Eyelid Surgery: Enhancing Eye Shape and Aesthetic Concerns

I would like to inquire about procedures to elongate the eyes by altering the inner or outer corners, as well as questions related to eyelid surgery?

Hello, doctor.
I am 23 years old and have a smaller palpebral fissure relative to my facial proportions, which gives my eyes a short and lackluster appearance (I have a slightly larger face with a longer midface to chin, making the small eye feature more pronounced).
I am unsure if this is simply due to the palpebral fissure being too short or if it is a result of congenital development issues with my eyeball or orbit.
I hope to achieve a more elongated eye shape, perhaps even a more classically Eastern "phoenix eye."
First question: Regarding lateral canthoplasty or medial canthoplasty (palpebral fissure surgery), my eye shape features a mildly drooping medial canthus (mongoloid fold) and a more elevated lateral canthus (almond-shaped eye).
The palpebral fissure is relatively short and does not have the elongated appearance of a phoenix eye, although it is close.
Additionally, I have a slight upward strabismus, which causes some scleral show and makes my eyes appear more lifted and less expressive.
Would this condition be suitable for lateral or medial canthoplasty? What is the general cost for such procedures? On the day the anesthesia wears off, will the changes be noticeable in appearance? I would prefer not to let my parents know.
Second question: Regarding whether to maintain my external double eyelids or switch to single eyelids (blepharoplasty), I currently have external double eyelids, but they are not deep-set, and the crease is shorter than the palpebral fissure itself.
Given my upwardly slanted and smaller almond-shaped eyes, I often feel that the double eyelid crease near the medial canthus obstructs my vision, making it difficult to open my eyes fully.
I have to strain my brow and eyes, which is quite uncomfortable.
Therefore, I would like to know if it is possible to convert my eyelids to single eyelids, or if this is solely an issue of the palpebral fissure not being elongated enough, unrelated to the double eyelid.
If the external double eyelid does play a role, would changing to single eyelids cause the distance between my eyebrows and eyes to decrease? My eyebrows are already close to the double eyelid crease, and any further proximity would be aesthetically unpleasing.
I have been confused by these issues for many years, and I hope you can provide detailed answers.
Thank you for taking the time to read this.

Mr. Chen, 20~29 year old female. Ask Date: 2017/05/13

Dr. Zhou Hongzhang reply Plastic Surgery

A physician must personally examine a patient before administering treatment, prescribing medication, or issuing a diagnosis.
These issues are complex and require face-to-face consultation for a more appropriate approach.
In simple terms: 1.
Simple eyelid surgery can only alter the appearance of the eyelids and cannot change the size of the palpebral fissure or the position of the eyeball.
2.
It is rare for someone to achieve a single eyelid appearance.
3.
Cosmetic surgery merely makes the eyes "look" more attractive, rather than changing the actual size of the eyes or the palpebral fissure.
4.
It is best to have an in-person consultation to better understand these complex issues.

Reply Date: 2017/05/13

More Info

When considering eyelid surgery, particularly for aesthetic enhancement, it is essential to understand the various factors that contribute to the appearance of the eyes and how surgical options can address specific concerns. Based on your description, it seems you are experiencing a combination of anatomical features that may be affecting your eye appearance, including a smaller eye fissure and possibly some degree of ptosis (drooping) at the inner corner of your eyelids.

Understanding Eye Shape and Aesthetic Concerns
1. Eye Fissure and Anatomy: The size and shape of the eye fissure (the opening between the eyelids) can significantly influence the overall appearance of the eyes. A smaller eye fissure can create the illusion of smaller, less expressive eyes. This can be due to genetic factors, the natural aging process, or even environmental influences. In your case, it seems that the combination of a smaller eye fissure and a longer facial structure is contributing to the perception of your eyes being less prominent.

2. Surgical Options:
- Canthoplasty or Canthopexy: These procedures can be performed to elongate the eye fissure by adjusting the outer or inner corners of the eyelids. Given your desire for a more elongated, almond-shaped eye (often referred to as "凤眼" or phoenix eyes in Eastern aesthetics), these procedures may be suitable for you. The specific choice between opening the inner or outer corners will depend on your individual anatomy and desired outcome.

- Double Eyelid Surgery: Since you currently have a double eyelid that is not very deep, you might consider discussing the possibility of adjusting the crease to enhance its definition or even transitioning to a single eyelid if that aligns better with your aesthetic goals. However, it’s crucial to understand that changing from double to single eyelids may not necessarily resolve the issue of eye fissure size.

3. Recovery and Aesthetic Impact:
- Post-Operative Appearance: Immediately after surgery, there will likely be some swelling and bruising, which can make the eyes appear different than expected. This is a normal part of the healing process, and most of the swelling should subside within a few weeks. However, it is advisable to prepare for the possibility that your eyes may look slightly different during the initial recovery phase.

- Cost Considerations: The cost of eyelid surgery can vary widely based on the complexity of the procedure, the surgeon's experience, and the geographical location of the clinic. Generally, you might expect to pay anywhere from $2,000 to $5,000 or more for these types of surgeries. It’s best to consult with a board-certified plastic surgeon or ophthalmic surgeon to get a detailed quote based on your specific needs.

4. Consultation and Decision Making: Given the complexity of your concerns, it is highly recommended to have a thorough consultation with a qualified surgeon who specializes in eyelid surgery. They can provide a personalized assessment, discuss the potential risks and benefits of each procedure, and help you set realistic expectations for the outcomes.

5. Psychological Considerations: It’s important to consider the psychological aspects of undergoing cosmetic surgery. Many individuals experience anxiety about their appearance and the potential outcomes of surgery. Engaging in open discussions with your surgeon about your concerns and expectations can help alleviate some of this anxiety.

In conclusion, eyelid surgery can be a viable option for enhancing the appearance of your eyes and addressing your aesthetic concerns. However, it is crucial to approach this decision with careful consideration and professional guidance to ensure that the outcomes align with your expectations and enhance your natural beauty.

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