Upper blepharoplasty is a skin operation, not a crease operation
Written by KCODI medical interpreter team · English deskUpdated · 8 min read
Upper blepharoplasty is what most people over about forty actually want when they start looking at Korean eye surgery. The complaint is not that there is no crease. It is that the skin above the crease has begun to sit on the lashes, the eye looks smaller in photographs, and eyeshadow disappears the moment the eye opens.
Korea markets double eyelid surgery so heavily that this gets conflated with it constantly. They overlap, but they are different operations with different aims, and a consultation that starts in the wrong place ends in the wrong place.
There is also a third possibility that gets missed: the lid may not be heavy at all. The eye may simply not be opening fully, which is a muscle problem and a different repair again.
Three problems that look identical in a mirror
| Problem | What you see | Usual operation | What it does not fix |
|---|---|---|---|
| Excess upper lid skin | Skin resting on the lashes, hooding at the outer corner | Upper blepharoplasty: skin, sometimes a little muscle or fat, removed | A low brow, or an eye that opens weakly |
| Weak lid opening (ptosis) | Eye looks sleepy, you raise your eyebrows to see, one eye sits lower | Ptosis correction, working on the lifting muscle | Loose skin, which may still need removing |
| Descended brow | Heaviness that improves when you push the brow up with a finger | A brow procedure rather than a lid one | Anything on the lid itself |
| Absent or uneven crease | No fold, or a fold on one side only | Double eyelid surgery, incisional or non-incisional | Hooding caused by loose skin |
The finger test is the one to do before you fly: push the tail of your brow gently upwards. If the heaviness largely disappears, a lid operation alone will not give you what you are imagining. The crease-focused operations are covered on the Korean eyelid surgery page and in monolid versus double eyelid.
What the operation involves
It is usually done under local anaesthetic with light sedation, takes under an hour, and leaves a line that sits in the fold. Stitches come out within about a week. Bruising varies enormously between people and has very little to do with the surgeon.
You will be awake for most of it and you will be asked to open and close your eyes during the operation. That is normal, it is how the surgeon checks the result in real time, and it is a great deal easier when somebody is translating the instructions rather than miming them at you.
- Marking is done sitting upright with your eyes open, which is the part that matters most. If nobody marks you sitting up, ask why.
- How much skin is removed is a judgement, not a measurement. Too much leaves an eye that will not close properly.
- Fat may be removed or repositioned, and increasingly surgeons remove less than they once did.
- If the lid also opens weakly, ptosis correction is done at the same time, which lengthens the operation and changes the price.
- The result settles over months. The line fades over considerably longer than that.
Why the Korean version is not just cheaper
Seoul surgeons perform eyelid operations in extremely high volume, and the technical standard in the better clinics is genuinely high. That is the real reason people come. The caution is the other side of the same coin: a market this busy also contains clinics that sell the same operation to everyone who walks in.
There is one Korea-specific detail worth knowing. Surgeons here are extremely used to eyelids with an epicanthal fold and thicker lid skin, and the techniques are adapted for that anatomy rather than borrowed from elsewhere. For patients with Asian eyelids this is a genuine reason to travel, and it is a different argument from the price one.
- Ask whether your case is skin, muscle, brow or a mixture, and expect a specific answer.
- Ask how often the surgeon does ptosis correction specifically, if that is part of your plan.
- Ask what happens if the two sides settle unevenly, which is common and usually minor.
- Ask about dry eye, particularly if you already have it or you wear contact lenses all day.
- Ask whether follow-up and stitch removal are inside the quoted price.
Cost questions for the crease operation are answered in how much double eyelid surgery costs in Korea, and the way to judge a surgeon in general is in choosing plastic surgery in Korea.
The recovery, and the part visitors get wrong
Swelling peaks in the first two days and then improves quickly. Most people are presentable with glasses after about a week, once stitches are out, and comfortable in photographs some weeks later. The scar line goes through a pink phase before it settles.
The mistake is flying too soon. Stitch removal is around day five to seven and it is worth being in Korea for it, rather than asking a clinic at home to deal with somebody else's surgery. Cabin air on a fresh lid is also unkind, and dryness is worse than people expect.
Plan for cold compresses, a room where you can sleep propped up, and low expectations for about ten days. The other eye operations and how they compare are set out in Korean eye surgery: which operation. To have clinics shortlisted around your photos and dates, use clinic matching.
