Aesthetic eye surgery in the Asian population is on the rise in Italy and has a significant impact on patients.
The anatomy of the eyelids is different in the Asian population compared to the Caucasian one, and understanding and respecting these anatomical variations allows for optimal results even in patients from this ethnic group.
Chinese version here: 东方或亚洲眼睑整形术
Specifically, the upper eyelid shows some significant racial variations, the most notable being the following: the upper eyelid fold is very low (3-4 mm from the lashes) near the lash margin, while in Caucasians it is much higher (8-9 mm from the lashes).
Moreover, the upper eyelid crease is always full and not hollowed: the combination of a low eyelid fold and a full crease creates a continuous upper eyelid from the eyebrow to the lash margin, which is typical of the oriental ethnic group.
At the inner corner, near the nose, the lower eyelid has a more or less noticeable fold called the epicantal fold. The external corner cut, which is higher than the inner corner, combined with a low upper eyelid fold, a full upper eyelid crease, and the epicantal folds, characterizes the so-called almond-shaped eye.
Obviously, there can be significant individual variations, but respecting these anatomical concepts allows for the desired results.
In my experience, not all Asians desire a Western look; in fact, the vast majority seek rejuvenation while maintaining the natural features of their gaze.
In all this, the aging mechanisms of the gaze are similar for both Caucasians and Asians… skin sagging and swelling in the upper eyelids and bags in the lower eyelids.
So, how should we proceed to rejuvenate the Oriental gaze while keeping its racial characteristics intact? Blepharoplasty is always performed, but with some specific techniques applied to the Oriental population.
For the upper eyelids, the incision is made in the natural fold, no matter how low it is, with minimal removal of fat, only where there is clear excess. Often, it is necessary to compare photos of the patient from their youth to assess the amount of tissue that needs to be removed. At the end, during skin suturing, the natural fold is reformed in its original position.
For the lower eyelids, the bags are removed through the internal approach, with excision or repositioning of the existing eyelid fat. No external incisions are made on the lower eyelids, and the design and shape of the Oriental eye are fully respected. In cases where there is a request to Westernize the gaze, we intervene by slightly modifying the Oriental features, acting on both the upper and lower eyelids.
For the upper eyelids, the eyelid fold is raised to 8-9 mm, creating a double upper eyelid fold. Fat is removed in a somewhat aggressive manner from the upper eyelid to deepen the upper crease. With this technique, the almond shape is maintained, but the gaze becomes less distinctly Oriental.
For the lower eyelids, we always intervene through the internal approach to remove or reposition the fat, but at the end, a small 3mm incision is made below the lashes to form a lower fold. The nasal epicanthal folds and the outer corner are not modified. The result is natural, and no external scars are visible.
