Double Blepharoplasty: Purpose, Recovery and More

Double blepharoplasty is a cosmetic surgery performed to change the shape of the eyelid and add an upper fold. Also called Asian blepharoplastywere among the most common cosmetic procedures in 2022 (up 13% from 2019), in part due to the use of virtual platforms such as Zoom that focus on the eyes and face.

The double eyelid procedure is usually an elective procedure aimed at improving appearance, especially among people of Asian descent. In some cases, it can be used to correct eye and vision problems such as fall (drooping eyelid).

This article explains double eyelid surgery and what to expect if you’ve had the procedure. It outlines the reasons why some people should avoid the procedure (underlying medical conditions, for example) and the risks and complications that may arise.

What is double blepharoplasty?

Monoids are common in Asian populations, although not all people have them. For example, 50% of Mongolians do not have a clearly visible double eyelid, but most Chinese living in Malaysia do. The monoidal shape is different because of epicanthium fold, fold of skin inside canthus of the eye between the upper and lower eyelid that can change both appearance and vision.

With double blepharoplasty, a strip of tissue is removed and, as a result, a single eyelid turns into a double eyelid with a fold. Surgery can also help those with droopy eyelids that obstruct vision or even reduce forehead wrinkles because it changes the facial muscles you use.

There are several techniques used to perform double blepharoplasty, including:

• Laser assisted procedures
• Open seam methods
• Partial or non-incisional methods
• Techniques that vary in how they affect muscles, remove skin folds, or reshape fatty tissue near the eye

People considering double blepharoplasty can discuss various techniques with their healthcare providers. Some approaches may not be the best choice for a particular situation.

Contraindications

Double eyelid surgery is growing in popularity, especially among men. But while many people may seek out the procedure, it’s not right for everyone. Contraindications for submitting this procedure include:

Coagulation disorders are often a risk with any surgery. People with a history of thyroid disease should also discuss surgery with their healthcare providers, who will want to carefully evaluate your underlying medical history and medications you are taking.

Maturity level is also important. People must be old enough to cooperate and understand the risks and potential complications of the procedure. Otherwise, they will have to wait and undergo the procedure later.

Preparation for double eyelid surgery

You’ll start with an appointment to discuss your medical history, reason for surgery, and more with your plastic surgeon.

Expect significant focus on measuring your eyes and not just your visual acuity. Eye shape is central to the decision for double blepharoplasty, and measurements are taken from every angle of skin folds, muscle and eye size for each eye.

Before surgery, you may be asked to stop taking certain medications including:

You should also avoid smoking and sun exposure before surgery. Your provider will give you specific instructions on preparation.

What to expect on the day of surgery

This is what will happen when you go in for your procedure:

• About 30 to 45 minutes before the procedure, most people will be given oral medication, including Valium (diazepam) and Tylenol (acetaminophen).
• To numb the upper eyelid during surgery, the area will be injected with a drug such as xylocaine or lidocaine, and topical tetracaine will be placed on the white part of the eye. This is done so that during the procedure there is no pain.

Types of Procedures

The specific processes require different approaches. If your operation is a double incision blepharoplasty, then:

• The upper eyelid will be measured and marked with a pen.
• An incision will be made in the marked area.
• Some fat and muscle will be removed to make room for the fold.
• The incision will be closed with stitches or stitches, which will be removed after about a week.

If the suture method is used:

• The upper eyelid is measured and vertical lines are marked.
• The entry points are marked between the vertical lines.
• At each of the entry points, a small incision is made with a knife and a small amount of fat is removed if necessary.
• Sutures are placed through the opening and tightened as needed. These stay in place.

Recovery

Postoperatively, your surgeon will instruct you to use eye drops and apply prescribed ointment. Depending on the procedure, you may also need to have stitches removed in three or four days.

It is not unusual for there to be mild swelling and some discoloration for the first couple of days. To minimize this:

• Apply ice packs or a cold compress (such as gauze soaked in ice water and wringing).
• Keep your head straight and up.
• Avoid vigorous activity and heavy lifting.
• Stay out of the sun.

After surgery, you will be able to shower and wash your hair and even wash your face. It will be a few days before you resume your normal routine.

Complications of Double Blepharoplasty

This is a common and usually safe surgery, but several complications can occur with double blepharoplasty. They include:

• Hematoma (bleeding under the skin due to damage to blood vessels)
• Orbital cellulitis (infection of the skin around the eyeball)
• Dry eye (changes in how your eyes make tears or how quickly they dry)
• Drop (dropped eye) due to muscle injury during surgery
• Bleeding (serious bleeding that can happen often with surgery)

Other complications can affect the appearance, such as loss of symmetry in the shape of the eyes or other results you do not expect. It’s not uncommon for some people to need follow-up procedures for overly high creases, faded creases, or drooping eyelids.

Summary

Double blepharoplasty is often called Asian blepharoplasty because it is a highly sought-after procedure among people of Asian descent who want to change the shape and appearance of their single eyes. But it is an increasingly popular cosmetic procedure for people with double eyelids looking for rejuvenation or for people with medical reasons for the procedure.

Keep in mind that eye surgery is not for everyone. Talk to your healthcare providers about whether double blepharoplasty is right for you.