Asian blepharoplasty, also known as double eyelid surgery, is differed from regular eyelid surgery. Asian upper eyelid anatomy varies. While some have double eyelid, many do not. Monolid is when the upper eyelid does not have the crease. Asian blepharoplasty is a surgical technique used to create the upper eyelid crease, also known as pretarsal crease, that is absent in many Asian upper eyelids. This is done not by skin removal, but by precisely placement of sutures of the deeper structure that help open the upper eyelid to the superficial skin. So when upper eyelid is open, the traction creates the crease in the upper eyelid. It may or may not involve some fat removal depending on the individual anatomy. Asian eyelid surgery only creates the double eyelid or the upper eyelid crease. This surgery does not make Asian eyes looks ‘westernize’ or “Caucasian.”