What is the real minimally invasive method – Korean double eyelid surgery? Minimally invasive eyelid surgery = being able to see with your eyes open (beautiful eyelids) + being able to be seen with your eyes closed (microscopic marks on closed eyes) = “0-6” areas of asymmetrical fat aspiration in both eyes + complete reshaping of asymmetrical orbicularis muscle in 2 areas + symmetrical blepharoplasty without removal of stitches and small incisions. Not many surgeons have been able to recognize this and achieve it perfectly. Double eyelid surgery started in Southeast Asia in the early 19th century and became prevalent in China in the 1860’s. The two main methods were the buried wire method and the incision method, and by the end of the 19th century a completely new procedure, “minimally invasive blepharoplasty”, was introduced. “In fact, the two surgical methods are subjectively similar in their intent to achieve similar results, and Dr. Bi Yanlong began the self-designated “minimally invasive double eyelid surgery” in 2001. Dr. Bi has been performing the “minimally invasive eyelid surgery” since 2001, before the “Korean” eyelid surgery was introduced in China, and there were experts in China who performed this procedure earlier, mostly naming it “small incision blepharoplasty” or “tunnel incision blepharoplasty. The term “minimally invasive” does not mean “minimally invasive”. In fact, “minimally invasive” is not “non-invasive”, which means that there are three small skin incisions, and the operation requires the complete removal of a smooth strip of prelid tissue and the release of fatty tissue in the orbital septum through only small skin incisions. This is easy to say, but not easy to do, which is the main reason why this procedure started late, is difficult to popularize, and is more often marketed as “minimally invasive”. After surgery, the skin has a trace of scarring for a certain period of time, which is only visible when the eyes are closed and dissipates over time. It is important to note that there is damage in any surgery, only the size of the damage and post-operative healing make a difference. According to information accumulated over the years, this procedure was first performed in Shanghai around 2000, when only a few doctors mastered this technique. Around 2005, a large number of private hospitals with “Korean-style minimally invasive double eyelid surgery” emerged, and the surgical results were only uneven. We have introduced this technology at national annual conferences and international plastic surgery meetings since 2008 (no one else has been competing on the same stage), which has largely contributed to the recognition of this technology in the academic world. After that, the Ninth People’s Hospital, the largest plastic surgery hospital in Shanghai, also started to recognize this technique after 2011, and some doctors started to do this work. However, the learning curve for mastering this technique is not easy, mainly because all operations are performed through small skin incisions under blind vision and require a good understanding of the anatomy of more than 10 different upper eyelid types in vivo (emphasis on “in vivo anatomy” here).