Sharon Horiuchi says applying makeup is a lot easier since she had eyelid surgery

More than 160,000 people have their eyelids reshaped by plastic surgeons each year. The eyelifts or blepharoplasty procedures tighten loose, sagging lids or remove puffy bags below the eyes. They can also add a fold or crease to the upper lid, an especially popular effect among some Asian women.

“The best candidate for this procedure is someone who can’t see their upper lid because they have a fold of skin that’s too low, or their fold is deficient,” says Garth Fisher, MD, a plastic surgeon in Beverly Hills who performs a new, simple eyelift procedure known as cinch blepharoplasty.

Sharon Horiuchi of Southern California underwent the cinch eyelift and says, “It’s just a very subtle and natural look. I was very pleased.”

Dr. Fisher explains that the procedure was developed in Asia for Asian women. “But I’ve modified it for Caucasian patients, and for those individuals that it’s really useful for.”

Dr. Fisher makes three tiny openings in each upper eyelid, and puts sutures through the skin. “Then I cinch it, and make a new fold,” he explains. He usually doesn’t have to cut any skin, and the patient recovers in about two days.

Eyelifts are sometimes necessary when drooping upper lids interfere with vision. But more commonly, people get them for aesthetic rather than medical reasons. Wider, more open looking eyes are in. At least among those who go for the procedures.

Others contend that Western standards of beauty shape images of women in the media, and falsely promote rounder, bigger eyes as more beautiful. But, William Chen, MD, of The Asian Eyelid Surgery Center in Southern California, says he honestly does not believe that most Asian patients seek Western looks.

“Rather, they want to retain their Asian features with the addition of an aesthetically pleasing Asian eyelid crease, just like their Asian friends or siblings,” says Dr. Chen.

About 50 percent of Asians are born with the single eye lid type, adds Dr. Chen. The others have an upper lid crease, often called the double eye lid.

“Asian eyelid creases are quite different from the Caucasians’ in terms of length, shape and height,” he explains.

“Although there are many attractive individuals that have the single eyelid type, many Asians desire to have the upper lid crease, giving an overall impression of a larger appearing eyelid opening.”

He adds that women like it because it’s easier to apply make up after an eyelift.

“I would do it all over again in a heart beat,” says Horiuchi. “I just put on some mascara and go. It’s a real time saver.”

Upper eye lid procedures represent the most common plastic surgeries in Asia, and the most frequent ones chosen by Asians living in America as well.

The subject, however, raises serious identity issues for some. Carrie Chang, chief editor of Monolid magazine, finds the eyelifts anything but attractive. An article titled “Eyelid Surgery in the 90s: Are Monolids a Dying Breed?” appeared in the first issue and captured the recurring theme of cultural assimilation that surrounds the issue of eyelifts for Asians.

In another feature, the rock group SuperChink addressed the frustrations of being “yellow” in a “snow white world.” Lead guitar player Bert Wang says he’s subject to racist comments like “Hey chinky boy what’s wrong with your eyes?”

Still, the delicate subject remains off limits in most polite circles.

Blepharoplasty costs as much as $3,500 in the United States compared to only about $800 to $1,200 in Seoul, Korea where it is said to be as common as braces are in America.

40 percent of young Korean women undergo the surgery, and many participate in groups where money is pooled so each person can obtain enough cash for an eyelift when her turn comes.

Dr. Fisher makes three tiny punctures in each lid and places several sutures to cinch and shape the eyelid fold

The cinch blepharoplasty procedure takes less than 30 minutes, says Dr. Fisher. Horiuchi returned to work just a couple of days after the procedure, and says her recovery was quick and easy. “It was just a very feasible and appealing option for me,” she says. “Before, I would apply my makeup strategically to make my eyes look bigger. Now, I don’t have to worry about that.”

The American Academy of Facial Plastic and Reconstructive Surgery points out that complications can occasionally follow various kinds of blepharoplasty procedures. Double or blurred vision can occur for a few days, temporary swelling, and a slight asymmetry in healing or scarring may follow.

The risks of blepharoplasty increase for patients who have thyroid disease, high blood pressure or lack sufficient tears to keep their eyes well lubricated.

The Plastic Surgery Information Service cautions that complications can arise from any surgical procedure. These include bleeding, infection, and scarring. But they are rare with blepharoplasty.