I spent a few months this year training under Dr. Qingfeng Li, the head of Facial Plastic Surgery at Shanghai’s 9th People’s Hospital. He and his colleagues are the world’s experts on facial reconstructive surgery for Asian patients, and treat some of the toughest burn cases in all of China. As Shanghai’s largest plastic surgery hospital, they see more than their fair share of cosmetic cases as well. During my visit I witnessed over 200 procedures performed in just one day in the minor surgery center. Over one third of these cases were Asian upper eyelid blepharoplasties or “double eyelid” surgeries (a procedure that creates a crease in the upper eyelid for the 50-80% of Asian patients who do not have one). Another quarter were lower lid blepharoplasties (a procedure to remove some of the bulge caused by prolapsing orbital fat against the lower eyelid). In this setting, I had the chance to learn from over 15 different attending surgeons, each of whom had developed their own modifications and pearls to performing eyelid surgeries for the Asian patient. As with my experience with Dr. Julian Perry at the Cleveland Clinic, I am truly indebted to their willingness to share and teach.
Asian Blepharoplasty Revision
The surgeons at the 9th People’s Hospital, with their enormous patient volume as well as their national recognition as reconstructive specialists, also had more than their fair share of patients seeking to fix “botched” eyelid surgery. In China, cosmetic surgery is still unregulated. “Beauty shops” are opening on every street offering beautifying procedures. The vast majority are not performed by a physician let alone a surgeon. The “double-eyelid” surgery is already the number one plastic surgery of Asian patients. As cultures continue to blend, I believe these eyelid procedures will gain even greater acceptance. This will inevitably result in greater numbers of people who become disfigured by untrained hands. The need for reconstructive surgeons who specialize in the repair of Asian eyelids will continue to grow.
Reconstruction involves removing scar tissue and is far more complex an operation. Dissection requires a significantly more advanced appreciation of the individual tissue layers in the Asian eyelid. As scars vary with every patient, each reconstructive procedure is unique. As an ophthalmologist who specializes in plastic surgery around the eyes, I found this type of scar revision to be most rewarding.