The eyes are often called the window to the soul, playing a crucial role in facial expression and conveying emotions. The classic almond shape, with its elongated curve, longer lashes, and subtly thinned eyebrows, is a highly desired aesthetic.
Eyelid surgery, or blepharoplasty, is a surgical procedure designed to enhance the appearance of the eyelids. Whether your goal is to achieve a more youthful look, address sagging skin, or create more defined eyelids, eyelid surgery can help you achieve your desired aesthetic.
A well-defined upper eyelid crease contributes to a youthful and refreshed appearance. However, many individuals of Asian descent have no or only partial eyelid creases. The presence of excess fat within the eyelid (orbital fat) can obscure the crease, making the eyes appear smaller or less alert.
Common concerns that eyelid surgery can address include:
- No crease or a partial crease in the upper eyelid, which is common in people of East Asian descent
- A crease hidden by excess fat or skin, making the eyes look smaller or tired
- Drooping upper eyelids (ptosis) caused by a weak eyelid muscle
- Under-eye bags, wrinkles or loose lower eyelid skin
- An inner eye fold (epicanthic fold) that makes the eyes look short or set far apart
- Outer corners that slant too far up or down
Kamol Cosmetic Hospital offers a comprehensive range of eyelid surgery procedures to refine the shape and size of your eyes, creating a more attractive and balanced appearance. These procedures can address various concerns, including drooping eyelids, excess skin, under-eye bags, and wrinkles.
1. Double Eyelid Surgery
Double eyelid surgery creates or defines an upper eyelid crease. It’s one of the most popular procedures among people of Asian descent with a single eyelid, or with a crease that’s faint because of thick eyelid fat.
Open (incisional) technique
The surgeon marks the new crease, usually about 8–10 mm above the lash line, then removes excess skin and fat through an incision along that line. A well-defined, permanent crease is created as the incision heals.
Suture Technique (Non-incisional)
The surgeon marks about six evenly spaced points along the planned crease and passes fine sutures through them, tying the knots beneath the skin. There’s no long incision, so recovery is faster, but this technique isn’t suitable for eyelids with a lot of fat or excess skin.
2. Eye Ptosis Correction
Ptosis is a drooping upper eyelid caused by a weak or stretched eyelid-lifting (levator) muscle. It can be present from birth or develop with age, and in severe cases it can cover part of the pupil and affect vision.
- Mild to moderate ptosis: the levator muscle is tightened and repositioned (levator plication) to lift the eyelid.
- Severe ptosis: when the levator muscle is very weak, the forehead (frontalis) muscle is connected to the eyelid to help lift it (frontalis advancement).
3. Lower Eyelid Surgery
Lower eyelid surgery treats under-eye bags, wrinkles and loose skin, which usually develop with age but can also appear in younger people due to genetics.
Transconjunctival Technique (Inside the Eyelid)
Suitable for younger patients with under-eye bags but good skin elasticity. Anesthetic eye drops are applied, followed by a local anesthetic injection inside the lower eyelid. A small incision of about 5–7 mm is made inside the eyelid, the excess fat is removed, bleeding is controlled with cautery, and the incision is closed with dissolvable stitches.
- Advantages: no visible scar, no stitches to remove, quick recovery
- Limitation: can’t remove excess skin, so it isn’t suitable for loose or sagging lower eyelid skin
Transconjunctival Technique (Inside the Eyelid)
Suitable for older patients with under-eye bags combined with loose skin and muscle. An incision is made just below the lower lashes, excess fat is removed, the muscle is tightened, excess skin is trimmed, and the incision is closed.
- Advantages: removes excess skin and tightens the lower eyelid muscle
- Limitations: a fine scar below the lashes and a slightly longer recovery
4. Epicanthoplasty (Inner Corner Surgery)
The epicanthic fold is a fold of skin covering the inner corner of the eye. If it’s prominent, the eyes can look short and set wide apart. Epicanthoplasty opens the inner corner so the eyes look longer and more open. Kamol offers three techniques:
W-Epicanthoplasty
A W-shaped incision at the inner corner allows the most adjustment. It’s suitable for a pronounced fold or a lot of excess skin.
- Advantage: suits a large fold and allows a wider opening
- Limitation: the longest scar of the three techniques
Z-Epicanthoplasty
The skin at the inner corner is rearranged without removing any skin. It’s suitable for a moderate fold.
- Advantage: a less visible scar than the W technique
- Limitation: a slightly longer scar than the V technique
V-Epicanthoplasty
A V-shaped incision preserves the natural downward point of the inner corner. It’s suitable for a mild fold and requires precise dissection.
[Image: 649f88947350f.jpg — Picture 8. V-epicanthoplasty]
- Advantage: the scar is the easiest to hide
- Limitation: suitable only for milder folds
5. Canthoplasty (Outer Corner Surgery)
Canthoplasty reshapes the outer corner of the eye to correct eyes that look short, droop downward, or slant upward too much.
Lateral Canthoplasty
Extends the outer corner of the eye horizontally by about 2–3 mm, making the eyes look wider. It suits small eyes or short outer corners, and is often combined with double eyelid surgery and epicanthoplasty.
- Advantage: widens small or short eyes
- Limitation: a small scar at the outer corner
Canthopexy (Outer Corner Lift)
Downturned outer corners can make the eyes look sad or tired. Canthopexy tightens and stabilizes the outer corner tendon, repositioning it about 5 mm higher on the edge of the eye socket. It’s often combined with double eyelid surgery. See also Foxy Eyes Surgery.
- Advantage: lifts downturned outer corners for a fresher look
- Limitation: a small scar at the outer corner
Lowering Canthoplasty
If the outer corners slant upward too much, which is more common in people of East Asian descent, they can be moved down by about 3–4 mm [CONFIRM: the English page states 3–5 mm]. Incisions are made at the outer upper and lower eyelids, the corner is reshaped and repositioned, and excess skin is trimmed.
- Advantage: softens eyes that slant upward too steeply
- Limitation: a small scar at the outer corner
A Good Candidate
- Anyone wanting to address hooding, under-eye bags, loose eyelid skin, or an undefined crease
- Drooping eyelids affecting appearance or, in more significant cases, vision
- In good general health, with no untreated eye conditions
- A non-smoker, or willing to stop
- Holding realistic expectations
If you have dry eye, thyroid eye disease, or have previously had eyelid or laser eye surgery, tell your surgeon — these affect both suitability and technique choice.
Anesthesia and Procedure
Most eyelid procedures are performed under local anesthesia, with sedation or general anesthesia available when several procedures are combined. Most patients go home the same day.
Post-operative Care
Proper post-operative care is essential to minimize discomfort, promote healing, and achieve optimal results after blepharoplasty. Here are some key instructions:
- Cold Compress: For the first two to four hours after surgery, apply a cold pack (cold towel or gel pack) over the eyelids to reduce swelling and bruising.
- Elevated Head: Sleep and rest with your head slightly elevated for at least a week to help minimize swelling.
- Avoid Straining: Take extra caution when coughing or sneezing to prevent bleeding or putting pressure on the incisions.
- Dietary Restrictions: Refrain from smoking, drinking alcoholic beverages, and eating salty, spicy, or preserved/pickled foods for 1-2 weeks, as these can increase swelling and hinder healing.
- Hygiene: 24 hours after the surgery, the plaster may be removed, and the face can be gently cleaned with a moist cloth. Avoid rubbing or applying pressure to the eyelids.
Recovery
In the first week, swelling, bruising, irritation and dry eyes are common, and are managed with medication, cold compresses and eye ointment. Most patients return to work and light activities within 7–10 days. It can take several weeks for swelling to settle fully and the final result to show.
Risks and Complications
While eyelid surgery is generally a safe and effective procedure, it’s important to be aware of the potential risks and complications. These can include:
- Swelling and bruising: These are common side effects and usually subside within a few weeks.
- Bleeding: There is a risk of bleeding during or after the surgery, although this is typically minor and easily controlled.
- Dry eyes: Some patients may experience temporary dryness in the eyes after surgery.
- Sensitivity to light: The eyes may be more sensitive to light for a few weeks after the procedure.
- Difficulty closing eyes: In rare cases, patients may have difficulty fully closing their eyes, especially during sleep. This usually resolves as the swelling subsides.
- Ectropion: This is a condition where the lower eyelid turns outward. It is a rare complication of lower eyelid surgery.
- Infection: There is a risk of infection with any surgical procedure, although this is uncommon with blepharoplasty.
- Pain: Some pain and discomfort are expected after surgery, but this can be managed with pain medication.
- Scarring: Incisions are typically made in the natural creases of the eyelids to minimize scarring. However, some visible scarring may occur.
- Temporary or permanent change in vision: This is an extremely rare complication.
Why Choose Kamol Hospital in Bangkok for Eyelid Surgery
- Every part of the eye in one place: Double eyelid surgery, ptosis correction, lower eyelid surgery, epicanthoplasty and canthoplasty, combined into one plan when needed.
- Designed for your face: Crease height and eye shape are planned around your eyelid thickness, brow bone and facial proportions, from a subtle natural crease to a wider or almond shape.
- Experience with Asian and international eyes: Our plastic surgeons routinely treat single eyelids, hidden creases and epicanthic folds, as well as age-related changes.
- Part of wider facial planning: Eyelid surgery can be combined with a brow lift, facial feminization surgery or a facelift.
- Hospital-level safety: Nurses monitor you in the recovery room until you’re ready to go home, in a JCI-accredited hospital.
- Support for international patients: Multilingual coordinators and Kamol Trip help you plan your stay in Bangkok.
Frequently Asked Questions (FAQs)
What is blepharoplasty?
Blepharoplasty, commonly known as eyelid surgery, is a surgical procedure to improve the appearance of the eyelids. It can address concerns like drooping upper eyelids, under-eye bags, excess skin, and wrinkles, resulting in a more youthful and refreshed look.
What are the different types of blepharoplasty?
Blepharoplasty can be performed on the upper eyelids, lower eyelids, or both. Specific techniques include:
- Upper Blepharoplasty: Removes excess skin and fat from the upper eyelids, often creating or enhancing the eyelid crease.
- Lower Blepharoplasty: Addresses under-eye bags, wrinkles, and excess skin in the lower eyelids.
- Ptosis Repair: Corrects drooping eyelids by tightening the levator muscle or using a brow suspension technique.
- Epicanthoplasty: Reduces or eliminates the epicanthic fold, common in people of Asian descent.
- Canthoplasty: Reshapes the outer corner of the eye to create a wider or more lifted appearance.
Open or suture double eyelid: which lasts longer?
The open technique creates a crease as the incision heals, so it’s permanent and suits most eyelids, including those with extra fat or skin. The suture technique is less invasive and heals faster, but the stitches can loosen over time, so the crease may become fainter. It works best for thin eyelids with little fat. Your surgeon will recommend the right option after examining your eyelids.
My eyelids droop. Do I need double eyelid surgery, ptosis correction or a brow lift?
It depends on the cause. If excess skin or fat hangs over the crease, double eyelid surgery or upper blepharoplasty removes it. If the eyelid itself sits low over the pupil because the lifting muscle is weak, ptosis correction is needed. If the eyebrows have dropped and are pushing the skin down, a brow lift may be more suitable. Many patients have a combination, which your surgeon can identify at consultation.
Can several eye procedures be done at the same time?
Yes. Double eyelid surgery is often combined with epicanthoplasty, lateral canthoplasty or canthopexy to change the shape of the whole eye, and with ptosis correction if the eyelid droops. Combining procedures means one recovery period, though swelling may last a little longer.
Will my double eyelid fade over time?
An open-technique crease is permanent, but natural ageing can cause the skin above it to loosen and hang over the crease, making it look smaller or less defined over the years. If that happens, a small revision to remove excess skin can restore the crease.
I've had double eyelid surgery and the crease is too high. Can it be corrected?
Often, yes. Revision surgery on the upper eyelid, sometimes combined with fat grafting to restore lost volume, can make a crease that’s too high or deep a little lower and softer. How much it can be changed depends on how much tissue remains, so your surgeon will assess this at consultation.
Is Bangkok, Thailand a good place to have eyelid surgery?
Thailand and the wider region have particular depth in eyelid surgery, especially the techniques developed around East Asian eyelid anatomy — double eyelid surgery, epicanthoplasty, and canthoplasty are performed here in high volume rather than occasionally.
As anywhere, the surgeon matters more than the location. Ask how frequently they perform your specific procedure, and to see results on eyelids similar to yours. At Kamol Cosmetic Hospital, these are routine procedures for our surgeons, performed in a JCI-accredited hospital.
How long should I stay in Bangkok, and when can I fly?
Short flights are usually possible after the first 24–48 hours, but long-haul flights are best avoided until early swelling has settled. Plan to stay in Bangkok for about 5–7 days, so your surgeon can check your healing and remove any stitches before you fly home. Thailand is one of Asia’s leading destinations for eyelid surgery, and Kamol Trip can arrange accommodation close to the hospital.
