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Asian Eyelid Surgery (Double Eyelid Surgery)

Dr. Zoumalan specializes in Asian eyelid surgery, also known as double eyelid surgery. Asian eyelid surgery is a type of cosmetic eyelid surgery, which Dr. Zoumalan performs on people of different ethnicities but mainly those from Asian descent. Dr. Zoumalan has a practice which caters to patients from all over Southern California (including Los Angeles, Orange County, and San Diego), other states and those who fly in from various countries (i.e. China, Korea, Philippines, Japan) for the Asian eyelid procedure. He also teaches the specific techniques of Asian eyelid surgery to other surgeons in training as an Adjunct Clinical Professor at the Keck School of Medicine of USC. Asian eyelid surgery can be done in our office under local anesthesia while the patient is awake and very comfortable.

What is Double or Asian Eyelid Surgery?

Asian eyelid surgery is also referred to as double eyelid surgery. Double eyelid surgery (a type of Cosmetic eyelid surgery ) is a common plastic surgery procedure selected by patients of Asian descent. Asian eyelid surgery requires the skill set of a surgeon that is experienced in eyelid surgery. Dr. Zoumalan finds Asian eyelid surgery to be one of the most gratifying types of surgeries. It is a very delicate procedure that involves incredible attention to detail. Each patient has different desires, and Dr. Zoumalan goes over the whole entire process of Asian eyelid surgery and then formulates a surgical plan that is customized to each and every patient.   It is absolutely important to choose your plastic surgeon wisely when it comes to Asian or double eyelid surgery. There have been recent advances in better understanding the eyelid structure and anatomy in the Asian population, which has enabled plastic surgeons to apply this toward better and more predictable results.

Beautiful before and after of an UPPER LID BLEPHAROPLASTY AND PTOSIS REPAIR. This was a tough case where he presented with some fairly significant asymmetry between the two eyes. An upper eyelid surgery was performed to help balance the eyes. His left eyelid’s main issue was ptosis aka droopy eyelid, whereas the right upper lid had excess skin. Two different issues seen in two separeate eyelids in the same patient. He underwent an in office procedure to correct both issues at the same time, and here he is just a few weeks out of surgery and looking fantastic already.

Before and after male Asian eyelid surgery and mole removal. ⁠Asian eyelid surgery is a procedure I perform in BOTH females and males. In this case, my patient had significant asymmetry in his upper eyelids. In fact, his right eyelid had NO visible crease, while his left had a visible crease but it was not complete and slightly higher than what he desired. He also had a mole (birthmark) on his right eyelid that he wished to remove. This procedure was performed in the office under local anesthesia. His after photos were taken several months out from surgery, and as you can see, he looks great, with a noticeable improvement while still maintaining his masculine and natural look.

Anatomic Structure Asian & Occidental Eyelids:

Although the Asian eyelid has the same anatomic structures as an Occidental (Caucasian or non Asian) lid, there are differences in the size and position of these particular eyelid structures. In general, the Asian upper eyelid crease forms closer to the eyelashes, is shaped differently, and is sometimes incomplete or broken into multiple folds. As a result, there are variations in Asian eyelids such that there is no true “one type of Asian eyelid.” Each patient is carefully evaluated and the surgical plan is designed based on what the patient desires.

It is important to state that most Asian patients without an eyelid crease who seek cosmetic Asian eyelid surgery do not want to look “westernized.” They rather want to have an eyelid crease similar to those Asian eyelids that do have an eyelid crease. Such patient wishes are carefully discussed so that the patient and Dr. Zoumalan are aware of the goals of the procedure. Photos of desired outcomes are always helpful to help clarify the patient’s wishes as well.

Occidental vs. Asian Upper Eyelids

The Asian upper eyelid also appears more full and “puffier” than the Occidental upper eyelid. The reasons include the following differences between Asian upper eyelids and Occidental upper eyelids:

  1. Orbital fat is also located at a lower position in the upper eyelids which also herniates easier and as a result “bulges” easier.
  2. Thicker brow fat which allows for a more prominent eyebrow.
  3. Thicker subcutaneous fat layer of the skin which allows for a difficult crease to form.

Variations of Eyelid Creases:

There are up to 8 or so various types of Asian eyelid configurations but the figures below illustrate three basic types of eyelid creases:

the picture below illustrate three basic types of eyelid creases

a) No visible crease shows and this condition is seen in up to a half of the Asian population. The crease may be present but it is low and near the eyelashes.
b) Others have a crease set 2-4 mm above the eyelashes as seen above in the middle figure.
c) Some others have a higher set crease at 6-8mm.

Most Asian eyelid surgery patients that see Dr. Zoumalan for a consultation have an eyelid similar to Figure a) above and wish to either have a result somewhere between Figures b) and c) at a height from 4-7mm. As a result, lid crease enhancement in Asians is customized to the lid anatomy of each individual patient. A careful discussion with the patient allows for both Dr. Zoumalan and the patient to be as best informed and prepared for the surgical plan as possible.

Crease: Many (up to a half) of Asian patients have an upper eyelid with a low but defined upper eyelid crease. An eyelid crease allows the lid to be “broken up” into two visible parts which is referred to as a “double eyelid.” The other half who do not have a crease or show very little signs of a crease (termed “single eyelid”).

A beautiful asian eyelid surgery transformation - female patient before and after picture

A beautiful ASIAN EYELID SURGERY transformation. She has excess skin, multiple/asymmetrical upper eyelid creaes that were all ill-defined, resulting in variable creases throughout the day. She desired to have one stable, well defined symmetric appearing creases that would also give her some more pretarsal show to her beautiful eyes. An Asian eyelid surgery (aka double eyelid surgery) was performed to create a stable, higher crease for her, along with FAT REPOSITIONING to help improve the hollowing she also had in her upper eyelid. The straight arrows designate the upper eyelid hollowing she has, which was dramatically improved with not only the Asian eyelid surgery but also with the repositioning of her excess upper lid fat to improve the hollows. These two procedures were done at the same time and you can see the amazing transformation. Post surgery photos were taken 6 weeks after surgery. She still has some very mild swelling, and some mild hyperpigmentation which will both improve with time.

Beautiful Asian eyelid surgery done in our office under local anesthesia - Female Patient before and after picture

Beautiful Asian eyelid surgery done in our office under local anesthesia. In her case, we created one beautiful eyelid crease that gave her eyelids some show, rather than the two she had that were not well defined prior to surgery. I’m thrilled to have been part of her journey! She’s now in college and in love with her new eyelids.


Asian lids may have some element of an epicanthal fold. An epicanthal fold is a small crescent of skin that is usually present between the inner eyelid corner and the nose. Dr. Zoumalan can help in revising some of the epicanthal fold at the same as an eyelid surgery.   In cases of severe epicanthal folds, Dr. Zoumalan can perform epicanthoplasty to reduce the prominence of the epicanthal fold.

Natural Double Eyelid Results with Minimal Scarring

Check out Our Amazing Patient Results

An Asian Eyelid Surgery (Double Eyelid Surgery) is performed with the utmost precision and care to ensure minimal scarring - female Patient before and after picture
Dr. Christopher Zoumalan is a board-certified Oculoplastic surgeon that specializes in minimally invasive cosmetic eyelid surgery. An Asian Eyelid Surgery (Double Eyelid Surgery) is performed with the utmost precision and care to ensure minimal scarring. Dr. Zoumalan is dedicated to helping patients achieve their desired aesthetic without the worry of scars. Dr. Zoumalan and a team of scientists have developed and perfected, Skinuva Scar Therapy, which works to kickstart the healing process and effectively reduce the appearance of scars. The Skinuva Scar Therapy is composed of an innovative silicone cream matrix that incorporates vitamin C, growth factors and natural ingredients to improve the appearance of scars.
Upper and lower eyelid blepharoplasty, fat repositioning to lower eyelids - female Patient before and after picture

Preoperative Diagnosis: Excess skin in upper and lower eyelids, fat pockets in lower eyelids.

Procedure performed: Upper and lower eyelid blepharoplasty, fat repositioning to lower eyelids


*Individual results may vary

All before and after pictures displayed are real patients who have consented to having their pictures published on our site. Individual results will vary with each patient and Dr. Christopher Zoumalan does not guarantee any outcomes of procedures shown. All pictures are meant for reference and illustrative purposes only.

Asian eyelid surgery - male patient before and after picture

Procedure performed: Asian Eyelid Surgery

Lower lid blepharoplasty using Natural Looking Blepharoplasty Technique - female Patient before and after picture

Procedure performed: Lower lid blepharoplasty using Natural Looking Blepharoplasty® Technique

Awake Asian Eyelid Surgery

More and more patients are now choosing to try awake Asian eyelid surgery. This unique sedation option allows patients to remain conscious during their eyelid surgery. However, it still keeps you entirely comfortable throughout the procedure. By avoiding general anesthesia, you can reduce recovery times and strain on your body. The lighter sedation of an awake procedure, however, still keeps you comfortable. Using modern techniques, Dr. Zoumalan can provide a quick and stress-free procedure. Ask us today about awake Asian eyelid surgery and its unique benefits. See why more and more patients are choosing this modern solution for eyelid surgeries and more.

What type of Asian Eyelid do you prefer?

Each patient desires a different look, and Dr. Zoumalan does not provide just one type of Asian eyelid surgery to all his patients. There are variations of an eyelid that females may desire more so than males, and there are subtle enhancements that some may like while others may not.

Questions that Dr. Zoumalan will ask you are:

What is your desired lid crease height?

Some desire a lower crease height than others such as at 4mm in comparison to the average which is 6-7mm.  Others want a slightly higher lid crease set at 7-8mm.    Dr. Zoumalan will go over examples with you in person and help you determining your desired lid crease height.

Low lid crease, set at about 4mm in height picture
Example 1: Low lid crease, set at about 4mm in height
Medium lid crease, set at about 6mm in height picture
Example 2: Medium lid crease, set at about 6mm in height
High lid crease, set at about 8mm in height picture
Example 3: High lid crease, set at about 8mm in height

Do you wish for a nasally tapered crease or a nasally parallel crease?

The way the lid crease ends closer to your nose can be designed as either parallel or tapered. A nasally tapered crease tends to be more popular among my patients, such that the lid crease ends in a tapered fashion toward the epicanthal fold or medial canthus. The epicanthal fold can often be revised and improved at the same time as well if a nasally tapered crease is created. A parallel crease is more often desired in men than in women, and the lid crease shape follows the shape of the eyelid, hence being parallel. Dr. Zoumalan will discuss both options and help guide you through your decision-making process.

Parallel eyelid crease picture
Example 1. Parallel eyelid crease
Nasally tapered crease picture
Example 2. Nasally tapered crease. Not how the crease tapers as it nears the nose.

Do you wish for a slight lateral flare in your crease or a parallel lateral crease?

Some people wish to have a parallel lateral crease while others want to have some of the corner of their eyelid appear more “lifted.” The difference between the two is usually very subtle, but both at the end offer natural looking results. Dr. Zoumalan will help discuss these options with you and help guide you through the exciting process of getting you ready for your eyelid surgery.

Parallel lateral crease picture
Example 1. Parallel lateral crease.
Lateral crease flare picture
Example 2. Lateral crease flare
lateral parallel crease picture
Example 3. Shows the differences in a lateral flare versus a lateral parallel crease.

These are some of the questions that Dr. Zoumalan will be asking you during your consultation, so it would be beneficial to you to prepare ahead and to have a better idea which type of lid crease you best prefer. But if you feel that you are not quite sure at this time but wish to undergo Asian eyelid surgery, meeting with Dr. Zoumalan will better help you in this decision-making process.

Dr. Zoumalan and his office will be there to assist patients throughout the entire process as they undergo Asian eyelid surgery.

Where is the incision in the upper eyelids performed for upper eyelid blepharoplasty?

Dr. Zoumalan will carefully identify your natural fold and make an incision over the natural fold. Most of us are born with a natural fold; If the fold is too high or non-existent (as in some Asian eyelids), Dr. Zoumalan will discuss with you the options to change the fold of the eyelid. Dr. Zoumalan uses a modified technique to remove the excess lateral hood of the skin by curving side marks upwards that help in removing the lateral hood but also opening the eyelid while holding the forehead elevated. The incision of the hair cures well inside the crow’s feet. Curving down can often result in a more visible incision and can leave the residual skin and also bring the eyebrow down. Dr. Zoumalan pays close attention to wound closure using very fine, non-absorbable sutures, which are usually removed in 5-6 days.

Dr. Christopher Zoumalan is a board-certified oculoplastic surgeon in Beverly Hills, specializing in aesthetic and reconstructive oculoplastic surgery. Dr. Zoumalan is passionate about helping patients reach their ideal aesthetic and restore functionality with the leading cosmetic eyelid surgery, reconstructive eyelid surgery, and non-surgical cosmetic procedures. Dr. Zoumalan has been featured on several television shows and has traveled the world as a trusted oculoplastic specialist. Browse the video gallery below to learn more about oculoplastic procedures and treatments.
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