Specialized Eyelid Surgery
Asian Blepharoplasty
Double Eyelid Surgery in Toronto
Upper eyelid crease creation and refinement for East Asian, Southeast Asian, and Central Asian patients — performed by an ASOPRS fellowship-trained oculofacial surgeon with specialized training in Asian eyelid anatomy.
What Is Asian Blepharoplasty?
Asian blepharoplasty — also known as double eyelid surgery — creates or refines an upper eyelid crease in patients with a single eyelid (monolid) or a minimally visible crease. The procedure is performed on individuals of East Asian, Southeast Asian, and Central Asian descent whose eyelid anatomy differs from European eyelid structure.
Approximately 50% of people of East Asian descent are born without a visible upper eyelid crease. This anatomical variation is normal, healthy, and reflects differences in levator muscle insertion, fat distribution, and orbital septum position — not a defect requiring correction.
Asian blepharoplasty is an elective cosmetic procedure chosen by patients who prefer a visible crease for personal aesthetic reasons. The goal is to create a natural-looking result that maintains ethnic identity while achieving the patient's desired appearance.
Anatomical Differences in Asian Eyelids
The Asian upper eyelid has several distinct anatomical features that require specialized surgical knowledge:
- ✦Lower levator insertion: The levator aponeurosis (the muscle that opens the eyelid) inserts lower on the tarsal plate in Asian eyelids, which prevents the formation of a visible crease.
- ✦Increased preaponeurotic fat: There is typically more fat between the skin and levator muscle, creating fullness in the upper lid and obscuring crease formation.
- ✦Epicanthal fold (inner corner): A skin fold covering the inner corner of the eye is more prominent in many East Asian individuals, which may affect crease symmetry and design.
- ✦Thicker skin and orbicularis muscle: Asian eyelid skin is often slightly thicker with more subcutaneous tissue, requiring precise surgical planning.
- ✦Variable orbital fat distribution: Fat pockets may extend more anteriorly (forward), contributing to upper lid fullness.
Surgical Approaches
There are two primary techniques for creating an upper eyelid crease in Asian blepharoplasty. The choice depends on anatomy, desired crease height, the presence of excess skin or fat, and patient goals.
Incisional (Open) Method
An incision is made along the planned crease line. Excess fat, muscle, and skin are precisely removed. The levator aponeurosis is then secured to the dermis (skin layer) to create a permanent crease.
Best For:
- ✓Patients with excess upper lid skin or fat
- ✓Asymmetric or uneven natural creases requiring refinement
- ✓Desire for a higher or more defined crease
- ✓Permanent, predictable long-term results
Recovery:
10–14 days visible recovery. Scar settles into natural crease over 3–6 months.
Non-Incisional (Suture) Method
Small puncture incisions are made, and sutures are passed through the lid to connect the skin to the levator aponeurosis. The crease forms as the sutures create adhesion points, without removing tissue.
Best For:
- ✓Younger patients with thin skin and minimal fat
- ✓Desire for a subtle, lower crease
- ✓Patients seeking faster recovery
- ✓First-time crease creation in a monolid
Consideration:
Crease may fade over time (5–10 years) in some patients. Revision rate higher than incisional method.
EyeFACE Approach: Dr. Gill performs both incisional and non-incisional Asian blepharoplasty. The technique is selected during consultation based on your anatomy, aesthetic goals, and long-term expectations. Most patients seeking permanent, natural results are best served by the incisional method.
Crease Design: Height, Shape, and Natural Appearance
The most important decision in Asian blepharoplasty is not whether to create a crease — it is what type of crease to create. Crease height and shape must be customized to the patient's facial proportions, ethnic identity, and aesthetic preferences.
Low Crease (6–7mm)
Subtle, natural-looking crease that preserves a distinctly East Asian appearance. Minimal exposure of the upper lid platform. Popular among patients seeking refinement without dramatic change.
Medium Crease (7–9mm)
The most commonly requested height. Visible crease that maintains ethnic characteristics while creating a more open, defined eye appearance. Balanced aesthetic outcome.
High Crease (9–11mm)
More pronounced crease with greater lid platform exposure. Creates a more Western eyelid appearance. Requires sufficient skin laxity and appropriate brow position to avoid a tethered or unnatural look.
Important Principle:
Asian blepharoplasty does not mean creating a "Western" eye. The goal is to enhance the natural beauty of the Asian eyelid while respecting ethnic identity. An appropriately trained oculofacial surgeon understands that the ideal crease for an East Asian patient is different from a European crease — and that individual facial harmony matters more than following a template.
Why ASOPRS Fellowship Training Matters for Asian Blepharoplasty
ASOPRS (American Society of Ophthalmic Plastic and Reconstructive Surgery) fellowship is the highest level of subspecialty training in eyelid and periorbital surgery. Fewer than 30 positions are awarded annually across North America.
Specialized Eyelid Anatomy Training
ASOPRS surgeons complete 1–2 years of dedicated training exclusively in eyelid, orbital, and lacrimal surgery after completing ophthalmology residency. This includes extensive experience with the levator muscle, tarsal plate, orbital septum, and fat compartments — the exact structures manipulated in Asian blepharoplasty.
Functional and Aesthetic Integration
Asian blepharoplasty is not just cosmetic — it requires understanding eyelid function, tear film stability, and ocular surface health. ASOPRS surgeons are trained to assess whether altering levator insertion or removing orbital fat will affect long-term eyelid mechanics, not just short-term appearance.
Dr. Harmeet Gill completed ASOPRS fellowship training and is a Fellow of the Royal College of Physicians and Surgeons of Canada (FRCSC) and the American College of Surgeons (FACS). His training included specialized experience in Asian eyelid anatomy, crease formation techniques, and ethnic-specific surgical planning.
What to Expect: Consultation to Recovery
Consultation
45–60 minutesComprehensive eyelid assessment including crease measurement, skin quality evaluation, fat distribution analysis, and discussion of your aesthetic goals. Computer imaging may be used to preview crease height options. Surgical plan and pricing provided.
Procedure
60–90 minutesPerformed under local anaesthetic with sedation at EyeFACE's CPSO-inspected Level 3 surgical facility. Precise crease creation using either incisional or non-incisional technique as planned. You return home the same day.
Recovery (Week 1–2)
10–14 days visible recoveryBruising and swelling peak at 48–72 hours and resolve over 10–14 days. Sutures removed at 5–7 days. Most patients return to work at 7–10 days. Eyes may feel tight or heavy initially — this resolves as healing progresses.
Recovery (Months 1–6)
Gradual refinementCrease settles into final position. Scar fades and blends into natural crease. Residual swelling resolves completely by 3–6 months. Final result is visible by 6 months, with continued subtle improvement over the first year.
Pricing and Consultation Fee
Asian Blepharoplasty (Incisional)
Upper eyelid crease creation — bilateral
$4,500
Includes surgeon fee, facility fee, anaesthesia, post-operative care, and all follow-up visits for one year. Pricing is for upper eyelid crease creation only. Additional procedures (ptosis repair, fat removal, lower eyelid) priced separately.
Consultation Fee
Private consultation with Dr. Gill
$450
Full consultation fee is applied toward your procedure if you proceed with surgery. Non-refundable if you decide not to proceed. Consultation includes comprehensive eyelid assessment, computer imaging (if appropriate), and detailed surgical plan.
Frequently Asked Questions
Will my result look natural or obviously surgical?
When performed by an experienced oculofacial surgeon, Asian blepharoplasty creates a crease that appears naturally formed, not surgically imposed. The key is selecting an appropriate crease height and shape for your facial anatomy — not copying a standard template. Your ethnicity is preserved while your aesthetic goals are met.
Is Asian blepharoplasty permanent?
Incisional Asian blepharoplasty creates a permanent crease. The levator aponeurosis is physically attached to the skin, forming a stable anatomical connection that does not fade. Non-incisional (suture) technique may lose definition over 5–10 years in some patients as the sutures relax.
Can I get a revision if I don't like the crease height?
Yes, but it is far easier to make a crease higher than to make it lower. This is why conservative planning is important. If the initial crease is too low, it can be raised with a secondary procedure. If the initial crease is too high, lowering it requires allowing scar tissue to mature and may not fully restore the previous appearance.
What is the difference between Asian blepharoplasty and regular upper blepharoplasty?
Regular upper blepharoplasty removes excess skin and fat from an eyelid that already has a crease. Asian blepharoplasty creates a crease where none exists or refines a minimal existing crease — requiring different anatomical understanding, surgical technique, and aesthetic planning.
Will I lose my ethnic appearance?
No. Asian blepharoplasty creates a double eyelid — a feature naturally present in approximately 50% of East Asian individuals. The goal is not to make your eyes look Western, but to create a crease that harmonizes with your facial features while maintaining your ethnic identity.
How do I choose the right crease height?
Crease height is determined during your consultation based on your eyelid anatomy, skin laxity, brow position, and personal aesthetic preferences. Dr. Gill will show you what different crease heights look like on your face and explain the long-term implications of each option. This is a collaborative decision, not a dictated outcome.
Begin Your Consultation
$450 in-person · $300 virtual — applied in full toward your procedure.