Why Asian Eyelids Can be More Easily Made Symmetrical

Symmetry is perhaps the hardest thing for me to fix.  I can improve one’s asymmetry but I can’t fix it.  In fact, in all my consent forms I state “the two sides of the body are not the same and can never be made the same,” a point that I typically try to underscore to every prospective patient who is considering a procedure no matter how big or small.  Curiously, when it comes to Asian blepharoplasty surgery, i.e., creating a crease in the upper eyelid, in most cases I can actually make the eyelids more symmetric even if one was born with a slight or gross asymmetry.  The reason for this is that the asymmetry results from a partial crease on one side and an absent crease on the other side that when I create symmetric creases surgically the asymmetry disappears. Let me explain it another way.  When one has a partial crease on one side and a non-existent crease on the other side, the side that has the partial crease typically has an eyelid opening that is wider or bigger than the side with a non-existent crease.  The reason for this is that the side without a crease has more fat that slides downward since the levator muscle does not insert into the skin crease causing the eyelid opening to be smaller on that side.  The side with a partial crease has less fat that slides down over the eyelid and therefore that side the eye opening is bigger.  When the surgery is performed and there is a much more durable and defined crease, then both eyelids open even more and look less “sleepy eyed” but typically also in a symmetric fashion.

Asian Eyelid Asymmetry

Anatomy of an Asian Eyelid

Samuel M. Lam, MD, FACS is a board certified plastic surgeon in Dallas, Texas. To schedule a Asian eyelid consultation please call (972) 312-8188. To Learn more about Dr Lams’ Asian blepharoplasty visit /procedures/asian-blepharoplasty surgery or to ask Dr Lam a question please visit his Asian plastic surgery forum.