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Semin Plast Surg 2009; 23(3): 185-197
DOI: 10.1055/s-0029-1224798
© Thieme Medical Publishers

Asian Blepharoplasty

Marilyn Q. Nguyen1 , Patrick W. Hsu2 , Tue A. Dinh3
  • 1Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
  • 2Department of Plastic and Reconstructive Surgery, M.D. Anderson Cancer Center, Houston, Texas
  • 3The Methodist Hospital System, Institute for Reconstructive Surgery, Houston, Texas
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Publication History

Publication Date:
13 July 2009 (online)

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ABSTRACT

One of the defining features between an individual of Asian descent and someone of Western descent is the presence of an upper eyelid crease. Approximately 50% of Asians do not have an upper eyelid crease. The double eyelid operation, or creation of a supratarsal crease, is the most common cosmetic procedure requested in Asia and the third most common procedure requested by Asian Americans. In this comprehensive article, we explore the art of creating an eyelid crease in the individual who either does not have a crease or has an indistinct crease. We will review the history of the development of Asian blepharoplasty, explain the anatomy of the Asian eyelid and how it differs from the Caucasian eyelid, and clarify how this anatomy then translates to differences in external appearance. The two main schools of surgical techniques will be discussed along with pearls, pitfalls, and personal observations.

KEYWORDS

Asian - blepharoplasty - double eyelid - supratarsal crease

REFERENCES

  • 1 Chen W PD. Asian Blepharoplasty and the Eyelid Crease. 2nd ed. New York, NY; Elsevier 2006
    Google Scholar
  • 2 McCurdy J A. Cosmetic Surgery of the Asian Face. New York, NY; Thieme Medical Publishers 1990
    Google Scholar
  • 3 Mikamo M. Plastic operation of the eyelid.  J Chugaiijishimpo. 1896;  17 1197
    PubMedGoogle Scholar
  • 4 Mikamo M. Mikamo's double-eyelid operation: the advent of Japanese aesthetic surgery. 1896.  Plast Reconstr Surg. 1997;  99 664 discussion 664-669
    PubMedGoogle Scholar
  • 5 Shirakabe Y, Kinugasa T, Kawata M, Kishimoto T, Shirakabe T. The double-eyelid operation in Japan: its evolution as related to cultural changes.  Ann Plast Surg. 1985;  15 224-241
    CrossrefPubMedGoogle Scholar
  • 6 Shirakabe Y. The development of aesthetic facial surgery in Japan: as seen through a study of Japanese pictorial art.  Aesthetic Plast Surg. 1990;  14 215-221
    CrossrefPubMedGoogle Scholar
  • 7 Uchida K. The Uchida method for the double eyelid operation in 1523 cases.  Jpn J Ophthalmol. 1926;  30 593
    PubMedGoogle Scholar
  • 8 Maruo M. Plastic reconstruction of a double eyelid.  Jpn Rev Clin Ophthalmol. 1929;  24 393
    PubMedGoogle Scholar
  • 9 Hata B. Application of eyelid clamp and beads in “double-eyelid” operation.  Jpn Rev Clin Ophthalmol. 1933;  28 491-494
    PubMedGoogle Scholar
  • 10 Hayashi K. The double eyelid operation.  Jpn Rev Clin Ophthalmol. 1938;  33 1000-1010
    PubMedGoogle Scholar
  • 11 Inoue S. The double eyelid operation.  Jpn Rev Clin Ophthalmol. 1947;  27 306
    PubMedGoogle Scholar
  • 12 Sayoc B T. Plastic construction of the superior palpebral fold.  Am J Ophthalmol. 1954;  38 556-559
    PubMedGoogle Scholar
  • 13 Mitsui Y. Plastic reconstruction of a double eyelid.  Jpn Rev Clin Ophthalmol. 1950;  44 19
    PubMedGoogle Scholar
  • 14 Fernandez L R. Double eyelid operation in the oriental in Hawaii.  Plast Reconstr Surg Transplant Bull. 1960;  25 257-264
    CrossrefPubMedGoogle Scholar
  • 15 Boo-chai K. Plastic construction of the superior palpebral fold.  Plast Reconstr Surg. 1963;  31 74-78
    PubMedGoogle Scholar
  • 16 Dobke M, Chung C, Takabe K. Facial aesthetic preferences among Asian women: are all oriental Asians the same?.  Aesthetic Plast Surg. 2006;  30 342-347
    CrossrefPubMedGoogle Scholar
  • 17 Kikkawa D O, Kim J W. Asian blepharoplasty.  Int Ophthalmol Clin. 1997;  37 193-204
    CrossrefPubMedGoogle Scholar
  • 18 Chen W PD. Upper blepharoplasty in the Asian patient. In: Putterman AM Cosmetic Oculoplastic Surgery. Philadelphia, PA; WB Saunders 1999: 101-111
    Google Scholar
  • 19 Anderson R L, Beard C. The levator aponeurosis. Attachments and their clinical significance.  Arch Ophthalmol. 1977;  95 1437-1441
    CrossrefPubMedGoogle Scholar
  • 20 Chen W PD. The concept of a glide zone as it relates to upper lid crease, lid fold, and application in upper blepharoplasty.  Plast Reconstr Surg. 2007;  119 379-386
    CrossrefPubMedGoogle Scholar
  • 21 Jeong S, Lemke B N, Dortzbach R K, Park Y G, Kang H K. The Asian upper eyelid: an anatomical study with comparison to the Caucasian eyelid.  Arch Ophthalmol. 1999;  117 907-912
    CrossrefPubMedGoogle Scholar
  • 22 Uchida J. A surgical procedure for blepharoptosis vera and for pseudo-blepharoptosis orientalis.  Br J Plast Surg. 1962;  15 271-276
    CrossrefPubMedGoogle Scholar
  • 23 Johnson C C. Epicanthus.  Am J Ophthalmol. 1968;  66 939-946
    CrossrefPubMedGoogle Scholar
  • 24 Baek S M, Kim S S, Tokunaga S, Bindiger A. Oriental blepharoplasty: single-stitch, nonincision technique.  Plast Reconstr Surg. 1989;  83 236-242
    PubMedGoogle Scholar
  • 25 Chen W PD. Review of Aguilar G. Complications of oriental blepharoplasty. In: Mauriello J Management and Avoidance of Complications of Eyelid Surgery. Vol. 3. Philadelphia, PA; Field & Wood 1994
    Google Scholar
  • 26 Song R Y, Song Y G. Double eyelid operations.  Aesthetic Plast Surg. 1985;  9 173-180
    CrossrefPubMedGoogle Scholar
  • 27 Liao W C, Tung T C, Tsai T R, Wang C Y, Lin C H. Celebrity arcade suture blepharoplasty for double eyelid.  Aesthetic Plast Surg. 2005;  29 540-545
    CrossrefPubMedGoogle Scholar
  • 28 Lee Y J, Baek R M, Chung W J. Nonincisional blepharoplasty using the debulking method.  Aesthetic Plast Surg. 2003;  27 434-437
    PubMedGoogle Scholar
  • 29 Yang S Y. Oriental double eyelid: a limited-incision technique.  Ann Plast Surg. 2001;  46 364-368
    CrossrefPubMedGoogle Scholar
  • 30 Megumi Y. Double eyelid procedure by removal of transconjunctival orbital fat and buried sutures combined with sling technique to avoid wounding the eyelid.  Aesthetic Plast Surg. 1997;  21 254-257
    CrossrefPubMedGoogle Scholar
  • 31 Park J I. Orbicularis-levator fixation in double-eyelid operation.  Arch Facial Plast Surg. 1999;  1 90-95 discussion 96
    CrossrefPubMedGoogle Scholar
  • 32 Sheen J H. Supratarsal fixation in upper blepharoplasty.  Plast Reconstr Surg. 1974;  54 424-431
    PubMedGoogle Scholar
  • 33 Millard D R. Oriental peregrinations.  Plast Reconstr Surg. 1955;  16 319–336
    PubMedGoogle Scholar
  • 34 Bang Y H. The double-eyelid operation without supratarsal fixation.  Plast Reconstr Surg. 1991;  88 12-17 discussion 18-19
    PubMedGoogle Scholar
  • 35 Chen W PD. Concept of triangular, trapezoidal, and rectangular debulking of eyelid tissues: application in Asian blepharoplasty.  Plast Reconstr Surg. 1996;  97 212-218
    CrossrefPubMedGoogle Scholar
  • 36 Park J I. Z-epicanthoplasty in Asian eyelids.  Plast Reconstr Surg. 1996;  98 602-609
    CrossrefPubMedGoogle Scholar
  • 37 Kao Y S, Lin C H, Fang R H. Epicanthoplasty with modified Y-V advancement procedure.  Plast Reconstr Surg. 1998;  102 1835-1841
    CrossrefPubMedGoogle Scholar
  • 38 Yen M T, Jordan D R, Anderson R L. No-scar Asian epicanthoplasty: a subcutaneous approach.  Ophthal Plast Reconstr Surg. 2002;  18 40-44
    CrossrefPubMedGoogle Scholar
  • 39 Park J I. Modified Z-epicanthoplasty in the Asian eyelid.  Arch Facial Plast Surg. 2000;  2 43-47
    CrossrefPubMedGoogle Scholar
  • 40 Lee Y, Lee E, Park W J. Anchor epicanthoplasty combined with out-fold type double eyelidplasty for Asians: do we have to make an additional scar to correct the Asian epicanthal fold?.  Plast Reconstr Surg. 2000;  105 1872-1880
    CrossrefPubMedGoogle Scholar
  • 41 Yoon K C. Modification of Mustardé technique for correction of epicanthus in Asian patients.  Plast Reconstr Surg. 1993;  92 1182-1186
    CrossrefPubMedGoogle Scholar
  • 42 Cho B C, Lee K Y. Medial epicanthoplasty combined with plication of the medial canthal tendon in Asian eyelids.  Plast Reconstr Surg. 2002;  110 293-300 discussion 301
    CrossrefPubMedGoogle Scholar
  • 43 Chen S HT, Mardini S, Chen H C et al.. Strategies for a successful corrective Asian blepharoplasty after previously failed revisions.  Plast Reconstr Surg. 2004;  114 1270-1277 discussion 1278-1279
    PubMedGoogle Scholar
  • 44 Weng C J, Noordhoff M S. Complications of Oriental blepharoplasty.  Plast Reconstr Surg. 1989;  83 622-628
    CrossrefPubMedGoogle Scholar
  • 45 Kim Y W, Park H J, Kim S. Secondary correction of unsatisfactory blepharoplasty: removing multilaminated septal structures and grafting of preaponeurotic fat.  Plast Reconstr Surg. 2000;  106 1399-1404 discussion 1405-1406
    CrossrefPubMedGoogle Scholar

Marilyn Q NguyenM.D. 

Resident, Division of Plastic Surgery, Baylor College of Medicine

1709 Dryden, Suite 1600, Houston, TX 77030

Email: mqnguyen@bcm.edu

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