
A frequent demand from the Asian population is the westernization of the gaze. The wish is not really to have a causal eye but rather to get an opening of the gaze. Different techniques exist to meet this demand.
ANATOMICAL DIFFERENCES BETWEEN ASIAN AND EUROPEAN EYES
Asian upper eyelid
- Orbital fat is more abundant.
- The septum is inserted very low, with the aponeurosis of the levator, under the upper rim of the tarsus. There are no attachments between the expansions of the levator aponeurosis and the skin.
- The palpebral skin is very lax.
- The palpebral fissure appears narrowed. The upper palpebral fold, very often even absent, is situated very low, at a little distance from the line of the eyelashes.
Epicanthic fold
Conjugation of cutaneous laxity and the low position (or absence) of the upper palpebral fold create a medial canthal fold: the epicanthus. There are four stages of epicanthus depending on the importance of the pretarsal skin fold at the level of the canthus. Types II and III are most commonly found in the Asian population.
Lower eyelid
- The insertion of the septum is high located near the ciliary line.
- The palpebral muscle is less thick at this level.
- The fat pockets appear early, but are stable over time.
There are several types of upper palpebral folds

Absent eyelid crease
This is known as the monolid, as there is no distinct eyelid crease separating the lid into two parts.

Tapering eyelid crease with lateral flare
The outer part of the eyelid platform is wider than the central part of the platform.

Multiple eyelid creases
Multiple creases exist in upper eyelid.

Parallel eyelid crease
The inner corner of the crease does not narrow as a tapering crease does

Partial eyelid crease
There is a crease but it isn’t well defined and it may not extend entirely across the eyelid. With age, the partial crease can become more defined as the skin above the crease becomes looser.

Tapering eyelid crease
A tapering crease becomes much more narrow toward the inner corner of the eye.
POSSIBLE TREATMENTS

Threads and mesothreads
The opening is at the level of the upper eyelid and the eyebrow. The result lasts about a year and a half and is visible after one week, once the inflammation has disappeared. For the upper eyelid of very fine threads, the mesofils are inserted into the skin which has a tightening effect. At the eyebrow we put notched threats, which have a lifting action more important but unfortunately can not be placed at the level of the upper eyelid.
Hyaluronic acid for making lower eyelid
A frequent request is the creation of the lower eyelid. The curved lower eyelid creates a zone of light at this level. We perform an injection of hyaluronic acid, usually by needle. The result lasts about two years.


Hyaluronic acid for look rejuvenation
As time goes by, the upper eyelid of Asia widens, like all eyelids. The loss of fullness is treated by injection of hyaluronic acid. Using a cannula, hyaluronic acid is injected at the orbital rim to replace the fat that has melted. The result is immediate and lasts about two years. The suites are mild, marked by hematomas (rare) and local edema.
BEFORE AND AFTER PICTURES




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