Introduction
Asian double eyelid surgery is the world's most requested cosmetic procedure. Dr Lamb's techniques are designed to enhance Asian beauty by creating an eyelid fold while maintaining the integrity of the Asian appearance. Double eyelid surgery can vary from a simple suture to a more complex procedure depending on the individual requirements of the patient. The aim of double eyelid surgery is not to ‘Westernise’ Asians. However, some people may choose to Westernise their appearance such as in the example below.
Making the decision to have eyelid surgery
During the pre-operative consultation, you will be examined and asked questions concerning tear production, use of contact lenses, eye drops and your expectations for surgery. Dr Lamb will examine your eyes and eyelids to exclude any problems that could affect a good functional result.
Many factors have to be considered in planning for successful surgery. The height of the brow and the position of the eyelid crease are critical to your result and these will be discussed and demonstrated during the consultation. The prominence of the eyes - whether due to the position of the eyes, excess skin or fat - must also be considered to achieve the desired cosmetic result. Epicanthic folds, the folds of skin at the inner corner of each eye are often prominent in Asians and can be altered by Epicanthoplasty if desired. Surgery to correct epicanthic folds is usually unnecessary for an excellent result. Epicanthic folds can also occur in Caucasians and surgical correction is often desired. As you can see in the photo below, excellent results can be achieved.
Understanding eyelid surgery
In double eyelid surgery Dr Lamb first marks the individual lines and creases on the lids in order to keep scars as invisible as possible within natural folds. The incision is made, and then excess skin, muscle and fat are removed using CO2 Laser. The use of laser greatly reduces swelling and bruising. Fine sutures are used to close the incisions, thereby minimising the visibility of any scar.
In lower eyelid surgery, the incision is usually made inside the lower eyelid. Excess fat is removed using the CO2 Laser, leaving no visible scarring. The lower eyelid skin usually requires tightening and this is done by skin excision. If less tightening is required laser can be used. This procedure is very common because of the prominence of fat in the lower lids of Asians.
Postoperative Instructions
No bending, lifting heavy objects or any strenuous exercises for ten days. Swelling is to be expected and can vary from mild to severe. For the first two days, frequent use of a cold compress is recommended. Take a clean bowl of cold water, add a clean facecloth, soak it in the cold water and squeeze it out. Place the facecloth over the incision site. When the cloth is no longer cool, rinse it again in the cold water. You could also use Johnson & Johnson or Swisspers eye makeup removal pads in replacement of a facecloth. A cold compress will reduce swelling and discomfort.
Do not use frozen peas, Cryo‑Gel™ Gel Packs etc. Use ONLY light cloths similar to what is supplied in theatre.
When lying down, use two to three pillows. During the day, it is best to keep moderately active. Lying down during the day will increase the swelling. You may take Paracetamol tablets if necessary for pain.
Risks
This procedure involves incisions on the outer surface on the upper lid and the inner surface on the lower lids. Complications can occur, but are rare.
Infection is always a possibility however this is uncommon after lid surgery.
Haemorrhage can occur and has the potential to affect eyesight however with laser surgery this is very rare. Dr Lamb has never seen this happen. Damage to the muscle in the upper or lower lid can result in a droopy eyelid. Precautions are taken for this not to occur but if it should occur, it can be repaired. Damage to a muscle in the lower lid can result in double vision. Usually this resolves, however it may require a further operation. If too much skin is taken from the upper eyelid, difficulty in closing the eye can occur. As the upper lid skin is incised, a scar may result. The incision is in the lid crease and will fade with time. However if one scars excessively it may be more prominent and require modification. Lid asymmetry can occur and may require modification. Some discomfort, swelling and possibly bruising can occur, however it is minimised by the use of laser.
