Monolids and Double Eyelid Surgery (Asian Blepharoplasty) – by Leading Oculoplastic Surgeon, Dr Sabrina Shah-Desai, in London

What is Double Eyelid Surgery?

Double Eyelid Surgery, otherwise referred to as “Asian Blepharoplasty”, is a surgical procedure designed to give a refreshed, wide-awake appearance in Asian patients. The goal of an Asian Blepharoplasty is to fashion a natural upper eyelid crease: creating a bespoke eyelid shape that stays true to the patient’s ethnicity.

When it comes to correcting eyelid issues, Surgical Blepharoplasty is the gold standard: providing excellent and long-lasting results, while allowing us to treat moderate to severe cases of puffy upper eyelids and lash ptosis. Otherwise, we can perform a Non-Incisional Blepharoplasty: this uses a running stitch to tighten loose skin, enabling the correction of mild eyelid concerns. This is a gentler correction and requires less downtime, making it perfect for patients seeking a temporary, scar-free correction.

What causes double eyelids?

Nearly half of people with Asian ethnicity are born with no upper eyelid crease (often described as a “single” or “mono” eyelid), which can cause the lashes to droop into the visual axis (referred to as “lash ptosis”). Sometimes the eyelid is droopy, or has a ptosis, and this can also cause a tired or “sleepy” appearance; while some patients also have a “mongoloid fold” or an epicanthic fold at the nasal corner. Dr Shah-Desai is a leading international oculoplastic surgeon who performs double eyelid surgery in London as well as providing non-surgical options such as PLEXR for patients who want to avoid surgery.

How does the procedure work?

Double Eyelid Surgery helps to create a “wide awake” appearance by creating a crease in the upper lids, where it would naturally occur. Excess skin and muscle are removed, as well as fat, if they are contributing to a puffy look.

Double Eyelid Surgery, or an Asian Blepharoplasty, can be performed in two ways. The first uses an incision, which enables the scar to be hidden in the crease, and requires 2 weeks of downtime, with the scar being fully settled by 3 months. The second uses a running stitch to create the crease, and requires no incisions – and therefore does not leave a scar. The recovery is faster – approximately 1-2 weeks – however the procedure only lasts 1-4 years.

Double Eyelid Lift Surgery is performed under local anaesthetic as a day case – so you can go home the same day.

  • ‘No scar’ – cut is hidden in the natural eyelid crease, or not required if using a running stitch
  • Long-lasting results – from 2 to 10 years
  • Unrivalled expertise – performed by leading oculoplastic surgeon

Double Eyelid Surgery – Before & After Gallery

Disclaimer: Your results may vary. Any specific claims or length of results vary for each patient and are not guaranteed.

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Patient Questions

Frequently Asked Questions

Why choose Double Eyelid Surgery?

Asian patients often have an upper eyelid crease, however it is so close to the eyelashes that it is not visible. They can also have fat or excess skin in their upper lids, which can cause the lashes to turn inwards and touch the eyeball – and, if left untreated, this can cause scarring of the front surface of the eye, light sensitivity and ocular discomfort. Asian patients often have a droopy eyelid called Ptosis and sometimes can have a nasal fold of skin called “Epicanthic or Mongoloid fold”.
Double Eyelid Surgery can correct these issues by creating a more visible upper eyelid crease and removing excess fat and/or skin.

There are also options to have a non-incisional double eyelid treatment, for patients looking for reduced downtime and a temporary procedure without scars. The surgical procedure can be customized to retain ethnicity with a “lateral flare crease”, “nasal slant crease” or a “parallel crease”. Some patients desire a more “westernized look” and the crease can be modified accordingly. For the epicanthic fold, a “magic epicanthoplasty”, hidden inside the inner corner of the eye, can help to open up the eye a bit more. In addition, eyelid ptosis and eyelash ptosis can also be addressed to open up the eye, and Dr Sabrina can discuss this at your consultation.

How do Surgical and Non-Incisional Asian Eyelid Treatment vary?

A Surgical Blepharoplasty is the gold standard in correcting eyelid issues. It provides excellent, long-lasting results for the patient and allows Dr Sabrina to treat moderate to severe cases of puffy upper eyelids and lash ptosis. Meanwhile, a Non-Incisional Blepharoplasty uses a running stitch to tighten loose skin, allowing for the correction of mild eyelid concerns. This is a gentler correction and requires less downtime, making it perfect for those seeking a temporary, scar-free correction.

What is the recovery time with Double Eyelid Surgery?

For a Surgical Double Eyelid Treatment, it takes one week to recover from the initial surgery. During that time you can go about your normal activities while healing, though you will not be able to exercise or put your body through extraneous strain. After one week the stitches will be removed.
For a Non-Incisional Double Eyelid Surgery, the eyelids will swell temporarily. However, this settles in 48-72 hours, and can be lessened through use of oral anti-inflammatory tablets.

What are the risks and complications of Double Eyelid Surgery?

The risks of Double Eyelid Lift Surgery include:

  • Infection: This is very rare; however, occasionally the stitches may become infected or inflamed. This can be swiftly settled with oral and topical antibiotics.
  • Scarring: Generally, scars are hidden in the skin fold. Stitches are normally visible for the first week, then, when they are removed, a faint scar is visible. While the scar may seem thickened and red for 6 to 12 weeks, it will gradually become almost invisible after that period. While not every scar heals equally well, silicone scar remodelling gel can improve the appearance of a thickened or reddened scar – however, the treatment needs to be continued for several months to have a good result.
  • Large bruise or haematoma: This is minimised by regular use of ice packs, avoiding heavy exercise for 2 weeks after surgery, and stopping aspirin and other anticoagulants (if safe so to do) 2 weeks pre-operatively. If you do experience a haematoma, you may have to go back into theatre to have the blood clot removed, and have your stitches redone. This runs the risk of a worse scar.
  • Theoretical risk to vision: Any eyelid surgery carries the risk that an undiagnosed infection or bleed could damage the optic nerve. This is so rare that, by comparison, a normal car journey poses a much greater risk to your vision.
  • Asymmetry of eyelid shape, height, upper lid fold or fullness: This is rare, but can occur. Often, asymmetry may be due to lid bruising and therefore settles as the swelling resolves. Rarely, this may require revision surgery. Occasionally pre-existing asymmetry of the face, eyebrow or eyeball position may be responsible; however. this will be discussed with you prior to the operation by your surgeon.
  • Temporary poor blink: This can occur as the muscle responsible for closing eyelid has been cut – in order to access the muscle that lifts the eyelid. Generally, blinking returns to normal within 12 weeks.
  • Droopy eyelid or lash ptosis: This can happen rarely and will need to be corrected by re-operation.

About Dr Sabrina Shah-Desai MS, FRCS

Dr Sabrina Shah-Desai is a distinguished oculoplastic surgeon and one of London’s leading eye specialists. She has over two decades of surgical experience and is renowned for her ability to create a natural look.

Dr Sabrina has a deep anatomical knowledge of the periorbital area and an appreciation for the differences in treating both men and women. When raising the brows and eyelids in a male Upper-Lid Blepharoplasty, it is important to preserve the T-shaped brow – in order not to feminise their appearance.

Asian Blepharoplasty Reviews

Double Eyelid Surgery Cost

Non-Incisional Double eyelid surgery £5,500
Double eyelid surgery £5,500

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