Double Eyelid Surgery

In the oriental population, many people are born without double eyelid creases or the creases are low and indistinct. Double eyelid surgery is a minor surgery done to create double eyelid creases for this condition.

There are two techniques of double eyelid surgery: suture method and incision method. The selection depends on the anatomy of the upper eyelid and the preference of the patient. If done correctly on the correct patient, both methods can give excellent results. The suture method is associated with a shorter recovery time. On the other hand, the incision method is a more versatile technique as it can correct other problems such as to remove excess skin and excess fat and also tighten the levator muscle, all of which cannot be addressed by the suture method. Generally, the results from the incision technique are more long-lasting compared to the suture technique. Each double eyelid surgery is individually designed to suit the needs of the individual patient. For example, the double eyelid crease can be adjusted for different height and length. The medial end of the double eyelid crease can either be joining the upper eyelid margin (tapered crease) or separate from the upper eyelid margin (parallel crease).

Sometimes double eyelid surgery is combined with epicanthoplasty and lateral canthoplasty to make the eye appears longer and bigger to enhance the overall aesthetic results. (see Epicanthoplasty and Lateral Canthoplasty)

Preparation

1.    Inform the doctor of any pre-existing medical conditions and drug allergy. All medical conditions must be treated and stabilized before surgery.

2.    Stop smoking at least one week before surgery. Smoking negatively affects wound healing and increases risks of other post-operation complications.

3.    Stop the following one week before surgery:

a.    All supplements that contain vitamin E, ginseng, ginkgo, garlic, fish oil and other ingredients which increase bleeding during surgery.

b.    Medicine that increases bleeding during surgery such as aspirin, NSAIDs and warfarin. However, you may need to consult your physician who prescribed the medicine before you stop them.

4.    On the day of surgery, wear simple and comfortable clothing. Do not wear any jewelry and metal objects on the face and body.

5.    Bring a pair of sunglasses on the day of surgery for use after surgery

6.    Don’t wear contact lens on the day of surgery

Surgery

Duration: Suture method: 1 hour. Incision method: 1 to 2 hours

Anaesthesia: Local anaesthesia

Hospitalization: Not required.

Recovery*: Back to work in 3-7 days, light exercise after one week, heavy exercise after 2-3 weeks.

*The speed of recovery and duration of rest may vary from person to person and also depends on the physical burden of the work and exercise the patient is going to resume.

Surgery Technique:

1.    Suture Method: Sutures are inserted into the skin of the upper eyelid at several points. This technique is suitable for patients with thin upper eyelid skin. There is a low but definite possibility that the sutures become loose and the double eyelid crease gradually disappears.

2.    Incision Method: This technique is suitable for all patients. An incision is made on the upper eyelid skin and fixation is done to create the double eyelid crease. The results from the incision method are usually permanent. The incision is located in the double eyelid crease itself and not visible when the eye is open. Most of the scars on the upper eyelid heal very well and would not be noticeable. This technique can correct other problems such as to remove excess skin and excess fat and also tighten the levator muscle.

Post-operative Care**

1.    What to expect: Swelling usually peaks on the second to third day after surgery and then gradually subsides. Post-operative pain is usually minimal.

2.    General care:

a.    Apply cold pack during the first 3 days and warm pack thereafter. Elevate the head during sleep to reduce swelling.

b.    Avoid smoking for at least one month. Smoking increases the risk of wound complications.

c.    Use sunglasses for protection when going outdoors.

d.    Get a good rest and enough sleep to speed up recovery.

e.    Be relaxed and calm. Contact the clinic if there are any queries.

f.     Don’t use contact lens for at least 1-2 weeks.

3.    Medicine: Finish the oral antibiotics as prescribed. Take the painkiller when necessary.

4.    Wound care: Clean the wound with a clean cotton tip soaked with sterile water/saline. After that apply antibiotic ointment. No dressings are required.

5.    Physical activity: Avoid heavy physical activities and exercises for at least one month.

6.    Follow-up: Come back one week after surgery for suture removal and review.

7.    Emergency: If there is heavy bleeding, rapid increase in swelling or severe pain, immediately contact the clinic/doctor for advice.

**The instructions in this section are not meant to be exhaustive and are only for general references. If you have any specific queries or concerns during the post-operative recovery, please contact the clinic for specific advice.