The round eye deformity is a consequence of making the double eyelid crease (Philip Young MD from Bellevue, Washington) too high for the particular persons eye shape. What happens is that the eye appears to be much wider in the vertical dimension that appears Round and Odd without the horizontal natural appearing eye that most eyes should have. Usually, most Asian eyelids should have at most 3mm of pretarsal show. That is the amount of eyelid that is showing under the eyelid crease. This area is usually smaller when the eye is open but larger when the eye is closed. The most it should show when the eye is open is 3mm for an Asian Eyelid for an Asian eyelid to look the most aesthetically pleasing. When the eyelid crease is higher than this, the result starts to put more tension toward the medial part of the eyelid. There are solutions to this. You can decrease the height of the eyelid crease so that it looks more natural. Or you can do another procedure, a medial epicanthoplasty which can open up the eyelid more in the horizontal dimension. This helps release the tension that is placed in the epicanthal area. My preference is to do Dr Park’s Z epicanthoplasty. Previous epicanthoplasties were notorious for their propensity to create a lot of scarring. The beauty of Dr. Park’s Z epicanthoplasty, is that it avoids the scarring and keeps the incisions within the double eyelid crease and the natural creases that would normally be created in the eyelid creases. When you look at the picture below, the triangle ECA is removed. The flap made from EAB is rotated into ECA. This effectively helps reduce the prominence of the epicanthal fold and helps open up the eye in the horizontal dimension. We have a video demonstrating these procedures.
Thanks for reading, Dr Young
Dr Young specializes in Facial Plastic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington