Blepharoplasty, also known as double eyelid surgery, is by far the most common cosmetic surgery in China. There are countless scientific and promotional articles about eyelid surgery, and many friends are often overwhelmed by the amount of information available from various sources, and are often misled and fooled by certain beauty advertisements because they know little about the terminology. The author has been working at the Chinese Academy of Medical Sciences Plastic Surgery Hospital for many years and has some attainments in this surgery, and is well known among many beauty seekers in China. First of all, there are three main types of blepharoplasty: the incision method, the buried line method, and the suture method, which are the most basic methods of eyelid surgery. They are just a way to attract attention. The incision method is suitable for most patients with single eyelids, especially those with loose upper eyelid skin and orbital fat, but it requires an incision and generally requires the removal of a strip of skin, which can leave a scar after surgery, the size of which is mainly related to the surgeon’s technique and personal constitution. The suture method is suitable for patients with thin eyelids, little upper eyelid fat, and no skin laxity, and involves the use of a suture that is embedded in the upper eyelid skin in a variety of ways to create a heavy eyelid. The suture method also involves making one or three or even more small incisions in the upper lid and forming a heavy eyelid with a few interrupted stitches, and is also suitable for patients with thin eyelids and less lax skin. The buried and suture methods generally do not form a visible scar, but they are not absolute, and the author often sees friends in the clinic who have developed a clear and more pronounced scar with three-point sutures. The choice of surgical method is a very important step for the surgeon and the friend seeking beauty, and requires a detailed preoperative examination and analysis, combining each person’s different eyelid characteristics and requirements for beauty and psychological ability to choose, not just a generalization. For example, if the patient is not very demanding and is worried about scarring after surgery, and has low psychological tolerance, the author would prefer the buried stitch method of surgery, even if the upper lid skin has some laxity and fat, because there is a way back after this surgery, even if the results are bad, and the original sutures can be removed as early as possible without permanent negative consequences. Secondly, many people think that blepharoplasty is a minor surgery and a very mature one, so they don’t have to worry too much about the results. The author is firmly against this idea! In the eyes of a competent surgeon surgery is not the size of the difference, and then small surgery also contains a very high technical content and contains a huge risk. Experienced plastic surgeons are able to recognize that blepharoplasty is actually a surgery that reflects both basic plastic surgery skills and aesthetic ability, especially for open blepharoplasty. So, what are the risks of an open blepharoplasty? In a word, unsatisfactory surgical results. Unsatisfactory surgical results can manifest in a variety of ways, such as obvious surgical scarring, bilateral asymmetry, too wide or too narrow, too deep or too shallow, disappearance of the eyelids after surgery, ectropion, ptosis, etc. The author has encountered many eyelids in need of repair in the clinic, and the performance varies. It may be possible for a doctor to do dozens of double eyelids with good results, but it is absolutely impossible to say that hundreds or thousands of double eyelids will all be satisfactory. After all, everyone’s opinion on beauty is a matter of opinion! The author has done thousands of open double eyelids over the years and has accumulated a wealth of experience, but there are still a few patients who are not satisfied, so every time I do this surgery I have a feeling of treading on thin ice. In order to avoid irreversible and disastrous consequences, an experienced surgeon will leave a certain margin for the first surgery, so that there is still tissue available in case a repair is needed. Therefore, some beauty lovers are advised to go to a regular medical place to find a doctor qualified in cosmetic surgery to perform the surgery. Once again, for those who are ready to have double eyelid surgery (especially the incision method), they must have strong psychological qualities, and those who are psychologically weak or unsound are better off not doing this surgery. Why is that? Because as mentioned before, eyelid surgery is still very risky, and there is basically no reversibility in open blepharoplasty, so you can never go back to your old self. The author has seen many friends in the clinic who are actually quite happy with their surgical results, but are not satisfied with their current state and always want to achieve more perfection and hope for a repair, but there is really nothing the doctor can do, and another repair may not be as effective as the current one; I have also seen individual friends who are depressed for this reason in the clinic, so I can only suggest that she seek psychological treatment with a psychologist, and another surgery may cause more harm. In addition, the recovery from open double eyelid surgery is a relatively long process, not one or two weeks may be fully recovered, but several months or even a year or two to recover a more natural state, in the recovery period after surgery, upper lid swelling, incision redness, scar growth, asymmetry, multi-layer eyelids, upper lid depression and other conditions may occur, for anxious friends is undoubtedly a serious ordeal process. So you need to adjust your mind and be at peace with this natural recovery process, time is the best medicine for healing. Finally, you must understand that not all single eyelids are suitable for blepharoplasty. This has two implications. On the one hand, from a purely academic point of view, some single eyelids are not suitable for blepharoplasty, and even if they are, the results will not look good. For example, some eyelids have very thick skin, a lot of subcutaneous fat (not orbital fat), very prominent eyeballs, or with more obvious ptosis, etc. They are not suitable for double eyelid surgery, and some friends have single eyelids that are very divine, distinctive, and coordinated with their facial features, forming In some cases, the eyelids are not necessarily more beautiful than before the surgery, so don’t go for blepharoplasty in order to have double eyelids. On the other hand, from a psychological point of view, there are friends who are not suitable for double eyelids. For friends who have their own psychological disorders are absolutely not allowed to have surgery, while for some friends whose expectations are too high and the surgery does not meet her expectations, the surgery will only bring her psychological trauma and pain even if the results are good and she needs to refuse the surgery. As a responsible doctor, one should choose appropriate patients according to one’s actual ability, and should have the courage to refuse to operate on them if the surgery does not meet their requirements.