Double Eyelid Surgery in Kuching

Overview

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What double eyelid surgery is

Roughly half of people of East and Southeast Asian descent are born without a visible crease in the upper eyelid — a "single" or monolid. Double eyelid surgery creates a defined crease, so that the skin above the lash line folds when the eye is open.

It is one of the most commonly requested facial procedures in this region, but it is genuine surgery on a delicate and functionally important structure. The eyelid protects the eye, spreads the tear film, and carries much of your facial expression. Small differences in where a crease is placed change the entire look of the face.

The two main techniques

There is no single correct method. Which suits you depends on your skin thickness, the amount of fat in the lid, whether there is excess skin, and how permanent you want the result to be.

Incisional (open) method

A fine incision is made along the planned crease line. A small strip of skin, and sometimes a little muscle or fat, is removed, and the skin is fixed to the deeper tissue so that a crease forms reliably. This suits thicker lids, lids with excess or hooding skin, and anyone wanting a durable result. It leaves a scar along the crease line, which is hidden when the eye is open.

Suture (non-incisional) method

Several small openings are made and buried sutures are passed through the lid to create the fold. Recovery is usually quicker and there is no continuous scar. It suits thinner lids with little excess skin. Because the crease is held by sutures rather than scar tissue, it can loosen or lose definition over time.

Related procedures. Ptosis correction is a different operation, addressing a droopy upper lid caused by a weak levator muscle. Eyebag removal addresses the lower lid. These are sometimes done at the same time, and Dr Kueh will tell you at consultation whether that applies to you.

Who it may suit

• Adults who want a defined upper eyelid crease
• People with an uneven or partial crease on one or both sides
• People whose upper lid skin has begun to hood with age
• Those in good general health, who do not smoke, and who have realistic expectations

Who it may not suit

• Anyone with active eye disease, severe dry eye, or uncontrolled thyroid eye disease
• Anyone with a bleeding disorder or on anticoagulants that cannot safely be paused
• Patients under 18, unless there is a functional reason and a parent or guardian consents
• Anyone hoping surgery will resolve a problem that is not really about their eyelids

What recovery involves

Expect noticeable bruising and swelling for the first week to ten days — this is normal and not a sign that something has gone wrong. Cold compresses and sleeping with your head elevated help. Sutures, where used, come out at five to seven days.

Most people feel presentable enough to return to work after one to two weeks, though residual swelling is still visible up close. The crease usually looks higher and harsher than the eventual result for the first month or two. It takes three to six months for tissues to soften and the final shape to settle, and slightly longer for an incisional scar to fade.

Avoid heavy lifting and strenuous exercise for two weeks, keep the area clean and dry as instructed, and do not wear eye make-up or contact lenses until you are cleared to.

Risks and limitations

Every operation carries risk. For eyelid surgery these include bleeding, bruising, infection, dry or irritated eyes, temporary blurred vision, and a visible or thickened scar.

Specific to this procedure: the crease may end up higher, lower or shallower than planned; it may loosen with time, particularly after the suture method; and perfect symmetry cannot be guaranteed, because almost no face is perfectly symmetrical to begin with. Revision surgery is sometimes needed and is more difficult than the first operation. Serious complications affecting vision are rare but are not impossible.

These are discussed with you individually, along with anything specific to your anatomy, before you consent to anything.