Double Eyelid Surgery: Costs, The Procedure, Risks & More

Double eyelid surgery is a procedure that creates a crease in the upper eyelid, giving the patient more rounded eyes and a wider field of vision. This turns a monolid into a double eyelid. 

Although some people seek the treatment for health reasons, most patients undergo the procedure for cosmetic purposes. Double eyelid surgery is one of the most common surgeries in parts of East Asia, with growing popularity elsewhere in the world. 

What Is Double Eyelid Surgery?

Double eyelid surgery is the fairly simple process of creating a crease in the upper eyelid that results in a rounder-shaped eye. 

Many people from East Asian cultures consider double eyelids to be a desirable aesthetic feature, and this procedure is a viable option for cosmetic confidence. Other patients opt for the surgery because of oversized or afflicted upper eyelids, but this is less common. 

Excess skin, fat, and muscle can all be removed during the procedure, with the operating physician creating a natural look that can also be beneficial by providing a fuller field of vision.

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Double Eyelid Surgery vs. Blepharoplasty

Although both procedures are performed in similar ways and mainly for cosmetic purposes, they do have their differences. First and foremost, the goal of a double eyelid surgery is to create a crease in a naturally creaseless upper eyelid. 

Blepharoplasty, or eyelift surgery, is when excess skin or fat is removed from the upper or lower eyelid regardless of whether the patient has a monolid or not. This helps to eradicate saggy upper eyelids and bags underneath the eye. 

Typically, patients who opt for blepharoplasty want more youthful-looking eyes, whereas patients who undergo double eyelid surgery prefer to have rounder eyes. However, some people do have eyelids that cover too much of the eye, and both procedures can be beneficial.

Who Is a Candidate for Double Eyelid Surgery?

Generally, any adult who wants a more cylindrical appearance to their eyes and understands the potential risks can be a candidate for double eyelid surgery. Patients who have undergone the procedure have vocalized how having rounder eyes has given them more confidence. 

Some people are in need of double eyelid surgery due to medical reasons, including the improvement of vision or changing the direction upper eyelashes flow to prevent impairment and inflammation to the eye. 

In all cases, an ideal candidate must be relatively healthy and should not have any serious illnesses or any allergic reactions to anesthetics. 

Types of Double Eyelid Surgery

There are two main types of double eyelid surgery: a method that involves an incision and one that does not. The former can be broken down to full incision and partial incision. 

During the full method, an incision is made in an arch shape on the top of the eyelid. If necessary, excess skin, fat, or muscle can be removed at this point. Then, the incised skin is flipped over to create a creased eyelid. 

The partial method is similar, but the incision does not make a full arch shape above the eye. Determining whether a person needs to undergo a full or partial incision method depends on the natural eye shape and the desired slant that the crease should be.

These natural and restorative factors also determine if an individual needs the non-incision procedure, or buried suture method. Instead of incising along the top perimeter of the eyelid, the surgeon will make a few small cuts on the eyelid and then maneuver stitching through the newly created holes. This buries excess skin into the upper eyelid and creates the desired crease effect. 

The buried suture method results in minor scarring and a quick recovery, making it the preferable option for most candidates seeking double eyelid surgery.

Risks of Double Eyelid Surgery

Even though double eyelid surgery is a relatively safe procedure with a low complication rate, there are risks, even with the most experienced and skilled surgeon. Here are some of them:

• Dry eyes: Dry, irritated eyes are one of the most common risks, but this is also the least severe complication and easiest to treat.
• Hematoma: Usually caused by a broken blood vessel during the procedure, hematoma is also one of the most common risks, but it is easily manageable. 
• Infection: Infection after the procedure is rare, but it can happen. It can be treated with antibiotics.
• Retrobulbar hemorrhage: Retrobulbar hemorrhage is a rare condition that results in pressure behind the eye due to internal bleeding.
• Blepharoptosis: Blepharoptosis is when the upper eyelid droops over a portion of the cornea, usually due to skin that is too loose.

Double Eyelid Surgery Costs

Double eyelid surgery can usually be covered by insurance if it is performed for medical reasons. 

If the procedure is performed for cosmetic purposes, the average cost of cosmetic eyelid surgery is approximately $4,120, according to 2020 statistics from the American Society of Plastic Surgeons. This average price does not include anesthesia, operating room charges, or other associated costs. 

Prices may also vary depending on what type of double eyelid surgery is needed.

Recovery

Regardless of whether the patient receives an incision or not, hospitalization is not required after a double eyelid surgery. 

For recipients of the non-incision method, stitches can usually either be removed or dissolve within three days. Overall, patients experience a shorter recovery time. 

Patients who undergo the full or partial incision method will have their stitches either removed or dissolved within a week after the procedure. 

Typically, a doctor will prescribe medication for the pain, as the upper eyelids may feel tight or sore. A patient’s eyes might also be sensitive to light, watery, or itchy during the days after the surgery. Bruising around the eyes might also occur, but it should subside within two weeks. 

If the area of the procedure is carefully cleaned and protected, most people can return to work and daily activities within 10 days.

Alternatives to Double Eyelid Surgery

There are no permanent alternatives to double eyelid surgery, but there is a plethora of cosmetic adhesives that can create a similar effect by forcing a crease into the eyelid. These prove to be helpful for people who are trying to decide whether they want the procedure. 

People who are unable to afford the cost of the surgery may also find cosmetic eyelid adhesives to be a good solution. However, if someone wants a permanent change without applying glues or tapes on a daily basis, double eyelid surgery is the best option.

References

1. Asian Blepharoplasty. (August 2009). Cosmetic Surgery in the Ethnic Population: Special Considerations and Procedures

2. Asian Upper Blepharoplasty Double-Fold Procedure. (November 2007). Aesthetic Surgery Journal.

3. Blepharoplasty: An Overview. (July 2009). Journal of Cutaneous and Aesthetic Surgery.

4. Commentary on: Visual, Physiological, and Aesthetic Factors and Pitfalls in Asian Blepharoplasty. (February 2016). Aesthetic Surgery Journal.

5. Modified Double-Eyelid Blepharoplasty Using the Single-Knot Continuous Buried Non-Incisional Technique. (June 2013). The Korean Society of Plastic and Reconstructive Surgeons.

6. Management of Cosmetic Eyelid Surgery Complications. (February 2007). Seminars in Plastic Surgery.

7. A Modified Mini-Incisional Technique for Double-Eyelid Blepharoplasty. (June 2016). Sage Journals.

8. Review of Complications in Double Eyelid Surgery. (May 2022). Indian Journal of Ophthalmology.

9. Simultaneous Double Eyelid Blepharoplasty and Ptosis Correction With a Single-Knot, Continuous, Nonincisional Technique: A Five-Year Review. (October 2015). Aesthetic Surgery Journal.