Asian Eyelid Aesthetic Surgery Techniques

Asian eyelid aesthetic surgery encompasses a range of procedures designed to enhance periorbital appearance by creating or refining the upper eyelid crease and correcting associated functional anomalies such as epiblepharon. The anatomical challenges include a low or absent supratarsal fold, robust preaponeurotic fat, a variable levator aponeurosis insertion and frequently prominent epicanthal folds. Surgical techniques fall broadly into incision and non-incision methods. Incisional approaches involve precise skin and muscle excision with pretarsal fixation to the levator complex, offering durable crease formation and ample opportunity for fat redistribution. Non-incisional (suture-only) methods rely on buried sutures to link the anterior lamella to the levator aponeurosis, yielding faster recovery and minimal scarring but occasionally less long-term definition. Lower eyelid interventions target epiblepharon through modified Hotz or lamellar splitting techniques, balancing eyelash alignment with preservation of eyelid contour. Attention to corneal optics, tissue healing and patient-specific aesthetic goals underpins contemporary practice.

Research from Nature Portfolio

A multicentre randomised controlled trial in a paediatric cohort compared incisional versus non-incisional repair of lower lid epiblepharon. At six months, the incisional group demonstrated a significantly higher rate of complete eyelid correction and a greater reduction in astigmatic error, reflecting improved eyelash orientation and corneal protection. A separate wavefront analysis study evaluated corneal low- and high-order aberrations before and after epiblepharon repair. Early postoperative follow-up revealed transient increases in coma and trefoil aberrations and a shift from with-the-rule to against-the-rule astigmatic axis. By the second follow-up, most aberrations normalised, although sustained changes in spherical aberration and mean keratometry emphasise the need for optical monitoring when planning refractive co-management.

Asian Eyelid Aesthetic Surgery Techniques publication trend

The graph below shows the total number of articles in asian eyelid aesthetic surgery techniques across all publications each year (not limited to Nature Index journals).

Technical terms

Epiblepharon: A congenital eyelid fold causing lashes to turn inward, often requiring lamellar splitting or Hotz modification.

Double eyelid: A supratarsal fold created surgically by linking anterior lamella (skin/ orbicularis) to levator aponeurosis for enhanced lid definition.

Incisional technique: Surgical creation of eyelid crease via skin and muscle excision, fat management and pretarsal fixation for long-term stability.

Non-incisional technique: Fold formation using buried sutures without skin removal, offering reduced trauma and quicker recovery at the expense of some durability.

High-order aberrations (HOAs): Complex corneal optical distortions beyond lower-order defocus and astigmatism that can affect postoperative visual quality.

Pretarsal fixation: The attachment of posterior lamella to the anterior lamella at the tarsal level to secure eyelid crease position and contour.

References

1. Comparing the effectiveness of two surgical techniques for treating lower lid epiblepharon in children: a randomized controlled trial. Scientific Reports (2023).
2. Analysis of corneal real astigmatism and high order aberration changes that cause visual disturbances after lower eyelid epiblepharon repair surgery. Scientific Reports (2020).
3. Principle and Mechanism of Double Eyelid Formation. Archives of Plastic Surgery (2023).
4. The small incisions combined with interrupted buried suture blepharoplasty: flexible-rigid fixation. Frontiers in Medicine (2024).