Upper Eyelid & Eyebrow
Why get a double eyelid?
In this part of the world, an upper lid blepharoplasty to create a “double eyelid” is a commonly done procedure. “Double Eyelid” is the colloquial term for creating a supra tarsal crease, which is considered attractive. May people feel that this makes the eye bigger and more attractive. Contrary to popular belief, few Asian women do this because they want to look more “Caucasian”. It is done simply because have a crease makes the eye aesthetically more pleasing. It also makes the eyes look bigger and less slitty. Having a prominent double lid may make a man look feminine and one has to be careful about how it is done.
Double eyelid only to create a crease?
Dermatochalasis is the condition where there is excess, loose skin of the upper lid. Mild laxity makes the eye look old. When the excess skin is severe, it will fall over to the eye and obstruct vision. Surgery to correct a visual field defect is considered surgery for “medical” reasons. The fees are claimable from health insurance and Medisave.
Lateral Hooding & double eyelids
Loose skin covering the corner of the eye is called “lateral hooding”. During the pre-op consultation, may patients typically pinch that loose piece of skin, lift it up and ask: “simply remove this piece of skin” so that my eyelid does not droop”, however, IT ALMOST NEVER WORKS because something needs to be done about the eyebrow. The outer corner of the eyebrow descends more than the inner end of the eyebrow. Cutting more and more skin is like trimming more of the hem of a pair of loose pain of trousers. The trousers need to be pulled up and secured with a belt instead.
Lateral Hooding after double eyelid surgery
The more skin that is excised from the upper eyelid, the lower the eyebrow will descend. This shortens the distance between the eyebrow and the upper eyelid margin. A Brow lift prevents this but a brow lift is a very unpopular procedure in the part of world. Many patients think that an easy compromise is to excise extra upper eyelid skin. This will not properly correct the lateral hooding. Instead, the eyebrow falls even lower. It will look like is almost lying on the upper lid. Inspite of the hype, the “non-surgical, scarlesss” methods are not enough to lift the eyebrow when there is too much excess skin
What you do not want after double eye lid surgery
Normal Eyes are not round. This is from over excision of skin or too much shortening of the upper lid. Not only is it ugly, it can cause dry eyes
Normal Eyes are elliptical. The upper lid should overlap the limbus by 1 – 2mm. The lower lid should just touch the limbus (black round part of the eye)
When the upper lid has been shortened too much, the upper eyelid becomes “retracted” and cannot close adequately. This will make the eye dry.