Obviously the less invasive “suture fixation” techniques offer quicker recovery time. Unfortunately, due to shearing effect of the suture and the inherent bulk and heaviness of the underlying fat and muscle tissues, high percentage of the folds will disappear. Using the open approach, the surgeon has the ability to visualize and accurately remove the appropriate amount of fat and muscle, and skin if needed. In essence, Dr. Kang “sculptures” the eye to appear more naturally like those patients who were born with the double eyelid fold, allowing the double eyelid creation to be more reliable and exact. Very often the swelling is only slightly more than the suture fixation technique, and the incision site heals quickly. When performing the open technique, Dr. Kang believes that the surgeon must be “light-handed” and must never create an artificially “overdone” looking fold. Most of the time, the open technique provides a permanent result with imperceptible scar, which in time, should look almost as natural as perhaps another similar appearing Asian person born with the fold. You should definitely ask to see Dr. Kang’s Portfolio and see how well versed he is with this procedure.
There are two ancillary procedures unique to creation of double eyelid surgery. Most Asian patients have a degree of epicanthal fold which rounds out the “inner” aspect of the eye, sometimes limiting the degree of the double eyelid show. In patient with mild epicanthal fold, at the time of double eyelid surgery, the tissues in the inner part of the eyelid is sculptured to open up the epicanthal fold as naturally as possible, without any additional incision. In patients with severe eipcanthal fold, a formal Epicanthoplasty procedure can be performed, which advances the small flap of skin and opens up the inner part of the eyelid. However, no matter how successful the epicanthoplasty procedure is, the external scar can be visible to a discerning eye, and Dr. Kang always reserves this procedure for patients who carefully outweigh the benefit of more open inner eye versus permanently having a small visible scar in this area. Lateral canthoplasty is a procedure which attempts to widen the “outer” aspect of the eye, but by nature, “loosening” an anatomical structure rather than “tightening” can lead to a more variable result, which can create greater asymmetry between the two eyes and Dr. Kang feels that the procedure should be limited for patients with severe lateral slant of the eye.