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Understanding Asian Eyelid Surgery: Upper Blepharoplasty Explained

Written by

Contour Clinic

Published on

September 4, 2025
Procedures

What is Upper Blepharoplasty?

Upper blepharoplasty, often called double eyelid surgery, is one of the most common cosmetic procedures in Asia. The surgery creates or enhances an eyelid crease, making the eyes look brighter and more defined. Many South East Asian patients naturally have monolids – eyelids without a crease – and choose this surgery to achieve a natural-looking fold.1 2

South East Asian Eyelid Anatomy

Asian eyelids are different from Western eyelids in several ways. About half of Asians do not have an upper lid crease. A small fold of skin (epicanthal fold) often covers the inner corner of the eye, giving the eyes their almond shape. Asian eyelids usually have more fat and tissue, which can hide the crease. When a crease exists, it tends to be lower and less pronounced than in Western eyes.3 4 5

How the Surgery is Done

There are two main approaches. The non-incisional (suture) method uses stitches to attach the skin to deeper tissue to form a crease. This is less invasive, heals quickly, and leaves no scar, but may not last as long in patients with heavy lids.6

The incisional method makes a fine incision along the new crease line. A small amount of skin or fat can be removed, and the crease is secured to deeper structures. This method is more permanent and is often used for fuller eyelids.7

Sometimes surgeons also perform an epicanthoplasty (adjustment of the inner corner fold) if needed to balance the look, but this is done conservatively to avoid visible scars.8

Risks & Safety

Most patients recover well, with mild swelling and bruising for 1–2 weeks. Risks are low when surgery is performed by experienced surgeons, but may include infection, scarring, or crease asymmetry. Over-removal of skin can make it difficult to close the eyes, which is why modern techniques are more conservative.9 10

Results & Satisfaction

When done carefully, Asian upper blepharoplasty provides a natural crease that brightens the eyes while maintaining ethnic identity. Studies show high satisfaction among patients, with improvements in both appearance and self-confidence. The key is a crease that matches the individual’s anatomy, usually set at a lower height than Western eyelids, so the result looks authentic.11 12

Dr. Vasinja performing rhinoplasty procedure at Contour Clinic Bangkok

References:

  1. Nguyen MQ, Hsu PW, Dinh TA. Asian blepharoplasty. Semin Plast Surg. 2009;23(3):185-197. https://pubmed.ncbi.nlm.nih.gov/20567708/ ↩︎
  2. Saonanon P. Update on Asian eyelid anatomy. Curr Opin Ophthalmol. 2014;25(5):436-442. https://pubmed.ncbi.nlm.nih.gov/25136807/ ↩︎
  3. Fakhro A, Yim HW, Kim YK. The Asian eyelid and eye appearance. Semin Plast Surg. 2015;29(3):135-144. https://pubmed.ncbi.nlm.nih.gov/26306086/ ↩︎
  4. Chen WP. Techniques in Asian blepharoplasty. Plast Reconstr Surg Glob Open. 2019;7(5):e2271. https://pubmed.ncbi.nlm.nih.gov/31211187/ ↩︎
  5. Burusapat C, et al. Anthropometry of Asian eyelids. Aesthetic Plast Surg. 2020;44(2):392-410. https://pubmed.ncbi.nlm.nih.gov/31873919/ ↩︎
  6. Baek SM, Jeong EC. Nonincisional suture technique for double eyelids. Plast Reconstr Surg. 1984;73(6):924-929. https://pubmed.ncbi.nlm.nih.gov/6711626/ ↩︎
  7. Chen SH, Mardini S. Asian upper blepharoplasty: modern incisional methods. Semin Plast Surg. 2009;23(3):185-192. https://pubmed.ncbi.nlm.nih.gov/20567708/ ↩︎
  8. Park JI, Cho BC. Epicanthal fold correction. Plast Reconstr Surg. 2000;105(5):1872-1880. https://pubmed.ncbi.nlm.nih.gov/10744222/ ↩︎
  9. Kang H, et al. Complications of Asian blepharoplasty. Aesthetic Plast Surg. 2007;31(2):198-204. https://pubmed.ncbi.nlm.nih.gov/17372796/ ↩︎
  10. Lin TY. Complications of Oriental upper blepharoplasty. Plast Reconstr Surg. 1990;85(4):537-544. https://pubmed.ncbi.nlm.nih.gov/2304979/ ↩︎
  11. Song J, et al. Long-term satisfaction after Asian blepharoplasty. Aesthetic Plast Surg. 2010;34(2):216-222. https://pubmed.ncbi.nlm.nih.gov/19777306/ ↩︎
  12. Hollander MHJ, et al. Functional outcomes of upper eyelid blepharoplasty — systematic review J Plast Reconstr Aesthet Surg. 2019;72(2):294–309. https://pubmed.ncbi.nlm.nih.gov/30528286/ ↩︎