Asian Upper Blepharoplasty in Women: A Comprehensive Approach for a Natural and Aesthetically Pleasing Outcome

Abstract Background Asian upper blepharoplasty is the most popular cosmetic procedure for Asian women. However, there is no standardized approach to this procedure and suboptimal results are still common. Objectives The aim of this article was to describe a comprehensive approach to Asian upper blepharoplasty in women and report the clinical outcomes obtained with this approach. Methods The comprehensive approach described here for Asian upper blepharoplasty in women includes: (1) determining the height and length of the upper eyelid skin crease; (2) creating a more optimal anatomy of the upper eyelid by removing excess eyelid skin, a portion of the orbicularis oculi muscle, and septal fat; (3) reconstructing the desired anatomic structures of the upper eyelid skin crease through plication of the levator aponeurosis, if necessary, and closure of the upper eyelid skin incision through the septum and the mobile portion of the levator aponeurosis; (4) adding a medial epicanthoplasty if needed to enhance final cosmetic results. Results Over a 5-year period, 332 Asian women underwent upper blepharoplasty for creation of double eyelids, or conversion from less visible to more ideal double eyelids, with the above comprehensive approach. There were no surgical complications postoperatively and 326 patients (98.2%) rated their outcome satisfactory over a 5-year follow-up. Only 6 patients (1.8%) required surgical revision for asymmetry or suboptimal shape of the upper eyelid. Conclusions The comprehensive approach to Asian upper blepharoplasty described here can be used for Asian women and produces a natural and aesthetically pleasing outcome and low revision rates. Level of Evidence: 4