recovery. This is normal and will resolve over a week or so with cold compresses and keeping the head elevated. It is important to avoid aspirin and NSAIDs like ibuprofen (Advil, Motrin) and naproxen sodium (Aleve), which can increase bleeding and increase the risk of blood clots.

How does it work?

Two main methods of creating a double eyelid crease are stitching and cutting. The stitching technique uses buried sutures that simulate the natural attachments between the deeper upper eyelid muscle and the overlying eyelid skin that create an eyelid crease line. The resulting internal scar tissue helps to stabilize the crease over time.

The suture method has a lower risk of complications and less downtime than the incision method. However, it is not ideal for patients with severe ptosis who require additional procedures like epicanthoplasty or those in need of excess fat, muscle, and skin removal.

Incision method blepharoplasty may be better suited for these cases since it allows for more precise adjustments of the crease line and can address concerns such as a lateral canthal tilt (a common trait in Asian eyes). A good surgeon will carefully assess your goals to ensure that the created crease is well-balanced in height and curvature, whether you want it higher or lower than your existing one. This is important because the resulting crease can be permanent.

What is the recovery like?

Your doctor may instruct you to take time off from work, school, or other activities to recover appropriately. Having someone else cover your responsibilities during this time is also helpful in reducing stress and pressure.

You should avoid medications containing aspirin, which can increase bleeding during and after surgery. It would help if you also stopped taking supplements that can cause bleeding (fish oil, cranberry extract, etc). Lastly, to lower the risk of wound complications following surgery, smokers need to give up at least four weeks before and following surgery.

Immediately following surgery, your eyes might feel itchy, dry, sticky, or more light-sensitive than usual. This is normal and will disappear over a few days as swelling and bruising fade. It’s important to protect your eyes from the sun and dust after surgery by wearing sunglasses whenever you go outdoors. Additionally, you can use artificial teardrops if your eyes get itchy or irritable to prevent them from being rubbed and to help wash away any dust particles that enter the area.

Is it safe?

Double eyelid surgery is one of the safest plastic surgeries, provided it’s performed under local anesthesia. However, a patient must be mature enough to thoroughly understand and participate in the procedure. This can be verified in the preoperative consultation.

The procedure is also an excellent choice for those with excess fat or sagging skin on the upper eyelids, which can make them look old and tired. But it’s essential to remember that the surgery is not a miracle cure and will not eliminate fine lines or crow’s feet around the eyes.

The most common technique for Asian blepharoplasty involves creating a new eyelid crease using a combination of sutures and glue. This method is non-invasive and can have a permanent effect. However, it may not be suitable for patients with excessive fat or skin hooding and is not recommended for those who need accompanying procedures such as eyelid ptosis surgery. The incision method can be a better option for these cases, offering more permanent results.

Are there any risks?

The surgeon will perform an eye exam to ensure the procedure is safe. This may include an assessment of tear production and a visual field test. In addition, the physician may take pictures of your eyelids from various perspectives and record any extra skin you may have. This documentation can help support an insurance claim.

The surgeon will ask you to stop smoking if you currently smoke before the procedure. Smoking raises your chance of problems and slows down the healing process. You may have bruising, swelling, and dark circles under your eyes for a few weeks after the procedure. This can be prevented by applying cold compresses and taking pain medication as needed.

Some people have mono lids and want to create a double eyelid fold to look more Westernized. Others have a double eyelid on one side and a single on the other and desire improved symmetry. It is essential to discuss your goals for the procedure with Dr. Liew so that he can help you achieve your desired results.