Asian Blepharoplasty
Asian blepharoplasty — also called double eyelid surgery — is one of the most commonly performed cosmetic procedures among patients of East Asian descent worldwide. The goal is to create a defined upper eyelid crease in patients who have a single eyelid (monolid) or an indistinct crease that makes the eye appear smaller or heavier than the patient would like. Patients of East Asian and other backgrounds travel to Dr. Rafizadeh's Morristown practice from across North Jersey — Bergen, Essex, Morris, and Union counties — and from the greater NYC area for double eyelid surgery that respects their natural features.
Approximately 40–50% of people of East Asian descent lack a defined upper lid crease. This is caused by a difference in the anatomy of the levator aponeurosis — in single-eyelid anatomy, the levator fibers do not attach to the overlying skin in the same way, so no crease is formed. Asian blepharoplasty creates that attachment surgically, producing a crease that opens the eye and adds visible lid platform above the lash line. For a broader overview of eyelid surgery options at our Morristown, North Jersey practice, see our guide to blepharoplasty & eyelid surgery.
“The goal of Asian blepharoplasty is not to create a Western-looking eye. It is to honor what is already there — and enhance it. A crease placed too high, or a lid sculpted too aggressively, will always look wrong. The result should make the patient look like a better version of themselves.”
— Dr. Farhad Rafizadeh MD FACS
Incisional vs. Non-Incisional Technique
There are two main surgical approaches, each with distinct advantages and limitations:
| Feature | Incisional | Non-Incisional (Suture) |
|---|---|---|
| How it works | Small incision creates crease, removes tissue, fixates skin to levator | Buried sutures link skin to levator — no excision |
| Permanence | Permanent — crease does not fade | Crease may weaken or disappear over years |
| Best for | Thicker lids, prominent fat, desire for permanent result | Thin lids, minimal fat, reversibility desired |
| Tissue removal | Skin, muscle, and/or pre-tarsal fat as needed | None |
| Recovery | 10–14 days | 7–10 days |
| Revisability | Revisable but more complex | Easily revised or reversed |
Crease Height, Shape, and Configuration
The crease can be designed in several configurations:
Parallel crease — The crease runs parallel to and equidistant from the lash line across the full width of the lid. Creates a symmetrical, open appearance. More common in patients seeking a noticeable change.
Tapered (convergent) crease — The crease narrows medially toward the inner corner, which is more natural-appearing for many Asian patients and tends to look less Westernized. This is often Dr. Rafizadeh's recommendation for patients who want a subtle, natural result.
Nasally tapered crease — Fades toward the inner corner, blending with the existing anatomy. Appropriate for patients with a prominent medial epicanthal fold who do not want epicanthoplasty.
Crease height is discussed and marked with the patient awake and upright, examining their own eyes in a mirror. This collaborative process is essential — the final crease position should reflect the patient's goals, not a formula.
Epicanthoplasty and Inner Corner Refinement
Some patients of Asian descent have a prominent medial epicanthal fold — a skin fold that partially covers the inner corner of the eye. Epicanthoplasty modifies this fold to expose more of the inner corner and create a longer-appearing eye. It can be performed at the same time as Asian blepharoplasty or as a separate procedure. Dr. Rafizadeh discusses whether epicanthoplasty is appropriate for each patient's goals and anatomy at the consultation.
Recovery Timeline
Days 1–5: Swelling is more pronounced than with standard upper blepharoplasty — this is expected. Cold compresses and head elevation are important. The crease may look exaggerated during this period.
Days 7–10: Sutures removed (incisional technique). Swelling begins to resolve significantly.
Weeks 2–3: Most patients are comfortable returning to social activities. The crease settles and softens.
Months 1–3: Progressive resolution of residual swelling. Final crease height and shape becomes apparent. Incisional scars fade to essentially invisible by 3–4 months.
Cost of Asian Blepharoplasty in New Jersey
Asian blepharoplasty in New Jersey typically ranges from $4,500–$7,500 depending on technique (incisional vs. non-incisional) and whether epicanthoplasty or other refinements are combined. An exact quote is provided at consultation. Financing through Prosper Healthcare Lending is available.