If you have not noticed or thought about it, the eyelids of Asians are quite different from those of other ethnicities. About 50% of Asians are born with double eyelids (i.e., an upper and lower part prominently defined by a crease). Performing eyelid surgery for patients of Asian and of Western descent (Occidental) differ tremendously in terms of goals, technique and procedure. For instance, the goal of eyelid surgery for Western patients is to restore to a fresh and youthful appearance. This is accomplished by removing extra skin, stretched skin, and fat that is not in the optimal position as well as lifting sagging eyelid tissue. Eyelid surgery for Westerners is performed on patients age 40+. Unlike eyelid surgery for Westerners, the aim of Asian patients seeking double eyelid surgery is usually not an anti-aging blepharoplasty procedure, but the actual creation of an eyelid crease, enhancing a poorly defined crease, and/or improving symmetry of the eyelid structure. Many young Asians in their teens and early 20’s desire double eyelid surgery. Despite what some commentators say, Asians do not seek double eyelid surgery so they can look more Western and are proud of their heritage and culture. Each patient has his/her unique reason for double eyelid surgery, and some reasons reported to Dr. Eisemann include wanting to have more expressive eyes, to enhance their unique beauty, to have eyes that look bigger and more proportional to the face, and some women enjoy having more eye “real estate” to work with when using cosmetics. As with any plastic surgery procedure, you should carefully vet your surgeon’s credentials, years of experience and certifications by the American Medical Association. But, with Asian eyelid surgery, you need to be very clear regarding your expectations. You want a surgeon who has performed more than just one or two of these operations during his/her career.