One of the most common changes Asians are seeking is the shape of the nose.  The majority of Asian rhinoplasty is to increase the height of the bridge and tip of the nose (also called augmentation rhinoplasty). 

One area many Asians patients get confused is assessing the length of the nose.  Many patient ask to have their nostrils reposition to a higher location.  However, many of these patients have what I believe to be a short nose.   A short nose appearance is frequently associated with a retracted columella  (The columella is the structure between the nostrils).  This finding is best appreciated on your profile view.  In some cases where the columella is too retracted, the nostrils can have an appearance of "hooding" over the columella. 

To address these finding, lengthening the nose (in addition to building the bridge and tip) may create more aesthetic harmony to the nose.

The epicanthal fold is present during early infancy in all ethnic groups. However in most ethnic groups as the face grows this fold becomes less apparent. In adulthood, the epicanthal fold is a unique feature to the Asian eye.

The epicanthal fold is located on the middle portion of the Asian eyelid and is essentially redundant skin overlying the lacrimal lake (aka the pink portion of the central eyelid).

The shape of the epicanthal fold can vary considerably, with a prominent fold creating a smaller appearance to the eye.

An epicanthoplasty is a surgical procedure performed to change the shape of the epicanthal fold. This procedure is usually performed in conjunction with Asian double eyelid surgery.

Several various surgical techniques have been developed over the years, using various skin flap advancement techniques.

Like all techniques in plastic surgery, the best results are usually from careful preoperative evaluation and proper selection of an effective surgical technique.

Asian double eyelid surgery is one of the most common cosmetic procedures performed on patients of east Asian decent.  This procedure is done to create an upper eyelid crease.  Approximately 50% of east asians, are born without a supratarsal fold (aka double eyelid crease).  

This procedure can be performed using several techniques.  But the major differences in techniques is whether the surgeons approaches this surgery using an incision or a suture technique (non-incision) to create a double eyelid fold.

Below, I have broken down some of the major differences between the two surgical approaches.  

Incisional technique          

Pros: more predictable long-term outcomes, more control to create precise placement of the desired fold, able to address other anatomic factors to the eyelid (such as addressing upper eyelid fat deposits, excess muscle, and redundant upper eyelid skin).

Cons: increased healing time, increased potential for a conspicuous scar,  and irreversible

Non-incision-suture technique

Pros: relative ease of performing the procedure, quick recovery time, reversible

Cons: Unable to address other structures in the eye (redundant skin, fat, or muscle), increased potential for loss of crease over time, increased potential for asymmetry.

In addition to performing both techniques, I also perform a limited incision technique.  The approach I use depends on several factors, including your desired changes, your eyelid anatomy, and your lifestyle.

I welcome you to come in and learn more about the different techniques I perform for asian eyelid surgery, as well as other facial cosmetic procedures.

ESK