The Effect of Single vs Double Eyelids on the Perceived Attractiveness of Chinese Women

Background: A well-defined supratarsal crease has often been considered attractive, representing a significant component in a beautiful upper eyelid. Approximately 50% of East and Southeast Asian women are born with either a minimal or absent supratarsal eyelid crease. Among people of Chinese descent, the creation of a supratarsal crease (double eyelid blepharoplasty) is the most common cosmetic surgical procedure, but no comparative study has assessed the height by which an upper eyelid crease is deemed most attractive and depending on cultural background. Objectives: The authors assess how attractiveness is interpreted by different cultural groups to determine whether double-eyelid blepharoplasty enhances attractiveness according to both Chinese and non-Chinese observers. Methods: Facial photographs were taken of 19 women of Chinese descent. The photographs were enhanced with computer imaging software to generate 3 additional pictures, depicting low, medium, and high upper eyelid creases on each model. Via an Internet-based survey tool, Chinese and non-Chinese observers were asked to rate the attractiveness of the faces with each potential eyelid position. (Surveys are available online at www.aestheticsurgeryjournal.com, as Appendix 1 and Appendix 2.) Results: Both Chinese and non-Chinese observers considered the medium-height upper eyelid crease most attractive (P < .00001). An absent upper eyelid crease was deemed the least attractive (P < .00001). Conclusions: These preference data for eyelid height can be used to better counsel patients on perceived attractiveness and expectations for surgical results, since these results further elucidate which facial features are universally considered attractive.