The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.

The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.



Unsightly scars from suture method for Asian blepharoplasty

Photo by Professor Chua

Asian blepharoplasty is the most common cosmetic surgery performed to the eyelids in East Asia. The purpose of the operation is to create an upper eyelid skin crease which makes the eye appears bigger and more animated. Two operations are commonly used: the suture method and the incision method. The suture method is easier to perform and allows a faster recovery. However, recurrence is more common. In Malaysia, the suture method is often performed by non-medically trained beauticians with varying degrees of success and complications.

The young girl below underwent suture method of Asian blepharoplasty a year ago by a beautician. Post-operatively, she developed unsightly lumpy lesions in the upper eyelids. In addition, she was unhappy with the appearance of the skin creases as they are not showing well. The lumpy lesions appeared to arise from the sutures used in the procedure. An incision method was performed to re-shape the skin creases. During the operation, prolene sutures that are responsible for the unsightly lesions were removed.


Patient presented with hidden upper eyelid skin creases.


Unsightly upper eyelid lesions along the skin creases created using the suture method.


Tissue excised during reshaping of the skin creases. The arrows show the non-absorbable sutures (prolene) used

to create the skin creases and were responsible for the lumpy lesions.


The appearance of the eyelid one week post incision method. There is a slight skin crease asymmetry due to

eyelid swelling.

Atlas of Oculoplastic Surgery