Upper blepharoplasty is a term used to denote upper eyelid rejuvenation. However in Asia, upper blepharoplasty has two meanings. One is to make the eyes look younger, the other is to create a crease above the lashes. To make things simpler and clearer, I believe that it is better to say upper blepharoplasty if the goal of the surgery is to restore the youthful appearance of the eyes. Whereas, DUOBLE EYE LID SURGERY is a more appropriate term to denote a procedure where in the goal of the surgery is to make the line above the lashes creating two eyelid components.  These terms should never be mixed up because each procedure has its own indications and uses.

Upper blepharoplasty is actually a western procedure and is indicated for patients 40’s and up. These individuals are usually complaining of an excessive skin over the eyes which are typically covering their vision. Some also feel that these makes them very tired looking or even older looking. Fat herniation is also a common occurrence due to the lack or weakened elasticity of the orbicularis oculi muscle. When these happened, skin excision together with fat debulking are warranted to achieve a superior result.

The Asian eye, especially those of northern decent, is very much different due to the absence crease above the lashes. Studies have showed that 50% of Asian lack the supratarsal crease. According to them, the absence of the line makes them very monotonous in their facial expression. They somehow feel that they are impassive or emotionless. In 1896, a Japanese doctor named Dr. Mikamo performed the first double eyelid surgery. This is in response to the more and more women who were seeking eye improvement. At that time, the Japanese women were exposed to western people noticing the absence of the line in their upper lids. Dr Mikamo used sutures and small incisions to finally create two upper eyelid components.

Today, the double eyelid surgery has been modified by many surgeons to answer the needs of the patient. The principle behind this surgery is to be able to tuck the levator apponeurosis high enough to the skin showing an evident and beautiful crease above. One can do this the conventional way where in a full incision is utilized. The other is to tuck in non absorbable suture in the level you want to have the line. This level is most of the time 6-8mm from the lash line. This is also called double eyelid surgery using buried sutures. Each procedure has its advantages and disadvantages. (For more info you can contact any FACES fellow).