This is an extremely technical operation that requires significant precision and skill. I liken this operation to microsurgery as the sutures and precision required to create symmetry and the functional crease with the levator aponeurosis to be of equal value. I perform this operation under high magnification and place sutures as precisely as I do with blood vessels that are less than 1 mm in diameter.
The double eyelid operation is one of the most popular procedures performed in Asia. It must be performed keeping in mind the natural aesthetics of the Asian eye, not merely to Westernize the eye.
I spend a lot of time with the patient setting the height of the new lid crease. This is a highly personal choice by the patient, which must be followed precisely during the operation. It is important to remember that the lid height can always be shortened, but at a later date cannot be lengthened. This means that I pay great attention to the patient’s aesthetics about lid height and whether more or less lower lid show is desired. Some patients desire a very natural, smaller crease, whereas some patients desire a much higher, glamorous lid height to place more makeup. These lid heights can vary between 5 mm to 9 mm.