Is Labiaplasty Right for You? A Guide to Costs, Benefits, and Realistic Expectations
When the upper eyelid has a defined fold, liner lands where you want it, shadow shows up, and lids feel lighter. Double eyelid surgery—often called Asian eyelid surgery—creates or refines that fold so your eyes read awake and balanced without looking “done.” On this page, you’ll find plain-language answers on techniques, recovery, cost, and how we plan for natural-looking results in Los Angeles and Beverly Hills.
A great crease is about geometry and tissue, not templates. At Nazarian Plastic Surgery, Sheila Nazarian, MD, MMedSc (board-certified in plastic and reconstructive surgery) plans each case around levator function (eyelid muscle), skin thickness, fat volume, brow position, and how makeup sits on your upper lid. We map both eyes seated and reclined to prevent height drift, then agree on a crease that fits your bone structure, not a trend. Cases run in an accredited suite in Beverly Hills with local anesthesia and light sedation or general anesthesia when indicated. Clear markings. Fine sutures. Results that hold on camera and in bright LA light.
A “double eyelid” is simply an upper lid with a natural fold that forms when the eye opens. Many East Asian lids have no crease or a faint, unstable one. Double eyelid surgery links skin to the tarsal plate and levator aponeurosis, so the fold fires every time. Think of it as setting a reliable hinge.
There are two main techniques:
Suture (non-incisional) method.
Through tiny entry points, buried sutures connect skin to the tarsal plate. Best for thinner skin with little excess skin, good levator strength, and minimal fat. Downtime is short. The trade-off: the fold can soften over time.
Incisional method.
A fine line in the planned crease lets us remove measured fat or skin, address a thick orbicularis strip, and set permanent fixation. This route suits heavier lids, prior failed sutures, asymmetry, or eyelid ptosis repairs done at the same time. It is still eyelid surgery; the line hides in the crease once swelling fades.
For select eyes, we add epicanthoplasty (inner corner refinement) or ptosis repair (tightening a weak eyelid muscle). Some patients pair upper crease work with upper blepharoplasty when extra skin hangs over the lashes. If true ptosis is present, we may co-manage with an oculofacial plastic or ophthalmology colleague. That’s good medicine.
The goal is a lid platform that looks like you—refined, not overbuilt. A steady fold opens space for liner and shadow, tamps down “droopy eyelids,” and makes the two sides track as a pair. Many describe a lighter feel at the lash line and a refreshed appearance on video calls. In rare cases where heavy skin blocks peripheral vision, crease work with upper blepharoplasty can help functional complaints and appearance at once.
Good candidates are healthy non-smokers with steady goals and a clear sense of crease height. Suture methods fit slimmer lids with low excess skin. Incisional methods fit thicker skin, full upper face tissues, or eyes that need ptosis repair. Dry eye, contact lens wear, thyroid eye disease, or prior LASIK aren’t automatic deal-breakers; they just shape planning. If you’re on isotretinoin, we’ll set timing. For teens, we wait until facial growth and personal preference are mature. If one eyelid is lower than the other (“one eye looks heavy”), we measure levator function; the plan may include a small ptosis correction for symmetry.
Low or absent fold, hooded eyes, multiple faint creases that split the lid, thick preaponeurotic fat that blunts the platform, mild excess skin on the upper eyelid, and lid drop from eyelid ptosis. Some choose crease work after brow lift when the brow now sits higher, but the lid platform still feels crowded. Others pair it with lower-lid treatments (skin-only laser or injectable fillers for dark circles) for balance across the upper and lower eyelid frames.
At our Beverly Hills practice, we examine brow position, lid fold height, levator strength, and fat distribution. You’ll try crease options—low, medium, or a touch higher “pretarsal show”—and talk tapered vs. parallel based on your inner corner and eye socket shape. We photograph seated and supine to catch height drift. If you’re combining a brow lift, lower-lid laser, or non-surgical procedures like Botox or filler, we stage those for clean healing.
Weeks prior: pause blood-thinning supplements as advised, arrange a ride, stock small gel packs, and plan a week away from full-sun workouts. If you wear contacts, switch to glasses until the seals form. We’ll review medications, allergies, and any thyroid, tear-film, or medicine issues that could change aftercare.
Most cases use local anesthesia with oral or IV sedation; some use general anesthesia. After precise markings, the suture method places buried knots through hairline entry points. The incisional method places a fine line in the planned crease, removes measured tissue (skin or fat only as needed), sets deep fixation to the tarsus/levator, and closes with micro sutures. If planned, ptosis repair tightens the eyelid muscle; epicanthoplasty refines a heavy inner fold; upper blepharoplasty trims surplus skin that drapes over eyelashes. Time in the suite runs 45–120 minutes based on technique and add-ons. You leave in dark glasses with cold compress and ointment instructions.
Swelling and bruising peak days two to three; a soft yellow fade follows. Most patients feel camera-ready for work at seven to ten days. External sutures (if used) come out near day five to seven. The fold sits high in the first weeks; it settles over six to twelve weeks as edema fades and the scar thins. Sleep head-elevated, keep incisions clean, avoid rubbing, and hold sweaty training until cleared. Makeup returns at two weeks for suture cases and at two to three weeks for incisional once the line seals. Protection from sun is non-negotiable.
Common complications are uncommon with tight planning: asymmetry, line show above the crease, under- or over-definition, dry eye flare, infection, or small bleeds. Good markings, careful hemostasis, and follow-up lower those risks. A successful eyelid surgery looks quiet—creased at open, smooth at close.
Technique Options: Incisional vs. Suture vs. Hybrid
We match method to anatomy, not trend. On narrow or Santa Monica-lean frames, low or medium crease height avoids a round “double fold.” On broader or male lids, a gentle taper feels authentic. If your goal photo shows a crease that would pull the brow down or over-open the inner corner, we’ll say so and offer a safer route.
A heavy brow can crowd the lid even with a perfect crease; a mild brow lift changes the frame so the crease reads well. Lower eyelid laser can soften fine lines and pigment for a smoother under-eye. Injectable fillers (conservative) along the tear trough can help dark circles when skin and volume both play a part. We stage cosmetic surgery and non-surgical procedures so healing stays calm.
Double Eyelid Surgery cost varies with technique (suture vs incisional), need for ptosis repair or epicanthoplasty, anesthesia, and time in the suite. Your quote includes surgeon, anesthesia, facility, and routine follow-ups. Fees in Los Angeles and Beverly Hills differ from smaller markets due to staffing and accreditation. We’re a self-pay practice and don’t bill insurance; for those seeking reimbursement on their own, we provide an itemized statement with codes. HSA/FSA cards are welcome when allowed by your plan. Financing is available through medical lenders.
Meet in Beverly Hills for mapping, try-on crease heights, and a game plan for blepharoplasty surgery that suits your eyes, your makeup habits, and your calendar. Call (310) 263-8239 or request a consultation. If you’re comparing methods, our video gallery walks through real case planning and recovery timelines.
With local anesthesia and light sedation, patients feel pressure, not sharp pain. Soreness after the procedure responds to cold packs and over-the-counter pain meds.
Asymmetry, visible scar, crease loss, over-definition, dry-eye flare, infection, or bleeding can occur. Careful markings, good hemostasis, and follow-up reduce risk.
Incisional creases last many years. Suture folds can soften with thick tissue or weight shifts. Revisions are rare with the right match of method to lid.
Plan 7–10 days for public-facing life. Swelling refines over 6–12 weeks. Makeup returns once incisions seal.
It’s a form of blepharoplasty focused on a stable fold. Many cases pair crease work with upper blepharoplasty if excess skin drapes over the lashes.
The goal is appearance. If heavy skin blocks peripheral vision, crease work with skin removal can help. We document findings and plan the safest route.
Mild side-to-side differences can show in early weeks. As swelling fades, the two sides settle closer. True drift is fixable in clinic or, rarely, with a small revision.
