Patients of East Asian and Southeast Asian heritage searching for eyelid surgery in Sydney often come across two terms: "double eyelid surgery" and "Asian blepharoplasty". The two refer to the same general operation. This page explains what the procedure actually involves, how the planning differs from standard Western upper blepharoplasty, and what the consultation pathway looks like at Dr Georgina Konrat's Bondi Junction practice in Sydney.
The Underlying Anatomy
The reason a separate term exists is anatomical, not aesthetic. The upper eyelid has a structure called the supratarsal crease — the fold that appears when the eye is open. In Western anatomy, the levator aponeurosis (the connective tissue that lifts the lid) attaches to the skin at a relatively high point, producing a defined crease.
In a proportion of East Asian and Southeast Asian eyelids, the attachment is lower or absent, the pre-aponeurotic fat pad is more prominent, and an epicanthal fold may be present at the inner corner of the eye. The result can be an upper eyelid without a defined crease (a "single eyelid"), a shallow or partial crease, an asymmetric crease between the two eyes, or a crease that sits very low. None of these are problems in any clinical sense — they are anatomical variations.
Asian blepharoplasty is the name commonly used when the operative goal is to create or refine the upper eyelid crease rather than remove redundant skin from a crease that already exists.
What the Procedure Aims to Do
The aim is to create a defined supratarsal crease at a chosen height and shape, fitting the rest of the patient's features. In practice, this is done by attaching the upper eyelid skin to the deeper structures (the levator aponeurosis or the tarsal plate) at the planned crease line. When the eye opens, the skin folds along that fixed line — that is what creates the visible crease.
Some patients also have skin or fat that benefits from being addressed at the same time, particularly older patients who have developed both an indistinct crease and excess upper eyelid skin. In those cases the procedure incorporates elements of both Asian and standard blepharoplasty planning.
Technique Families
Incisional
A continuous skin incision is made along the planned crease line. This allows controlled removal of skin or fat where indicated, direct fixation of the crease, and a more permanent result. The trade-off is a more visible incision line during early healing — although the scar settles into the new crease and is generally well hidden once healed.
Non-incisional (suture)
Small entry points are made along the planned crease line. Permanent sutures pass between the skin and the deeper tissue at the chosen height, producing a crease without a continuous skin incision. The approach has less surface scarring and a faster recovery profile, but the crease is generally less permanent than an incisional result — the suture loops can loosen over time in some patients, and the approach does not allow for skin or fat removal.
Partial incision
A middle-ground approach using two or three short incisions along the crease line. Allows some debulking and direct fixation while keeping less surface scarring than a continuous incision. Suitability depends on the amount of skin and fat present and the patient's preferences.
Technique selection is decided at consultation based on the patient's anatomy, the goal crease height and shape, and other practical factors like whether skin or fat removal is indicated. There is no single "best" technique — different patients suit different approaches, and Dr Konrat will explain which would suit your specific case before any decision is made.
What the Procedure Does Not Do
Asian blepharoplasty does not change the colour of the iris, the shape of the eye opening (the palpebral fissure), or the underlying ethnicity-defining bone structure of the face. It does not address epicanthal folds — that is a separate procedure called epicanthoplasty which Dr Konrat does not currently perform. It does not address dark circles under the eyes or crow's feet, which are skin-quality and muscle-movement issues respectively.
It also does not guarantee a specific celebrity lookalike result. Photo references can help the consultation conversation about crease height and shape preferences, but the final result depends on the patient's own underlying anatomy. AHPRA rules prohibit outcome promises in cosmetic advertising and Dr Konrat's practice follows those rules in both advertising and consultation.
Recovery and Realistic Expectations
Most patients take 7 to 10 days off work, more if their work is customer-facing. Bruising and swelling are most noticeable in the first 48 to 72 hours and settle gradually over two to three weeks. Strenuous exercise is avoided for two to three weeks. Crease definition often appears higher and more defined than the final result for the first several months — the final crease settles by three to six months as deep tissue swelling resolves.
Asymmetry between the two eyes during healing is common and not the same as final asymmetry. Final symmetry is assessed several months post-procedure, and revision is discussed only after the result has had time to settle. Detailed written recovery instructions and follow-up appointments at the Bondi Junction practice are part of the standard pathway.
Risks Specific to Eyelid Surgery
All surgery carries risks. Risks specific to Asian blepharoplasty include asymmetric crease height, partial loss of crease definition over time (particularly with non-incisional techniques), unfavourable scarring, dry eye in the early healing phase, altered sensation, difficulty with full eye closure during the first week, and the possibility of revision surgery. Risks specific to any eye-area surgery — bleeding behind the eye, vision changes — are very uncommon but recognised. All of these are discussed in detail during the two required consultations, and written information is provided for the seven-day cooling-off period before booking.
The Consultation Pathway in Sydney
Asian blepharoplasty in Australia follows the same regulated cosmetic surgery pathway as any other cosmetic procedure:
- Current GP referral required before the first consultation.
- Two consultations before surgery, with at least one in person.
- Mandatory seven-day cooling-off period before surgery can be booked.
- Patient must be 18 or over.
- Written quote provided after the first consultation, covering practitioner, anaesthesia, and facility fees.
Dr Konrat's practice is at Suite 402, Level 4, 59-75 Grafton Street, Bondi Junction NSW 2022 — three minutes' walk from Bondi Junction station, opposite Westfield. The practice has an all-female clinical team. For full procedure information including recovery, risks, and anaesthesia options, see the main eyelid surgery page. For fees, see blepharoplasty cost Sydney.