Asian eyes have a distinct anatomic structure that gives them their characteristic beauty — and that requires a fundamentally different surgical approach when the patient seeks aesthetic refinement. Many Asian eyelids have a single fold rather than the supratarsal crease that creates the “double eyelid” appearance, while others have an incomplete or asymmetric crease. For some patients, the upper eyelid skin can encroach on the eyelashes themselves, impeding vision. Asian eyelid surgery — also called Asian double eyelid blepharoplasty — creates a defined, natural-looking upper eyelid crease that opens the eyes and balances facial features. The most important consideration in this procedure is preserving the patient’s ethnic identity. The goal is never to create a “Westernized” eyelid; the goal is an Asian double eyelid that complements rather than erases the patient’s heritage. At Los Angeles Plastic Surgery, Dr. John Anastasatos performs Asian eyelid surgery at his Beverly Hills practice with the cultural sensitivity and surgical refinement this specialized eyelid procedure specifically requires.

Dr. Anastasatos performs Asian eyelid surgery with international peer-recognition across the highest academic forums in plastic surgery. He has delivered plenary lectures at the Pan-Hellenic Congress of Plastic Surgery — the Greek specialty’s highest academic forum — and has been an invited lecturer at the Royal Society of Medicine in London on advanced facial surgical techniques, with an invited 2026 return as featured speaker. His international practice and credentials reflect engagement with diverse aesthetic standards across continents, foundational for the cross-cultural surgical sensitivity that Asian eyelid surgery demands. With over two decades of facial surgical expertise in Beverly Hills since 2007, he is board certified by the American Board of Plastic Surgery, a Fellow of the American College of Surgeons (FACS), a member of the American Society of Plastic Surgeons (ASPS) and American Society for Aesthetic Plastic Surgery (ASAPS), and named by The Luxe Insider as one of the Top 10 Plastic Surgeons in the World.

Understanding Asian Eyelid Anatomy

The defining anatomic feature in Asian eyelid surgery is the supratarsal crease — the horizontal fold above the upper eyelashes that creates what is commonly called a “double eyelid.” Approximately half of Asian populations naturally have this crease, while the other half have a single eyelid (a “monolid”) without a defined fold. Both anatomies are normal, healthy variations of human eyelid structure.

Several specific anatomic considerations distinguish Asian eyelid surgery from Western blepharoplasty:

• Lower-positioned levator attachment to the upper eyelid skin
• More substantial preaponeurotic fat compared to typical Western anatomy
• Different epicanthal fold characteristics in some patients
• Variable crease height and curvature preferences based on individual aesthetic goals and ethnic heritage

A surgeon who treats Asian eyelid surgery as if it were Western blepharoplasty will produce results that look unnatural — too high a crease, too aggressive skin removal, or features that erase ethnic identity. The procedure must be tailored specifically to Asian anatomy and aesthetic preferences.

What Asian Eyelid Surgery Addresses

The single eyelid fold on some Asian eyes affects multiple aspects of facial appearance:

• Eyes appear smaller and less open
• Upper eyelid can seem to droop, producing a tired appearance
• Eye makeup is challenging to apply because the lid has no defined crease to anchor it
• Facial proportion can feel unbalanced when the eyes lack visual definition
• Vision can be physically impeded when the upper eyelid skin extends down to the lash line

Asian eyelid surgery addresses these concerns by creating a defined supratarsal crease appropriate to the individual patient’s anatomy and aesthetic preferences.

How Double Eyelid Blepharoplasty Is Performed

There are several factors that must be carefully considered before Asian eyelid surgery, and the consultation specifically focuses on aligning patient expectations with anatomic possibilities:

• Crease height — most Asian crease patients prefer 6-8mm rather than the 8-10mm typical of Western blepharoplasty
• Crease curvature — parallel, tapered, or partial creases each produce different aesthetic effects
• Excess skin removal — minimal compared to typical Western blepharoplasty to preserve natural eyelid character
• Epicanthal fold management — some patients pursue subtle modification while others want their epicanthal anatomy preserved entirely
• Bilateral symmetry — particularly important when one eye has a natural crease and the other does not

Two general surgical approaches are available:

Incisional Method

A small incision is placed at the planned crease location, excess skin is removed conservatively if needed, and the underlying tissue is sutured to create a permanent supratarsal fold. The incision is hidden in the new crease once healed.

Suture Method

Small sutures are placed without significant skin incision to create the crease. This approach is less permanent than the incisional method but produces results without visible scarring. Suture method results may need refinement over time.

The choice between methods depends on the patient’s anatomy, the amount of skin laxity, and the durability of result desired. Dr. Anastasatos’s consultation outlines the appropriate approach for each individual.

Preserving Ethnic Identity

This is the most important principle of Asian eyelid surgery. The goal is never to create a Westernized or “Caucasian” eyelid. The goal is to create an Asian double eyelid — the natural variant of Asian eyelid anatomy that approximately half of Asian populations have from birth. The patient’s ethnic identity must be preserved.

Dr. Anastasatos’s consultation specifically addresses what each patient wants — including patients who may have seen aggressive Westernization results elsewhere and want to ensure their results respect their heritage. Specific design choices reflect this: more conservative crease heights, preservation of epicanthal anatomy when desired, and careful attention to maintaining the patient’s natural eye character.

Recovery and Results

Most patients return home the same day with mild discomfort. Bruising and swelling resolve over 7-14 days. Sutures are typically removed at one week if visible sutures are used. Most patients return to work within 7-10 days. Strenuous activity is restricted for approximately 2-3 weeks. Final settling of the result emerges over 3-6 months.

Results from incisional Asian eyelid surgery are permanent. The new crease maintains its position and character indefinitely.

Frequently Asked Questions About Asian Eyelid Surgery

Will the procedure make me look less Asian?

No — when performed appropriately. The goal is an Asian double eyelid, which is a natural variant of Asian anatomy that approximately half of Asian populations have. Dr. Anastasatos’s approach specifically preserves ethnic identity rather than producing a Westernized result.

What’s the difference between incisional and suture methods?

Incisional method involves a small hidden incision at the new crease and produces permanent results. Suture method uses small sutures without significant incision but produces results that may be less permanent. The right method depends on individual anatomy and goals.

How long does the procedure take?

Most Asian eyelid surgery procedures take 1-2 hours, performed under local anesthesia with sedation as an outpatient procedure.

Can the procedure correct asymmetric creases?

Yes. Many patients have natural asymmetry — a defined crease in one eye and a single lid or partial crease in the other. The procedure can create symmetric, defined creases on both sides.

What if I don’t like the result?

The consultation specifically aligns expectations with anatomic possibilities before surgery to reduce this risk. If concerns develop after surgery, Dr. Anastasatos discusses options for refinement. Refinement of incisional results may require revision blepharoplasty.

Is the crease permanent?

Incisional method results are permanent. Suture method results may diminish over time and may require touch-up procedures.

Why Choose Dr. Anastasatos for Asian Eyelid Surgery

• Pan-Hellenic Congress Plenary Lecturer: International peer-recognition at the highest academic level of the Greek plastic surgery specialty.
• Royal Society of Medicine London Lecturer: International peer-recognition with invited 2026 return as featured speaker.
• International Aesthetic Sensitivity: Cross-continental practice exposing the surgeon to diverse aesthetic standards.
• Two Decades of Beverly Hills Practice: Sustained experience in facial and eyelid surgery since 2007.
• Ethnic Identity Preservation Philosophy: Specific surgical approach designed to create Asian double eyelids rather than Westernized eyelids.
• Board-Certified, FACS, ASPS, and ASAPS: Certification by the American Board of Plastic Surgery and full membership in the specialty’s most respected peer societies.
• Both Incisional and Suture Methods Available: Surgical options matched to individual anatomy and goals.
• Top 10 International Recognition: Named by The Luxe Insider as one of the Top 10 Plastic Surgeons in the World.

Schedule Your Asian Eyelid Surgery Consultation in Beverly Hills

If you have considered Asian eyelid surgery to create a defined upper eyelid crease while preserving your ethnic identity, the consultation is the most important first step. Dr. Anastasatos welcomes patients to the Beverly Hills office at 436 North Bedford Drive, Suite 202, Beverly Hills, CA 90210, for a private consultation evaluating your specific anatomy and outlining the surgical approach. Contact our team at Los Angeles Plastic Surgery to schedule your Asian eyelid surgery consultation with Dr. Anastasatos.