Having natural-looking double eyelids can be a dream for some, increasing one’s confidence. If you are interested in achieving natural-looking double eyelids, there are some things that you need to take note of.
My experience as a plastic surgeon in Singapore for over 10 years has allowed me to share my knowledge with you. In this article, I talk about:
- Non-surgical method to achieve double eyelids,
- How double eyelid surgery works,
- Cost of the procedure,
- And other related questions regarding achieving natural-looking double eyelids.
I hope this article helps.
“Why do I have single eyelids?”
You may be wondering- why do some of my friends have double eyelids and I have to live with single eyelids?
A Double eyelid happens when your eyelid crease is perfectly formed, where the eyelid skin and the deep eyelid opening muscle is attached. 
If your peers have natural double eyelids, it means that their crease is strong and present.
Getting double eyelids without surgery
If you feel like getting double eyelid surgery is a bit too extreme, there are ways you can do to give yourself double eyelids:
Eyelid tape or glue
Eyelid tape is a thin and clear strip that you place on your eyelids to create a temporary crease. On the other hand, eyelid glue uses the same method to create a crease. These products help to make your eyes appear ‘awake’ and fresh. The only difference is that eyelid glue looks more natural compared to eyelid tape.
Plexr is a non-surgical procedure that lifts your eyelid and creates creases by tightening the skin around your eyelid area. The recovery time for plexr procedure is short and the result lasts up to 3 years. 
How double eyelid surgery work
There are 2 types of double eyelid surgery that people commonly do:
Non-incisional blepharoplasty or suture blepharoplasty is a scarless method where your eyelid is stitched to create a crease. You will be injected with a local anaesthetic before the doctor proceeds with the procedure.
Generally, the procedure lasts 20-30 minutes. Since this procedure is not a surgery, it has little downtime.
Incisional blepharoplasty is a type of eyelid surgery that involves cutting excess fat, skin, and muscle on where the eyelid crease is meant to be. The average downtime is 2 to 3 weeks and the result is relatively permanent.
Aside from creating a double eyelid that enlarges your eyes, this technique can also: 
- Treating droopy upper eyelids
- Get rid of excess skin that impedes with your vision
- Change the shape of your eyes
Even though incision can seem scary, the scar generally decreases after 4-5 months.
Cost for double eyelid surgery in Singapore
In Singapore, the cost for incisional double eyelid surgery starts from $5000, whereas the cost for non-incisional double eyelid is around $3200-$4000.
Double eyelid surgery procedure
Before the procedure
Before the double eyelid surgery procedure, you will be given an option for local anaesthesia or sedation. Your doctor will also make a measurement and mark your eyelid before proceeding the procedure. According to your medical background, your doctor will recommend the best choice for you.
If you are choosing the non-incisional procedure, your doctor will usually recommend the local anaesthesia instead of sedation due to the duration of the procedure.
During the procedure
Your doctor will start to make an incision on your upper eyelid within the natural crease of your eyelid. During this process, your doctor will remove or reposition the fat or muscle on your eyelid.
Typically, the incision is closed using stitches or skin glue. After one week, the stitches will be removed. 
4 small holes are made to allow the stitches to be placed. The procedure itself takes a maximum of 30 minutes for both eyes. There is little downtime as it is a less invasive method.
Typically, the stitches can be removed after 4 to 5 days.
Is double eyelid surgery painful?
The thought of having surgery on your eyes can sound scary. However, if you are under sedation, you will not feel or hear anything and you will wake up with your eyes feeling tight or with a bit of aching.
Local anaesthesia is usually used for non-incision eyelid surgery. You will be able to hear but you will not feel anything. Aching and tightened skin are the common side effects post-procedure.
That being said, the aching feeling will go away after the swelling is gone.
Will my double eyelids be permanent after surgery?
The result for incisional surgery is permanent, whereas the result for non-incisional surgery is temporary. Even though it is temporary, the result for non-incisional surgery can last up to 10 years.
Your skin loses its elasticity and your eyelid muscle loses its strength to elevate the eyelid as you age, so it is natural for your eyelids to change over time.
Chances of surgery failure
There is always a chance of failure for every surgery. If you are doing the incisional surgery, your eyelids are cut to form a scar between the tissue and muscle in order to make the eyelid crease.
On the other hand, when you are doing the suture method, there is a higher chance for the method to fail due to:
Surgery failure can occur if your surgeon is not trained in the field. Mistakes, like using too little stitches or using an old technique, can also increase the chance of failure.
Suture blepharoplasty is not for you
Failure can also occur if you have thick and heavy upper eyelids. However, this risk can be reduced if you consult your doctor before proceeding to the procedure.
Lack of scar tissue forming
Since this method does not use incision, there is no area that can be used to stick down the eyelid to the muscle.
Is the post-surgery scar noticeable?
There will be no scar from the suture method. The mark from the suture will disappear completely, depending on how diligent you are when applying the scar gel. As for the incision method, the scar will heal and blend in with the skin and is varied within 4 to 6 months.
Most people are scared that the incision technique will leave a permanent scar. However, the scar from the incision technique will definitely heal.
What is the most common double eyelid surgery procedure in Singapore?
At the moment, suture blepharoplasty is the most common eyelid surgery, followed by the incisional blepharoplasty. The reason why the suture method is more common is that there is no downtime, and the cost is cheaper than the incisional blepharoplasty.
How to make sure I receive the best results after double eyelid surgery?
To receive the best results after the double eyelid surgery, you have to make sure:
You choose the best surgery options
During the consultation, make sure you discuss the end result that you wish with your doctor. It is done so your doctor can help you to choose the best treatment for you. It is important because some people have a certain eye condition that only allows them to do the incisional blepharoplasty.
You take proper measurement
Measuring your eyelid is one of the most crucial steps before doing the procedure. Inaccurate measurement can increase the chance of failure. Therefore, during this step, make sure you discuss your expected outcome with your doctor to minimise the risk of miscommunication.
Your surgeon is experienced
Highly trained and experienced surgeons mean that they are well trained to handle any unexpected scenarios. Highly experienced surgeons also mean that their works are recognised by many people. Therefore, it is more likely for them to exceed your expectation.
You get proper aftercare
Aftercare is one of the most important steps after the double eyelid procedure. You have to make sure that the staff is trained and professional in their field.
Professional staff means that they know the pre and post-surgery protocol as well as ensuring that the protocols are implemented. Aside from that, trained staff can help to educate you on which food/supplements to take or avoid and how to take care of the side effects post-surgery to minimise complications.
What factors determine the end result of my double eyelid surgery?
There are a lot of factors that can determine how your eyelid will end up look like:
- The actual size and shape of your eyes
- The amount of makeup that you use
- If you wear contact lenses, size matters
- The initial shape and position of your eyebrow
How long is the recovery time?
The recovery time for the non-incisional method is relatively fast. There is almost no scar visible and very little swelling. The recovery time varies from 2-10 days.
As for the incisional method, you can see the full result in about 6 weeks. The scarring and swelling should subside in about a week. However, there is still mild swelling or bruising after a few weeks, so you should refrain from bending or lifting exercise.
What if the result is unsatisfactory?
If the result is unsatisfactory, depending on your skin condition, some height and shape adjustments can still be done. Corrective surgery can also be done if there is a major complication from the blepharoplasty. However, the risk factor is also higher.
That being said, I would advise you to wait until the swelling is gone before deciding to ‘correct’ the surgery result as it takes time for the eyes to heal, especially if you are doing the incisional method.
Some of the double eyelid results that require surgical correction are: 
Excessively wide or narrow double eyelid fold
In Asia, a caucasian-looking double eyelid is one of the most desired results. However, there are cases where too much skin is folded, the skin is stitched to the levator muscle, or muscle and eyelid fat is cut off excessively and resulting in an excessively wide double eyelid fold.
Sunken upper eyelid
This occurs when the muscle that closes the eyelid is excessively removed. To correct this, a new incision is made and an adequate amount of fat from the lower eyelid is filled into the depression after the muscle that closes the eyelid is opened.
Uneven removal of eyelid muscle
To correct this, an incision is made on the upper eyelid skin to release the adhesions and trim the excess fat above the connective tissue (tarsus).
Disappearance of double eyelid
The cause of the disappearance of your double eyelid is due to the skin not firmly attached to the tarsus. Disappearance can also occur if you have mild ptosis and a weak eyelid muscle.
Asymmetrical-looking double eyelid
This may occur if your doctor did not measure your eyelid and height precisely. If you wish to repair this, you have to wait until 3 months before you can do the corrective surgery.
Loss of double eyelid muscle strength
This can occur due to injury to the muscle. The correction method for this is by making an incision to release the scar adhesion above the tendon sheath of the levator muscle, partially cutting the muscle that closes the eyelid and moving it to cover the released tissue of the muscle and stitch the skin.
Deformation of the double eyelid
This occurs mostly due to infection. To correct this, a new incision that follows the original line is made and releases the scar adhesion to restore the original position of the eyelid.
How to get the best result after my double eyelid surgery?
To get the best result, you have to:
- Use sunscreen and wear a hat or sunglasses when you are outdoors. This will allow the incision to fade and prevent the sun from damaging the area.
- Avoid heavy exercise and lift heavy objects as it can increase pressure in your eyes.
- Take cold compress. Compressing the eye area can help reduce the swelling significantly.
How to find the best double eyelid surgeon in Singapore?
To find the best double eyelid surgeon, you need to:
Do your research
Ask around or find information online to find out which clinic is the most popular to do double eyelid procedures. You can see the before after pictures as a comparison to see which suit your aesthetic preference.
Go with the surgeon that invests time to help you achieve the best result
A patient and friendly surgeon that invests their time to measure your eyes, and simulating the eyelid crease shapes and heights and make sure they can give you the best result is very crucial in determining which surgeon to go to.
If you are aiming for a long-lasting natural-looking double eyelid, you can achieve it through surgery and stitches. Before you proceed, make sure you are well-informed with the side effects that will come alongside the benefits.
I hope this article provides you with some enlightenment before you choose which procedure to go for. Do consult your trusted doctor if you have more questions regarding blepharoplasty.